I now have to travel the 30-or-so miles to
Girard to take flowers to my friend Elizabeth Brown, who’s
living at the Pleasant Hill Village nursing home. She was organist
at our church for many years, and though she likes the care
she’s getting and the facility in which she lives, she always
talks about how much she misses the church in Springfield. Until
now she’s lived her entire 92 years in Springfield, except
for the time she served in England and France with the
Women’s Army Corps during World War II. Elizabeth is one of
many in the “greatest generation” whose later years are
made more difficult by bad public policy on nursing-home funding.
Like several nursing homes in Springfield, the
facility in which Elizabeth lived until recently won’t accept
government Medicaid payments for care. Though she’s still
paying her own way, as she has throughout her life, her assets are
dwindling. It would bother her to know she may have to accept public aid soon.
Her family decided to move her now, before the money runs out, to a
place that will still care for her when she is no longer classified as
“private pay.” The family learned that some Springfield
nursing homes that will keep patients after they convert to Medicaid
still ask brusquely how many years they’ll be on private pay.
Some homes were downright rude when the possibility of Medicaid was
brought up. Others, where most patients are on Medicaid, offered
undesirable facilities or care.
“We’re in trouble as a
society,” says Mary Link of Springfield, Elizabeth
Brown’s younger sister, who has served as a nursing-home
ombudsman for the Department on Aging. “We don’t take
care of our old people. What have these people done wrong? Why are
we punishing them for taking care of themselves so well that they
live a long time?”
The reason many facilities shun Medicaid
reimbursement — and Elizabeth Brown along with it — is
that the government simply doesn’t pay enough to cover the
cost of nursing-home care. At Pleasant Hill Village, the nonprofit
Church of the Brethren home on whose board I serve, the basic
“private pay” rate is $99 a day, and many area facilities charge
considerably more. But Medicaid pays only $69.52 a day, a sum that will
buy a modest hotel room but which no one believes is adequate to cover
costs of 24-hour nursing care and meals. Also, low Medicaid rates
sometimes force nursing homes to increase their private rates, which in
turn hastens the day on which a patient’s assets will be
exhausted.
Medicaid is a joint federal-state program, and
nursing-home reimbursement is a problem all over the country. But
reimbursement rates are largely set by states, and Illinois is
particularly stingy, ranking 47th among the states in the average
rate paid to nursing homes, even though it is the ninth-wealthiest
state. The average daily Medicaid rate for Illinois nursing homes
is $96.99, compared with Indiana’s $107.27 and
Minnesota’s $135.
Many of the nursing homes that labor to
provide care under these conditions are faith-based nonprofits that
already go the extra mile to care for the needy in their charge.
Rather than protest or make demands, they designated April 12 a
“Day of Reflection,” on which some 35,000 nursing home
residents, staff members, and family members prayed that legislators and Gov. Rod Blagojevich would do their
moral duty by adequately funding care for the elderly. Life Services
Network, the statewide association for nonprofit homes, credits last
year’s Day of Reflection with helping persuade legislators to
restore the 5.9 percent Medicaid cut made in 2002. So far this year the
prayer has been lost on the governor, who clings stubbornly to his
pledge to absorb deficits without increasing sales or income taxes.
The governor could use a day of reflection. We
couldn’t help but notice that he arrived late for and left
early from Sunday’s interfaith worship service in Springfield
to dedicate the new museum. We know that the governor is a busy
man, and TV cameras beckoned. But he would do well to sit still and
pray about his moral obligations. Better yet, he should visit
Elizabeth Brown, thank her for her service to her country and
community, and try to explain to her why this wealthy state
can’t afford adequate funding for her care.
This article appears in Apr 21-27, 2005.
