NH’s plan to “empty the hospitals” does not provide balance to ensure a choice of settings. Payment preference and guarantees for institutional care have been established. The same has been denied for community based care alternatives. Those being transitioned out of the hospitals need long term care, however this does not mean the care must be delivered in a facility. The need for nursing home level of care does not equate to a need for placement in a brick and mortar facility. In fact, those with the highest needs, such as ventilator dependent care, can be and many currently are cared for at home.
NH residents must have an option to choose where they want to receive long term care supports. Choice results in better outcomes, is cost effective and is encouraged by our federal partner, CMS. Nursing facility beds are a finite resource, as such our community based care placements should be utilized, funded and supported. The current path leads us to a scenario where there will be no support network available to support community placements when we get to “empty the nursing homes” stage. Simply asking the question “where do you want to be?” doesn’t offer meaningful choice, when the care is paid for in the facility and not in the community. A balanced continuum of long term care offers meaningful choice of settings. Payments for home and community based care options should be similarly guaranteed to their facility counterparts. NH needs both options.
Carolyn Virtue
Canterbury