Facilities shouldn’t be made arbiters of who lives and dies

opinions

December 6, 2017 - 12:00 AM

Of all things in life, we should be able to die in peace, take our last breaths in as comfortable circumstances as possible, free of temporal concerns.
Unfortunately that’s not the case in Kansas, where a growing number of nursing homes are being forced to decide whether to deny admittance to end-of-life patients on Medicaid or face financial ruin because they will not be adequately reimbursed for their cost of care.
Ever since Kansas privatized its Medicaid program in 2012 with KanCare, its funding to nursing homes, hospitals and other care facilities has decreased while the backlog of applications has grown. One outcome for nursing homes is that they are forced to go months without reimbursement by the state, putting their entire finances in jeopardy.
“We have waited for hundreds of thousands of dollars to come through,” said Linda Milholland, CEO of Iola’s Windsor Place, in a story this summer. “That’s not a sound business model.”
In the case of hospice patients, if they die before their applications to Medicaid have been approved, the nursing home loses its chance of any significant reimbursement.
Those dire circumstances have only grown. Today the backlog for Medicaid applications at least 45 days old — the federal limit for processing — is  more than 2,000, placing nursing homes in a terrible predicament.
To qualify for Medicaid, a nursing home resident’s income must be $2,000 or less. At Windsor Place, about 68 percent of its residents qualify.
Advocates for the elderly say they would like to see these desperate patients qualify for “presumptive eligibility,” where they could leap to the front of the line to receive benefits.
State officials replied that if that were to occur, more money for the program would be necessary.
And that’s not going to happen.
Remember, the current tax bill before Congress will demand cuts to Medicaid, Medicare and Social Security.

IT’S NOT FAIR to make hospitals, nursing homes and other care facilities decide the “winners and losers” as to who gets care.
But that’s what we’re doing as a state and increasingly as a society.
That 68 percent at Windsor Place is not just a statistic, but people. It’s time we treated them as such.

— Susan Lynn

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