| Description |
Following the expiration of Certificate of Need in 1984, the State of Utah experienced uncontrolled growth in the number of nursing home beds being constructed. This growth placed a strain on the state's finances, exposed providers of long term care services to potential financial harm because of the Medicaid reimbursement formula being utilized, and had a negative effect on the quality of long term nursing home care. In an attempt to rectify this situation, the Utah Department of Health, in 1989, adopted and implemented a formal Moratorium prohibiting any further Medicaid certification of nursing home beds in Utah. This project addresses the following questions: a. Is the Medicaid Moratorium continuing to serve the primary purpose for which it was created? b. Is the existence of the Moratorium causing any difficulty in accessing needed care due to a chronic shortage of beds in any community or catchment area? c. Is there any indication that a community is experiencing unfair pricing policies for private paying patients due to the protection from competition afforded current nursing home providers by the Medicaid Moratorium? d. Should the Utah Department of Health undertake formal study, collect additional data, and hold public hearings to determine if the Moratorium should be repealed? This study included, but was not limited to, a review of occupancy statistics, private and Medicaid reimbursement rates, and construction data. Available data suggest the Moratorium has limited, but not eliminated, construction of beds in this state. Under the Moratorium currently certified providers are allowed to expand facility size at an existing site. Many have chosen to do so. Still there are areas of the state which do not have ready access to nursing home beds. Individuals in these locations are often faced with placement in facilities 50 to 100 miles from their home. Although access to a nursing home close to ones' personal residence may be difficult, there are adequate bed numbers available throughout the state. No evidence was found indicating unfair pricing policies. In-home services are available, in varying degrees, throughout the state. In some areas however, alternatives to institutional care are not fully utilized. A greater understanding of these programs is necessary. In summary, further study is needed before any recommendation to abandon the Moratorium is warranted. Potential nursing home residents, providers of care, local and state officials, and professional gerontologists, should all have an opportunity to evaluate, assist in the development of, and comment upon a long range plan for long term care. Careful evaluation of what is currently available, projected needs, future direction, cost implications, alternative delivery systems, and effect on the elderly population should be undertaken by the Utah Department of Health, in cooperation with other interested agencies and parties, to chart a course for what lies ahead. |
