The California Long-Term Care Reimbursement Act of 2004 increased nursing home costs, but failed to improve quality or access to care, according to a UCSF evaluation on the legislations impact.
Between 2004 and 2006, MediCal costs in Californias free-standing nursing homes increased by $590 million, or nearly 9 percent, to a total of $6.6 billion in 2006, according to the study, which was released today by researchers in the UCSF School of Nursing. Yet during the same time period, nursing home staffing levels remained significantly lower than the recommended numbers and staff turnover actually increased.
The study used publically available federal and state data to provide an initial evaluation of the impact of the new rate system. Among the elements analyzed were MediCal admissions and length of care; staffing levels, staff turnover, complaints and citations; and nursing home profits and income margins.
The quality of nursing home care has been a serious problem in California and nationwide for many years, said Charlene Harrington, PhD, RN, UCSF professor of sociology and nursing and lead author of the study. This legislation was designed to address that, but so far it has not met the challenge.
Harrington said the bill was designed to improve both the quality and access to nursing home care by increasing MediCal reimbursement rates, using a payment system based on actual costs of care for each facility, with certain cost ceilings. It also aimed to increase nurse staffing levels, foster improved compliance with state and federal regulations, and improve efficiency in nursing home administration.
Implemented in 2004-05, the system effectively raised MediCal rates from $124 per day in 2004 to $152 per day in 2006, this analysis found.
However, that rise did not result in improved access to nursing homes; the total number of patient days billed to MediCal actually decreased 2 percent between 2004 and 2005, whi
|Contact: Kristen Bole|
University of California - San Francisco