The Kansas Department on Aging has put together a list of 800 nursing home residents who officials believe might be able to move to less expensive, less institutional settings.
The agency has asked the state’s Area Agencies on Aging and Centers for Independent Living to have their case managers meet with each of the 800 residents to see if they are able and willing to move.
The effort is part of Aging Secretary Shawn Sullivan's ongoing effort to reduce the number of people in nursing homes. Kansas, with its disproportionately elderly population, has a higher percentage of people in full-care nursing homes than all but a handful of other states.
KDoA officials have pledged to pay the case manager’s employer $2,000 for each Medicaid-funded nursing home resident who is able to move out of the nursing home and stay out for at least 90 days.
KDoA Secretary Shawn Sullivan said the payments were designed to offset some of the uncompensated case management costs that hamstrung earlier efforts to reduce the state’s nursing home population.
But the notion of rewarding someone for helping people move out of nursing homes has upset the state’s nursing home lobby.
“It’s a bounty. There’s no other word for it,” said Cindy Luxem, executive director of the Kansas Health Care Association, which represents most of the state’s for-profit nursing homes. “If a nursing home paid a case manager a bonus for every resident they got to move there from another nursing home – that’s a felony,” Luxem said. “It’s illegal, but here we have the state paying bonuses to case managers who are essentially doing the same thing. They’re being rewarded for getting people to move out.”
She also said it seemed unfair that nursing homes aren’t paid $2,000 when their social workers help residents return home or move to community-based settings.
“For us, this is just beyond belief,” Luxem said of the agency’s new policy.
But Sullivan said the nursing home industry was mischaracterizing the payments, which have not started because the policy is so new.
“It’s not a bounty,” Sullivan said. “It’s an attempt to cover some of the administrative costs that haven’t been covered in the past.”
In recent years, KDoA stopped reimbursing Agencies on Aging for their case managers’ mileage and travel time.
The Kansas Department of Social and Rehabilitation Services has never covered the so-called “windshield time” incurred by case managers with the Centers for Independent Living.
Nor does either of the state agencies cover the costs of required training for the case managers.
The Area Agencies on Aging and Centers for Independent Living are the local agencies charged with assessing current or potential nursing home residents to determine what level of assistance each may need.
More independence, less cost
Sullivan said no one who’s living in a nursing home would be forced to move as a result of the new policy.
The initiative, he said, is designed to give the 800 residents and their family members information on services that could be made available to them in their communities. The result could be more independence for the beneficiaries and their families, and savings for the Medicaid program.
Sullivan said the $2,000 payments would be state-funded and come from the department’s administrative budget. Each payment will be made in three installments.