Getting Persons OUT Of Nursing Facilities!!!

 

According to the CMS’s Minimum Data Set (MDS), as of 6/31/06, there were approximately 24,624 people in Maryland’s Nursing Facilities.  A break down shows that:

·        49% of the total 24,642 people (12,075) were on Medical Assistance.  These were the people from whom the MA program spent $895 million dollars.  That’s about $74,580 per person per year.

·        15.1% of the total 24,642 (i.e., 3,789 people) were 64 years or younger; 13.9% (3,488) were 65-74 years; 31.6% (7,929) were 75-85 years and 39.3% (9,861) were over 85

·        4,879 of the total (19.8%) are married while they are in the nursing home; 4,610 (18.6%) were never married, and 12,236 are widowed.

·        68.9% of the total (17,260) are female.

·        23.7% or 5,895 people indicated they want to live in the community.  These are the people that the Supreme Court addressed in the Olmstead decision.  They are being “unnecessarily institutionalized.”  Given the2/18/05 CMS Memo to State Medicaid Agency Directors subject: Release of LTC MDS Data to State MA agencies, Waivers, Real Choice and the ADA, the 5,895 persons who indicated they wanted to reside in the community should be the primary focus to reach and determine what services they require to move back to the community.

·        8.9% of the total Nursing Home residents  (2,077) entered directly from their homes (not from hospitals, rehabilitation Centers, nor other nursing homes) and were not receiving health services in their homes;

·        Another 3.1% (724) entered nursing homes directly from their homes but had been receiving some health services.  

·        1.1% (251) entered nursing homes directly from a rehabilitation hospital.

·        Immediately prior to admission, 61% (15,031) of nursing home residents did not live alone.

 

 

 

 

MARYLAND MEDICAID EXPENDITURES -

DEVELOPMENTALLY DISABLED PERSONS:

INSTITUTIONAL  VS.  COMMUNITY

 

 

YEAR

ICF / MR     VS. (INSTITUTION)

MR WAIVERS (COMMUNITY

Expenditure Ratio: Institution vs. Community

FY 1995

$79 M

$10 M

$0.78 TO $1

 

 

 

 

FY 1999

$54 M

$139 M

$0.39 TO $1

 

 

 

 

FY 2000

$59 M

$168 M

$0.35 TO $1

 

 

 

 

FY 2001

$58 M

$207 M

$0.28 TO $1

 

 

 

 

FY 2002

$62 M

$197 M

$0.31 TO $1

 

 

 

 

FY 2003

$57 M

$434 M !!!

$0.13 TO $1

 

 

 

 

FY 2004

$60 M

$345 M

$0.17 TO $1

 

 

 

 

FY 2005

$63 M

$357 M

$0.18 TO $1

 

 

 

 

INCREASE

 

 

 

1995 - 2005

5%

253%

 

 

Nationally, there was a 20% increase between 1995 and 2004 for ICF-MR and a 195% increase for community services.  During the same years, in Maryland there was only a 5% increase in ICF-MR and a 253% increase in MR/DD community services.

In FY 2005, the nation spent 42.4% of its LTC expenditures for MR/DD on institutional-based services and 57.6% on community-based MR/DD services.  Maryland spent only 15% of its LTC expenditures for MR/DD on institutional-based services and 85% on community-based MR/DD services.