Hole torn in a dollar bill with medicaid text

Nursing Home Residents on Medicaid Suffer Most 

Most whose financial situation would be characterized as low income and need to remain in a nursing home for longer than expected, Medicaid will quickly become the primary payer for their long-term care. Designed as a public assistance program for individuals with limited financial support, Medicaid funds a person’s physician visits, hospital, and long-term care, drugs, medical equipment and transportation, and other medical services.

The Buffalo News recently reviewed data from New York’s Department of Health and found that five-star nursing homes in the state are less likely to admit low-income residents on Medicaid than one-star facilities. One-star homes are rated lowest by the government’s Five-Star Quality Rating program for skilled nursing facilities.

According to the publication’s findings:

  • Those who enter nursing homes on Medicaid from their first day were as much as four times as likely to be admitted to one-star nursing homes than to five-star homes.
  • In 2017, 7 percent of new residents at New York nursing facilities were Medicaid admissions at five-star nursing homes, while 15 percent of new residents were Medicaid admissions at one-star facilities.

Medicaid already pays out less than other forms of insurance, even though it is the primary source of funding for 6 out of 10 nursing home residents. As of May 2018, there were 3,042,715 Illinois residents enrolled in the state’s program amounting to 57 percent of nursing home residents who receive the assistance. The program remains the most significant single payer of nursing home care in the country and provides financial support to nearly 70 percent of all older adults with disabilities.

Why Nursing Homes with Most Medicaid Residents Are Failing

The Buffalo News’ findings ring true, and historically, nursing homes that rely heavily on Medicaid are more likely to provide the worst care for their residents. The lack of quality in services found in these facilities remains ongoing subjects of concern among consumers, policymakers, and families of those relying on the coverage because these facilities have cyclical problems regarding:

  • staffing
  • infection control
  • unsafe or accident-prone environments
  • mental health services
  • food sanitation
  • dementia care
  • medication consultation
  • physical therapies and mobility needs
  • administrators guilty of fraud

According to the Centers for Medicare & Medicaid Services (CMS), low-income populations on Medicaid will experience disproportionately high burdens of disease and face more barriers to accessing long-term care than others as well. CMS officials say, “these populations include racial and ethnic minorities, sexual and gender minorities, persons with disabilities, as well as individuals living in rural areas.”

To learn more about Medicaid benefits in Illinois, and the program’s requirements, be sure to visit the Illinois Department of Healthcare and Family Services website.

Long-term Care Attorneys Who Are Here to Help Everyone

If you’re unsure how Medicaid coverage may be impacting the care of a loved one, let us help. For over 25 years, we’ve passionately pursued justice for those who have been victims of medical malpractice, wrongful death, and nursing home abuse and neglect. Our attorneys are committed to fighting for the best results for you and your family no matter what the socioeconomic background.

Consultations with our attorneys are both free and confidential. Please call us at (312) 332-2872 or complete our free online consultation request form.

Also read: Chaos Consumes Louisiana Nursing Homes as Massive Amounts of Medicaid Recipients Face Eviction Notices