[responsive_vid]Many families looking for a nursing home know they cannot long afford the $8,000 per month cost. They know they will ultimately have to rely on Medicaid. And that brings with it the fear of the mythical “Medicaid nursing home.”
If you read articles in the popular press about nursing homes and Medicaid you will soon hear that Medicaid nursing homes are places to be avoided. They supposedly reek of bad care. And, life is so much better if you “private pay” and avoid a Medicaid nursing home. And all of that is nothing but nonsense.
So, what is a Medicaid nursing home? It is just about every nursing home. Almost all nursing homes in Southeast Michigan participate in the Medicaid program.
Only a few, about 15, in the entire region do not participate. Their corporate strategy seems to be to try to cash in on the higher post-hospital Medicare dollars available for rehab and such. Medicare will pay over $700 per day for full course therapy. Some of these have a captive relationship with Beaumont hospital. Others, notably the Heartland chain, somehow are able to capture the lion’s share of post-hospital Medicare patients. These homes empty the patient’s skilled care benefit. They then pass the patient on to a “long term care” nursing home, which has the same post-hospital Medicare beds. These latter nursing homes too could provide the post-hospital rehab but they don’t get these Medicare patients. They must not have the same “pull” or “connections” as the few do.
The problem with Medicare only nursing homes is that it is harder for a family to get their preferred nursing home. It is much easier to get in if one can offer Medicare days.
Tip: if you think your family member might be in for long term care after the hospital, bypass a short term Medicare only facility for one that has Medicare and Medicaid certified beds.
There is an unanswered question. Since all long term care nursing homes accept Medicaid, will one get better care if one avoids Medicaid and “private pays”? That is, do Medicaid patients get worse care? The legal and real answer is “no.” Medicaid patients receive equal care. You can test this by your own observation.
It is illegal for a nursing home to discriminate by basis of payment source. You can go to any nursing home and you will not see a “private pay,” or Medicare or Medicaid section. You will see no dim and dusty corridors for Medicaid patients. You will see no marking on the door, walls or bed of a Medicaid patient.
You can ask the nurses and aides where are the Medicaid beds and they will tell you they don’t know. And note, since everybody knows that Medicaid has “spend down” you will find some people private paying in a Medicaid bed. You can ask the staff which patients are private paying and which have Medicaid pay and they will tell you they don’t know.
So, there you have it. A Medicaid nursing home is almost any nursing home. And care in a nursing home varies by the quality of the patient and patient advocate more than by how the bill is paid.