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Nursing home population trends shift

By BILL SHEA

Messenger staff writer

Iowa nursing homes are no longer a place where people spend a large portion of their retirement years, a pair of industry association officials said Friday.

People don't live in nursing homes for 10 to 15 years, according to Steve Ackerson, who is executive director of the Iowa Health Care Association and the Iowa Center for Assisted Living.

He said 30 percent to 40 percent of the nursing home population consists of people who are there for rehabilitation only. Those people, he said, are recovering from surgery, illness or injury. He said they move from a hospital to a nursing home for two to three weeks of physical therapy and other care, then go home.

The people who live in nursing homes for extended periods are usually suffering from dementia, he said.

According to Ackerson, the growth of assisted living options is enabling senior citizens to stay out of nursing homes. In an assisted living program, elderly people can get help with everything from household chores to managing their prescriptions without going into a nursing home.

Those people who do move into a nursing home can expect a high caliber of care, according to Lisa Uhlenkamp, director of quality and clinical services for both organizations.

Uhlenkamp said a statewide survey showed 90 percent of nursing home residents and their families said they were satisfied with the care.

''We provide the best care for a low cost,'' she said.

Contact Bill Shea at (515) 573-2141 or bshea@messengernews.net

Nursing homes across Iowa may close as the result of proposed cuts in government funding, according to a long-term care association leader.

''If these cuts go through, access to care is going to be severely limited,'' Steve Ackerson told a Fort Dodge audience Friday morning.

Ackerson is the executive director of both the Iowa Health Care Association and the Iowa Center for Assisted Living. Those groups, he said, represent 585 long-term care facilities that are home to about 40,000 people.

But those numbers could shrink, he told local legislators and nursing home administrators gathered at Careage of Fort Dodge, 728 14th Ave. N.

Ackerson said projected losses of Medicaid and Medicare money could lead to nursing homes shutting down, especially in rural areas. He added that the remaining nursing homes would probably be reluctant to admit anyone who is at high risk of falling or who suffers from any kind of dementia that makes them combative.

He identified a 5 percent across the board cut in Medicaid funding as one cause of the problem. He said that actually amounts to an average 6.1 percent cut for nursing homes.

''We are being penalized more than the average Medicaid provider,'' Ackerson said.

Medicaid is the federal and state health insurance program for the poor.

At the same time Medicaid funding is being cut, nursing home revenue from Medicare is also down, according to Ackerson. Medicare is the federal health insurance program for the elderly.

He added that the cost of living adjustments that the federal government has traditionally included in its Medicare payments to nursing homes have been stopped. That means the homes won't get any additional money, even though their costs to care for residents are all but certain to rise.

''It just seems like everything has hit in one year,'' Ackerson said.

Ackerson's audience of some 25 people included state Sen. Daryl Beall, D-Fort Dodge; and state Reps. Helen Miller, D-Fort Dodge; and David Tjepkes, R-Gowrie.

Ackerson made some specific requests to the lawmakers.

First, he asked them to restore the Medicaid funding for nursing homes. He said that would cost $13 million.

Second, he asked them to enact a more precise legal definition of abuse of a dependent adult. He said the state Department of Inspections and Appeals uses a vaguely worded definition that can result in serious penalties for minor mistakes by caregivers.

''It's going to be a very austere year,'' Beall said of the 2010 legislative session.

He added that he doesn't want to forget that the budget figures lawmakers will grapple with affect people.

''It's not about numbers,'' he said. ''It's about people.''

Tjepkes said legislators must not take the Medicaid money for nursing homes to plug other holes in the budget.

He added that state government must realize that nursing homes are small businesses that employ thousands of people.

Miller said she wants to introduce legislation to ensure that caregivers who make minor mistakes don't end up being banned from the profession.

Contact Bill Shea at (515) 573-2141 or bshea@messengernews.net