Committee?s hearings yield nursing home recommendations

|tab|

"It was a well-attended hearing," said Speaker of the Missouri House of Rep-resentatives Jim Kreider, D-Nixa. "We had the industry testify, state agency testimony, and individuals testified who had concerns and problems with nursing homes. Some weren't pleasant to hear."|ret||ret||tab|

Krieder was referring to the public hearing held in October in Republic by his Interim Committee on Nursing Home Caregiving, officially charged with "in-vestigating nursing home operation, both rurally and statewide, including quality of care, staff turnovers, and occupancy rates," as well as "the need for nursing home caregiving for the baby boomer generation" and "reviewing the Medicaid rate compared to the actual costs of running a nursing home."|ret||ret||tab|

The committee is chaired by Sam Berkowitz, D-Memphis, and consists of Reps Nancy Copehaver, Joan Barry, Robert Hilgemann, Vicky Riback Wil-son, Jason Crowell, Kathlyn Fares, Blaine Luet-kemeyer and Mark L. Richardson. |ret||ret||tab|

Kreider said he appointed the committee because nursing home care "is a pretty great concern, and an issue that keeps rearing its head is whether we have adequate nursing home care in this state." He added, "Our real hope is to provide great health care for our seniors, especially those in nursing homes. When we have loved ones in nursing homes, it's a tough situation."|ret||ret||tab|

From the public comments made in hearings throughout the state, the committee derived 13 recommendations for improvements.|ret||ret||tab|

|ret||ret||tab|

Medicaid reimbursement|ret||ret||tab|

Increasing the Medicaid reimbursement rate is essential, the committee said, calling it a priority to "ensure quality of care and services."|ret||ret||tab|

"In a nutshell, we really do need to raise the Medicaid reimbursement rate," Kreider said. "They are all figured on a 1992 basis at this time in this state. There is a lot of feeling that nursing homes are cutting corners because of it. We don't want them cutting corners because they are having a hard time. We want to find money through the federal government to raise the reimbursement rate in order to have better care," Kreider said.|ret||ret||tab|

In its report, the committee recommended a task force to examine Medicaid reimbursement methods and to relieve the burdens of "a reallocation in state funding, an increase in regulations, high ratios of staff turnover, and the inability to pay a competitive wage to long-term care employees," and a "rebasing process necessary for Medicaid reimbursement." |ret||ret||tab|

The committee also recommended that the Department of Health and Senior Services submit a plan to the General Assembly to "address the bed tax" which is the "only devised method the state of Missouri has at maximizing its federal draw down on Medicaid reimbursement."|ret||ret||tab|

|ret||ret||tab|

CNAs|ret||ret||tab|

Kreider cited certified nursing assistants as another issue, adding that there is a need to get their pay raised because it is extremely low and many, once trained by the nursing homes, leave for better-paying positions. He also wants CNAs to be better paid so quality of the nursing home work force will be better.|ret||ret||tab|

The committee report cited the need to retain good help, calling it "one of the biggest problems facing nursing homes today," as well as "a significant factor in determining quality of care." To address the problem, they called for a career path plan with incentives, classes and varying levels. |ret||ret||tab|

It also recommended that the Missouri Department of Health and Senior Ser-vices promote nursing professions through grants, scholarships and internships.|ret||ret||tab|

The committee also noted that the "inability of facilities to provide on-site training puts seniors at risk by reducing the quality of care" and asked for the Department of Health and Senior Ser-vices to study the issue, particularly within facilities already lacking in CNA staff.|ret||ret||tab|

|ret||ret||tab|

Inspections|ret||ret||tab|

"Probably one of the biggest issues is inspection," Kreider said. "We absolutely will not stand for terrible, bad practices in nursing homes. We want to in-crease inspections, especially on those homes which have had a lot of complaints. For those homes that rarely have a complaint against them, we want to reduce their number of inspections as kind of a reward."|ret||ret||tab|

|ret||ret||tab|

Baby boomers|ret||ret||tab|

The report stated, "Many baby boomers will be reaching retirement age in the very near future. At the current time, the number of beds available for persons over the age of 65 in this state is about 25 percent above the national average. With people living longer and long-term care facilities generally providing services for persons over the age of 85, the baby boom generation will not have a major impact on the long-term care industry for another 30 years, but the committee feels by implementing long-term strategies to deal with the influx of baby boomers that will be occurring in the future would be prudent."|ret||ret||tab|

Other recommendations included:|ret||ret||tab|

Making sure all state surveys of nursing home facilities are applied consistently across the state; |ret||ret||tab|

Making informal dispute resolution more fair and objective; and|ret||ret||tab|

Funding for the non-emergency transfer of bed-ridden clients from one facility to another to ensure the client's welfare when they need treatment.|ret||ret||tab|

Kreider said he "couldn't be prouder" of the committee. "They went to all parts of the state and took hours of testimony. They worked hard and came up with common sense recommendations. We will work hard now to try to improve the health care for our seniors."|ret||ret||tab|

He added that people shouldn't be afraid to call elected officials when there is a problem with a nursing home. "If they don't call, we don't know," he said.[[In-content Ad]]