Senior care faces crunch of numbers

Published 12:00 am Wednesday, January 10, 2001

It is time to reform Minnesota’s long-term health care system, agree state elder adult services leaders and staff of the Albert Lea Good Samaritan Center.

Wednesday, January 10, 2001

It is time to reform Minnesota’s long-term health care system, agree state elder adult services leaders and staff of the Albert Lea Good Samaritan Center.

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Members of the Good Samaritan staff joined 50 other Good Samaritan facilities in attending a teleconference addressing the crisis in older adult services Tuesday.

Rick Carter, President and CEO of Care Providers of Minnesota, and Lori Meyer, Manager of Government Relations for the Minnesota Health and Housing Alliance, urged the staff to support legislation that would encourage more flexible, community-based long-term care options, and support existing long-term care facilities.

A grassroots effort called Self-Reliance. Options. Security (SOS) wants $500 million allocated in 2001 to renovate and reform the long-term care system. The system is outdated and will be crushed by the pending senior boom if it is not overhauled, Carter said.

&uot;The cost of reform is expensive today, but rest assured, if we don’t act now it will be unaffordable tomorrow,&uot; Meyer said.

Today, 40,000 Minnesotans are in long-term care facilities, at a yearly cost of almost $1 billion to state taxpayers. Medicare and Medicaid programs are already overextended and underfunded, experts say. Yet, many nursing home residents are there not because they need the level of care, but because they have few other options, said Carter.

Minnesota needs to create choices in care and living arrangements, and support caregivers in their work, Carter said. With a range of affordable, appropriate living arrangements, seniors can get the care they need without excess cost or loss of independence.

&uot;Communities will be stronger because we will make it possible for our parents and our grandparents to live in their own homes, in their own communities,&uot; he said.

Medicare pays for 3 percent of nursing home days, and provides for no skilled nursing. As a result, about 70 percent of nursing home days are paid for by Medicaid, a program designed for low-income people.

&uot;Minnesota is abandoning seniors,&uot; Carter said. &uot;We are asking nursing homes to provide quality care on the cheap.&uot;

Good Samaritan Administrator Mark Anderson has been encouraging staff, residents and families to get active in SOS to take an active part in seniors’ futures. Issues of staffing, aging buildings, and community have to be addressed, he said.

Anderson agreed with Carter that nursing homes are over-regulated and underfunded. Employees are working longer hours with fewer resources, and have high turnover rates – 60 percent turnover for nursing assistants statewide.

Good Samaritan has tamed its staffing problem by focusing on retention, making existing staff feel appreciated and making sure they are well trained, Anderson said, but staffing is still a concern.

&uot;The state, in effect, asks caregivers to provide Cadillac care at Chevette wages,&uot; Carter said.

Documentation is another problem faced by the Good Samaritan Center, Anderson said. Nurses estimate that paperwork takes up about 80 percent of their time.

&uot;We need to get back to nurses providing nursing care,&uot; he said.

Nurses are required to document all resident behaviors, medications, activities and daily living routines, special concerns, and communications, Anderson said.

There are reasons for the regulations. Reimbursement for care is based on the resident’s log books, and state departments need to be able to refer to concrete documents when looking over a resident’s file. But fixation on documentation is distracting for nursing staff.

&uot;The state’s view is that if it’s not documented, it didn’t happen,&uot; he said.

It’s up to people affected by long term care to push for reform, Meyer said. She urged providers and consumers to register as reform supporters by calling 1(866) 877-4SOS or logging on to www.care providers.org or www.mnha.com.

&uot;We are encouraging everyone – family, staff, friends – to read the information and to become involved and ask the legislature for support,&uot; Anderson said.