Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SATURDAY, May 29, 1993 TAG: 9305290107
SECTION: VIRGINIA PAGE: C1 EDITION: METRO
SOURCE: GREG EDWARDS STAFF WRITER
DATELINE: BLACKSBURG LENGTH: Medium
Roughly 100 people - including nursing-home administrators, health-care providers and relatives of nursing-home patients from Brookneal to Big Stone Gap - attended a hearing at Virginia Tech by the state Board of Medical Assistance Services.
Under the proposed rules, people who don't have a medical condition but who otherwise are unable to care for themselves - such as those who have Alzheimer's Disease - could not use Medicaid to pay for nursing-home care or nursing care at home. That would force them into adult homes or into the homes of relatives.
Adult-home patients receive basic custodial care, meaning they get assistance with daily living needs such as transportation, medication andshopping. Nursing-home patients need more attention, including more intense medical care. The regulations are scheduled to take effect in September but similar emergency rules already are in place.
"We are hurting people by these regulations who are unable to provide the care for themselves without some sort of supervision," David Tucker, administrator of the Raleigh Court Health Care Center, said.
Del. Joan Munford, D-Blacksburg, who is a nursing-home administrator, was among the chorus voicing disapproval of the new rules. Many of the patients threatened with the loss of nursing-home care are people who "must be in a structured environment for the their own safety," she said.
Under the emergency rules, 14 patients in six Roanoke-area nursing homes have had their eligibility for Medicaid lifted, said Susan Williams, executive director for the League of Older Americans Area Agency on Aging.
Included in that group, Williams said, was a 76-year-old woman who moved into an adult home but came back to the nursing home several weeks later "black and blue" and with her health ruined to the point that she now qualified under Medicaid for nursing-home care.
Williams asked what was going to happen to patients forced from nursing homes by the new rules. She pointed out that the state has been cutting back on the geriatric beds at state institutions and that local services for people suffering from dementia don't exist.
Jody Harris of Pulaski told of his 86-year-old grandmother in Heritage Hall Nursing Home in Tazewell. She uses a walker and has a $300-a-month income.
Although she is not capable of taking care of herself, she is on a list of 18 people who are scheduled to be moved out of the nursing home because of the new rules, he said.
His family lacks the financial means and the skills to provide the kind of care his grandmother needs, Harris said.
"Please, please try to give this some extra consideration," he said. "We've not only got a professional consideration here but a moral one also."
Several speakers warned that turning out patients who can't care for themselves from nursing homes without providing a good alternative source of care could lead to a worsening of their health and more expense for the state in the long run.
Speakers urged several options, including:
Putting the regulations on hold until the state Department of Social Services upgrades standards for adult-care homes.
Grandfathering in the eligibility of patients whose nursing-home stays already are being paid for by Medicaid.
Increasing funding for local agencies that provide assistance to people in the home who can't care for themselves.
The hearing was the fourth of four held around the state this week.
by CNB