Proposed Medicaid Payment Requirements Could Make Nursing Homes Safer

Currently, when nursing homes in Orange County and elsewhere in the country receive payments from Medicaid, they are able to spend the payments on facility maintenance, operations, and even toward profits. According to a recent article in California Healthline, newly proposed legislation could change that, requiring nursing homes in California to spend those Medicaid payments on patient care alone. There are currently about 15,500 nursing homes in the United States, and the article underscores that the Biden administration is considering making this change for all nursing homes nationwide. In the meantime, however, California lawmakers are considering making the change across the state. 

A bill that is currently being considered “would require nursing homes to spend at least 85% of revenue from all payers on direct care for residents.” What do you need to know about potential changes and how they could limit nursing home abuse injuries in Southern California? 

Pandemic Has Changed the Way Many Think About Nursing Home Safety

Several states have already required nursing homes to change the way they spend Medicaid payments, and California could soon be among them. As the article emphasizes, many of these changes have resulted from the realities of the COVID-19 pandemic. Indeed, it is “among several steps officials are considering after the COVID-19 pandemic hit vulnerable nursing home residents especially hard.” In the first year of the pandemic, more than one-third of all people who were killed by the coronavirus were nursing home and other long-term care facility residents. To put that figure in perspective, residents of those facilities account for under 1% of the total population.

Approximately 62% of nursing homes and other long-term care residents pay for their care with Medicaid, and those payments total to more than $50 billion. Those payments include both short-term and long-term stays in nursing homes. The Centers for Medicare & Medicaid Services (CMS director Dan Tsai has emphasized that appropriate staffing at facilities is the most important issue to address in order to reduce rates of nursing home abuse. By directing Medicaid payments to direct patient care, that money could play a role in helping to reduce injuries by allowing for increased staffing at many facilities.

Limited Staffing Results in Nursing Home Negligence Injuries

Understaffed facilities often have poor safety records and histories of nursing home neglect injuries resulting from passive neglect. While many of those facilities do not necessarily intend to cause patient harm or to provide patients with a low quality or inadequate quality of care, inadequate staffing means that patients and residents are not getting the care they need.

The California Assembly has already approved the bill. When California lawmakers say 85% of Medicaid payments would need to be directed to patient or resident care, what do they mean? According to California Healthline, that revenue would need to be spent on “services that benefit residents, such as nursing staff, drugs, therapy, food, and laundry.” Other proposed legislation, in addition to the Medicaid legislation aimed at Medicaid payment use, could further improve nursing home care in California.

Contact an Orange County Nursing Home Neglect Attorney

If you have questions about nursing home neglect injuries or filing a claim, one of our experienced Orange County nursing home negligence lawyers can help. Contact the Walton Law Firm to learn more about how we can assist you.


See Related Blog Posts:

I Am Concerned About Abuse in My Parent’s Los Angeles County Nursing Home: Now What?

Five Things to Know About Nursing Home Psychological Abuse in Orange County

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