What is a Medicaid Nursing Home?
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Call for a copy of our publication "Patient Advocate Guide" free to Michigan residents. It is a 70 page guide to how to get good care, patients rights and invaluable information about Medicare and Medicaid rights of patients. In addition it lists all the nursing homes in southeast Michigan. |
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• In Wayne, Oakland, and Macomb Counties very few nursing homes do not participate in the Medicaid program.
• Medicaid coverage does NOT affect the quality of care. By law and in practice all patients are treated equally.
• Medicare pays for "skilled care," not long term care.
Nursing Homes
I often read articles in national publications about a “Medicaid nursing home.” One gets the impression of a place on the wrong side of the tracks, up a dark alley, bang on a steel door next to the dumpster and enter your Nursing-Home-of Doom. I wouldn’t want to board my dog there!
The truth is that a Medicaid nursing home is almost any nursing home.
In Wayne, Oakland and Macomb Counties very few nursing homes do not participate in the Medicaid program. Out state it can be hard to find a nursing home that does not participate in the program. These are Medicaid nursing homes. In most nursing homes, every bed has a Medicaid certification. Others may be partially certified, that is Medicaid will not pay for care inbeds without certification.
The law prohibits any discrimination between Medicaid patients and any other patient.
If a home is partially certified does that mean that the Medicaid beds are found in a dusty, dirty hallway, with neglected patients loitering about? No. In fact, the beds that have Medicaid certification may not have any designation of the status. If one asks the care staff or the Director of Nursing “Can you please show me where the Medicaid beds are?” the answer will be “We do not know.”
Does Medicaid coverage mean that a patient will receive inferior care?
No. The law does not allow discrimination in quality of care based on the source of payment. All similarly situated patients must receive the same quality care. Some patient advocates notice a big difference in the level of care on transition from Medicare coverage and Medicaid. The effect is the difference between “skilled care” and “basic care.”
Medicare covers “skilled care” for up to 100 days upon release from a hospital.
During the covered period the patient will see a high level of activity by nurses, aides and therapists if rehabilitation therapy is the reason for skilled care. A resident who does not get well enough to leave the nursing home will enter the long term care after the expiration of Medicare coverage.
Long term care is not skilled care.
It is basic care. The source of payment – Medicaid, private funds, long term care insurance – does not matter. The resident will not be making daily trips to the rehabilitation room. There may not be as many nurses and aides needed to take care of the resident as there was upon release from the hospital. The intensity of care is much less.
