411. 11111111111111111011.11111111111111WINNOWNOMMank-

a day would solve a lot of our
problems."
Some of those problems
are tied to the rising cost of
medical care in general
which affects all residents.
Medical costs rose 7.7 percent
in 1986, according to the U.S.
Bureau of Labor Statistics. In
comparison, the Consumer
Price Index rose by its
smallest amount in 25 years
— 1.1 percent. Specifically,
doctors' fees rose 7.8 percent -
and prescription drugs were
up nine percent.
Recent studies report that
elderly Medicare participants
are facing increasing health
care expenditures. A major
finding of the 1984 U.S.
House Select Committee on
Aging was that health care
payments by the elderly will
increase more. than twice as
fast as their incomes. In 1980,
health care costs absorbed 12
percent of an elderly person's
income; in 1989 they are ex-
pected to consume almost 19
percent. In 1984 the elderly
spent more of their income for
health care than they did
before Medicare and
Medicaid began.
Taking those general problems
and solving them for the Jewish
Home for Aged and its deficit is the
task ofa joint committee established
by the Jewish Welfare Federation and
the Home.
"We're taking two directions," said
Thomas Klein, Federation vice presi-
dent and chairperson of the joint com-
mittee. "Our first approach is to ap-
point a consultant who will provide us
with a very detailed picture of the
Home's current financial status.
"At the same time, we are going
to appoint another consultant who
will address the long-range needs of
the community in terms of caring for
our elderly population. This person
will help us develop a strategic plan
and provide recommendations for
solutions. We plan to have the con-
sultants in place by June 1 and the
strategic plan in operation within one

Glenn Triest

severity of functional im-
pairments, the lower the
likelihood that residents or
their families can provide
financial support.
"The percent of people
who self-pay (private pay) is
decreasing even as the costs
of living at the Home in-
crease because of a growing
resident population that re-
quires more labor-intense in-
tervention," Funk continued.
"Annual costs for • a resident
today average $30,000:"
And the prospects are not
encouraging. Over 200 are on
the Home's waiting list and,
according to Steinberg, most
are Medicaid cases.
Medicaid Payments are
limited in making up the
shortfall. The Home receives
$43.20 per diem per patient
for 1986-1987 as Medicaid
reimbursement and expects
to receive $43.68 for
1987-1988. Five years ago the
reimbursement rate was
$34.75 and three years ago it
was $38.93.
Dr. Conrad Giles, presi-
dent of the Jewish Welfare
Federation, believes most of Sisters Libby Laurens and Bessie Schein sell crafts made by Borman Hall. residents.
the Home's financial prob-
lems would be resolved immediately Care Policy Section in the Medicaid bursement in 1983 for medical care
if Medicaid reimbursements were Program for the state of Michigan, facilities, nursing homes, and hospital
adequate. "Medicaid does not proper- has a different perspective. He does long-term care operations was just
ly reimburse us for the services it re- not see a need to -revise the rate over $40. This year it's $42.50. Our
quires that we provide to residents structure.
rates may be slightly behind because
who receive it." Giles said. "Moreover,
"Nursing homes are always tell- they're based on the previous year's
those services must be of a certain ing us they're not getting paid costs, but this shouldn't make a
quality to meet our own standards. enough, but I haven't seen many notable difference."
That's our responsibility to the corn- bankrupt homes or a decrease in the
Steinberg disagrees and believes
munity. Yet, Michigan's reimburse- number. We reimburse the nursing the Home's budgetary problems are
ment rate for nursing homes ranks homes over half-a-billion dollars an- from insufficient Medicaid
among the ten lowest in the nation." nually. That's big business!"
reimbursements.
_Eggleston explained that each nur-
Funk acknowledges the need for
"The mission of the Home is to
state guidelines, "to make certain sing home has its reimbursement rate provide care for as many who cannot
that standards of care are met and determined by its fixed and opera- afford to pay;' Steinberg explained.
that the elderly receive proper care. tional costs and staffing. The rate "Most of our residents can't afford to
But not only do they tell you how, they structure is designed for the average pay and we are reimbursed by
tell you how much, and that can resident, but costs for patients with Medicaid for their care — except it
sometimes be wasteful. At the same extraordinary needs are negotiated. costs us $12,000 more a year to care
"The rates are adjusted annually," for a person than Medicaid reim-
time, Medicaid has no variable for
providing kosher food, which is an ad- Eggleston said. "And this rate adjust- burses. A private paying person could
ment recognizes the shift toward more cover these costs. In Toledo, the
ditional cost for us:'
Ronald Eggleston, manager of In- intense care needs over the years. For Jewish home is reimbursed about $60
stitutional Alternative • Long-Term example, the average per diem reim- per diem per patient. That extra $17

4000110-

Continued on next page

25

