Medicaid recipients are getting treated like second-class citizens in a number of Seattle area nursing homes, assisted-living facilities and group homes.
Medicaid is a joint program of federal and state governments that pays for medical and health services for poor people.
When some local care providers have a choice between a Medicaid patient and a private-pay patient or even a Medicare patient, they opt for the latter two because they’ll be paid more on a monthly basis.
Care providers are faced with a substantial reduction in fees when the patient is using Medicaid. The numbers are telling: Care providers charge daily fees of $200 or more. However, when one of their beds is occupied by a Medicaid patient, the rate they are allowed to charge is $65 or less. The bottom line is clear; a difference of as much as $4,000 per month.
Many care providers will not even consider giving one of their beds to a Medicaid patient. In some instances, when a private-pay or Medicare patient inquires about availability of care, a Medicaid patient will be asked to move out.
There’s a legion of devoted social workers around Puget Sound who are tasked with the responsibility of finding care facilities for Medicaid patients. Their job is to knock on as many doors as possible to locate an acceptable care environment. This process can sometimes take months. In the meantime, it isn’t unheard of that a care provider will put pressure on the social worker work more quickly, since the provider wants to make the bed available for a patient who will pay more than twice as much.
In the case of a private-pay patient or a Medicare patient whose funds begin to run low, some care providers will show them the door once they have to turn to Medicaid to cover costs. It isn’t difficult to imagine the trauma a patient and their loved ones experience when faced with having to find a new care setting.
As the Baby Boom Generation continues its progression into retirement and senior citizenship, there are increasing numbers of patients and loved ones who are suddenly faced with previously unimagined realities regarding the costs of long-term nursing care.
Directing blame strictly at the care providers is a nonstarter, however. They work within a system regulated by our government. They have significant operating expenses. Their employees are often underpaid and overworked. Their work environments can be abysmal.
That being said, our society has a moral and ethical responsibility to people who require long-term nursing care, regardless of their age. We have the duty to make sure that care-facility standards are exceptional, and that Medicaid patients are accorded the same dignity and respect as are private-pay and Medicare patients.
The nursing community has what might be described as a modified Hippocratic Oath. It’s called the Nightingale Pledge, named after Florence Nightingale, who is recognized as a role model by the nursing world for her selfless devotion to the well-being of her patients. The oath reads in part: “ I will do all in my power to maintain and elevate the standard of my profession. ... With loyalty will I endeavor to ... devote myself to the welfare of those committed to my care.”
The deep empathy and inspiration that leads people into careers as nurses deserves to be recognized. We owe it to them to reward their work well done.
At the same time, Medicaid patients have a right to expect first-class service. The powers that be who decide the future of oversight and regulation for care providers are to be charged with the responsibility of reversing what have become dismal, if not appalling, circumstances faced by some Medicaid patients.
There are Medicaid patients in care settings who need people from our community to take a stand on their behalf because it’s difficult for them to advocate for themselves. Contacting elected representatives is a good first step.
Government officials and experts from the health care community are in a position to craft a Medicaid system that honors the dignity of each person. The travesty of a patient being targeted for removal from a facility because of a lack of financial means must stop. People of conscience certainly cannot be expected to abide anything to the contrary.