Steve Gold, The Disability Odyssey continues

Nearly 11.9 % of 1,304,810 people in nursing facilities were admitted directly from their home or apartments. Despite the common misconception, these people were not admitted from an acute care hospital, a rehabilitation hospital, another nursing home, or either a board and care, assisted living or group home.

Prior to being admitted to the nursing facility, these 155,272 people (the 11.9 %) were really living in their own homes and apartments.

And here's the real kicker: None of them was receiving any home health services before they were admitted to a nursing facility! They went from receiving NO health services directly to an institutional medical setting.

An additional 4.5 % persons (58,716) in nursing facilities were admitted directly from their homes and apartments but were receiving some home health services. We do not know what services, whether they were adequate, or whether more or different health and attendant care services might be necessary for these persons so they might continue residing in their own homes.

How can persons go directly from their homes to expensive residential nursing facilities without, at the least, being offered home health services? How can States approve expensive nursing facility Medicaid payments without first, at the least, offering persons MA home health services, whether visiting nurses or attendant care so the persons could remain in their own homes? Do States want to pay for nursing facility services without, at the least, attempting to try to provide services in a person's home or apartment?

States claim they are worried about their Long Term Care Medicaid budgets. They are supposed to be complying with the Supreme Court's Olmstead decision to stop "unnecessary institutionalization." They are supposed to want to save taxpayers unnecessary expenditures of public funds.

A Simple Proposal:

How about screening persons BEFORE they go into a nursing facility to determine what community services might prevent institutionalization?

How about, dare we use the term, "prior authorization" before a person can be admitted into a nursing facility?

How about really offering a full range of community health and attendant services when persons are still in their own homes and apartments?

States could talk with persons before institutionalization.

Can you imagine the conversation: "Hi. We understand you're thinking about going into a nursing facility. Would you want to stay in your apartment or home IF we could offer your health and attendant care services? What services do you think you would need to stay at home? Here's what we have available and what these services might be able to do." Or, "Do you think additional services are needed? What additional services might you need?

Disability and Older American Advocates:

Can you persuade your Governor and/or your MA Director to adopt this proposal? What plausible reasons could they give you for NOT trying to prevent unnecessary institutionalization?

Why should even one person go directly from his or her home/apartment to an institution, if with community-based health and attendant services she or he could stay at home.

Below is a breakdown of the national 11.9% by State from CMS' Minimum Data Set that shows the percentage of persons in nursing facilities in your State who were admitted to nursing facilities directly from their homes and apartments with NO home health services being provided in their homes or apartments.