Concerns Raised Over Plan To Reward Nursing Homes for Care Quality
Some eldercare advocates are expressing concern that providing California nursing homes with financial incentives to improve patient care and staffing levels could increase the facilities' profits without improving conditions for seniors, the Ventura County Star reports.
The state is developing a plan to link $40 million in Medi-Cal rate increases to five standards of nursing home care. Medi-Cal is California's Medicaid program.
The higher payments, which would start next summer, would go to nursing homes that receive the best scores for care standards, such as:
- Nurse-to-patient ratios;
- Preventing bed sores; and
- Minimizing physical restraints.
Vanessa Baird, deputy director of the California Department of Health Care Services, said the state has proposed basing the nursing homes' scores on whether they surpass state averages for each care standard. Facilities that receive scores in the top 20th percentile would receive the higher payments.
The proposal calls for a separate incentive payment category for low-performing nursing homes that demonstrate significant improvement.
Some eldercare advocates have expressed concern that the incentive payments:
- Would not penalize facilities that use powerful drugs to restrain patients;
- Would not withhold payments from facilities that have faced penalties for mistreating seniors or committing other violations; and
- Would allow low-performing nursing homes to receive incentive payments for showing improvement.
Mike Connors of the California Advocates for Nursing Home Reform noted that the plan would not require nursing homes to invest their incentive money directly in patient care.
Plan Still Under Development
According to Baird, it is unclear whether the state can compel nursing homes to spend the Medi-Cal funds in a certain manner.
State officials say the proposed care standards are a work in progress and are scheduled for completion at the end of November (Kisken, Ventura County Star, 11/11).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.