June 7, 2019 10:38:18 AM
America faces a crisis few of us seem to be giving much attention, even though the odds are good that most of us will someday be dramatically affected by it.
This week, the federal Center for Medicare and Medicaid released a list of 440 nursing homes in the U.S. that would warrant closer scrutiny if funds were available. These facilities, called Special Focus Facilities (SFF) candidates, have a history of providing poor care, based on CMS's annual inspections. One of the 440 facilities on the list is in Columbus.
Because of budget limitations only 88 facilities are officially SFFs and therefore subject to the closer monitoring prescribed by the program, which means there's sort of a waiting list for a facilities that might warrant that closer supervision. That's certainly not the kind of waiting list anyone wants to be on.
It's a serious issue. Most of those people have limited finances and are confined to their nursing homes. In fact, Medicaid funds the vast majority of the 1.4 million Americans in the nation's 16,000 nursing homes.
In recent years, the shift in elder care has gone to home care. In fact, it's the largest growing job in the nation, with 2.9 million people employed to provide health care to patients who remain in their homes. But finding and retaining these workers is difficult. The one-year turnover rate is as 74 percent, which can be attributed to a great degree to low pay (the average home healthcare provider makes $22,000 per year).
Options are few, often unsafe and increasingly cost-prohibitive.
Americans currently spend $300 billion on elder care each year, which is a staggering six times the budget of the U.S. Department of Housing and Urban Development.
And that's where we are now.
By 2050, it is estimated that the over-65 population state will soar from 47.8 million to 88 million, including 10 million over age 90.
Until now, Medicare and Medicaid have provided most of the money needed to take care of our elderly population.
But at the moment, even sustaining those federal programs at current levels of funding is a subject of fierce political debate. As noted, we lack the funding needed to provide closer inspection for 80 percent of the facilities with a history of providing poor care, much less to actually care for the elderly. We are not only failing, we are falling further behind.
Yet increasing funding, given the current political climate, is out of the question.
Americans must insist that our leaders take this issue seriously and begin to work on a workable plan.
It may well turn out to be greatest public health issue we will face in this century.