Weld policy hurts the elderly

The Boston Herald

BEVERLY BECKHAM

The facts exclude the faces - old, lined, frightened, weary, faces; gums smooth where teeth used to be; thin hair; knotted hands; parched skin; frail, fragile bodies.

The facts ignore the feelings - feelings of people at the end of their lives, dependent upon others, too poor and too ill to take care of themselves.

The facts are terse and cold.

"Citing a need to save money, the Weld administration is proposing a ban on Medicaid payments to nursing homes for those patients who are temporarily hospitalized."

The facts steal from the old the few things they have left - their beds, their routines, and the last of their pride.

Come July 1, if the Weld administration gets its way, the old and the permanently disabled who live in nursing homes and who are supported by the state, will be evicted from their room every time they have to be admitted to a hospital. They will have to sign forms that say they are being discharged.

They will have to pack up their clothes and their pictures. They will have to say goodbye to their nurses and aides, to friends on their floor, to the people who share their room, to the life they have grown used to. For the likelihood is that after their hospital stay, they will be sent to another room on another floor.

Currently, nursing homes hold residents' rooms for up to 10 days while they are hospitalized. Private paying residents pay for these rooms; if the resident is on Medicaid, the state pays.

But the state has decided it doesn't want to pay anymore. The state looks at its bills and computes that it's being dunned twice, once by the hospital and once by the nursing home. The state adds up the numbers and figures it can save some $20 million a year with a flick of a pen.

But can it?

On paper, yes. But in fact?

It's unlikely. Skilled nursing home care costs the state about $115 per day for Medicaid recipients. Hospital care costs at least three to four times this amount. When a nursing home patient has recovered enough to leave a hospital and return to his nursing home, if there is not a bed available, he will be kept at the hospital until a bed can be found. The state's theoretical savings could be obliterated in days, and if a patient has to remain in the hospital for a longer time, the state will end up paying more to house the infirm and the elderly than it does now.

The federal government has mandated that all nursing home residents have the right to be returned to the home they were in before they were hospitalized. Therefore, the state figures that if nursing homes have to take their patients back, why should the state pay to hold beds?

Why? Because one less patient doesn't mean less staff for the nursing home, less food ordered, less electricity spent. Nursing homes operate like all businesses. They can't give their services away. The state expects the nursing homes to absorb the full cost of its proposal. That simply isn't practical.

Nursing homes to stay in business must fill their empty beds as quickly as they can. The state should at least attempt to barter with the nursing homes and come to some mutually acceptable agreement.

When Bill Weld was running for governor, he pledged to get rid of the fat in the budget. But that's not what he's doing. He's getting rid of programs that serve the powerless and the vulnerable. He has cut programs for disabled young adults. He has denied our children quality education. And now he's taking the sickest elderly out of their beds and moving them around like old furniture that nobody wants, but that nobody wants to throw away.

Now he's taking the sickest elderly out of their beds and moving them around like old furniture that nobody wants

There isn't enough money in the state budget for everyone. But everyone doesn't need help. The impoverished elderly do. They need help, and some basic understanding.