Medicare should pay the costs of long-term care, Utah should continue to regulate the nursing home industry, and the human service and health departments should seek a federal waiver to establish services for the elderly and severely disabled in the home and community whenever those services would be appropriate.
Those recommendations by the Governor's Task Force on Long-Term Care are an attempt to set public policy that will balance the supply of nursing home services with demand, keeping costs down while ensuring quality care.Other key points of the report:
-The Health Department should design a request-for-proposal system to procure any more nursing home beds in areas where they might be needed.
-Nursing home costs should be studied so the flat rate paid by Medicaid can be adjusted, if needed. Similar studies should be done every five years.
-Efforts must be taken to increase the supply of nurses.
In Utah, the nursing home industry is plagued by rising costs and a flat Medicaid reimbursement rate (Medicaid funds about 70 percent of nursing home placements in the state), low occupancy rates and a shortage of nurses. The Health Department implemented a moratorium on certification for Medicaid funding to those facilities that had been certified by Jan. 13, 1989. The move was designed to prevent creation of more Medicaid nursing home beds as long as occupancy rates are low.
The panel released its report to Gov. Norman H. Bangerter this week.
The combined budget for Medicaid and the Utah Medical Assistance Program in the state totals $210 million. Of that, 39 percent purchases long-term services, usually nursing home care. Data indicates that nursing home occupancy rates in Utah have dropped from 89 percent in 1980 to 77.6 percent (estimated) in 1989.
Meanwhile, costs have risen from an average of $10,732 in '80 to an average of $19,070 in 1989. And while the profit margin in 1980 for nursing homes was 6.08 percent, in 1988 (the most recent information available), revenue didn't even meet costs.
The report points out that there's nothing to show a direct link between a facility's profitability and "observed deficiencies on an individual facility basis" but says that "overall deficiencies in the industry appear to have risen as profitability has fallen."
The Utah Health Department and the Governor's Task Force on Long-Term Care will hold the following public hearings on a draft report dealing with ways to control the number of nursing homes in Utah:
-Washington County Senior Citizens Center, 254 N. 200 West, St. George at 5 p.m., Thursday, June 14.
-Midvale Senior Citizen Center, 140 Park St., Tuesday, June 19, at 6:30 p.m.
-Brigham City Senior Citizen Center, Thursday, June 21, at 1 p.m.
Copies of the report are available from Carolyn Park, Health Department, 538-6149.