Louisiana’s effort to improve the quality of care for aging and elderly citizens took another step forward with the approval by the federal government of a plan to encourage closure of older, low-occupancy homes. This follows two other reforms for long-term care undertaken by the Louisiana Department of Health and Hospitals.

This plan allows for additional (incentive) payments for fair rental value, property tax, and property insurance when a Medicaid participating nursing facility purchases and closes an existing nursing home that participates in the Medicaid program.

According to Charles Castille, undersecretary of the Department of Health and Hospitals, the incentive is expected to encourage the closure of older homes that are in need of repair and that are significantly under-utilized.

“Low-occupancy, older facilities often fail to have the necessary resources to provide the highest quality of care,” Castille explained. “Should a loved one be living in one of these homes, he or she will be able to choose a new provider or some other form of long term care, if desired. This can occur without an interruption of care.” 

In addition to improving care, the plan is designed to save the state money.

“Currently, the Medicaid reimbursement formula includes a payment for empty beds,” Castille said. “Under this program, money will be saved by reducing what the state pays for empty beds.”

Another plan revises the manner in which reimbursements for nursing homes are calculated to allow for additional payments for private room conversions. This occurs when a Medicaid-participating nursing home converts one or more semi-private rooms to private rooms for occupancy by Medicaid recipients. Medicaid-participating nursing homes that make these conversions are eligible to receive an additional $5 per diem payment.

Both this initiative and the previous one were pursued at the recommendation of the Nursing Home Quality and Efficiency Board chaired by Castille.

The Louisiana Nursing Home Association’s Joseph Donchess said he commends LDH, Gov. Kathleen Blanco and the chairs of the Legislative Health and Welfare Committees, Joe McPherson and Sydney Mae Durand, for their leadership in the development and implementation of these initiatives.

“These creative and progressive efforts will bring a leaner, more efficient nursing home program, and will encourage operators to diversify to better serve the community needs of the elderly and disabled. It is gratifying to see our efforts culminate in the successful implementation of these initiatives,” he said.

In another action, the department has introduced PACE programs in several areas of the state. PACE (Program for All-Inclusive Care for the Elderly) offers flexibility in providing the medical and support services necessary for a senior citizen to maintain independence in their home for as long as possible. The PACE program coordinates and provides all needed preventive, primary, acute and long term care services so that older individuals can continue living in the community. 

The federal government participates with the state in the cost of PACE through its Medicaid and Medicare programs. The federal government requires that PACE must be cost-effective when compared to institutional (nursing home) care.