Could New Regulation Slow Movement Away from Nursing Homes for Seniors?

A new federal regulation that calls for alternatives to nursing homes to develop specific care plans for individual Medicaid-covered residents could slow the decades-long movement away from institutionalization in nursing homes and toward greater use of home- and community-based services for seniors in need of assistance.

Under a new Medicaid regulation to take effect next year, operators of alternatives to nursing homes like adult day care programs, group homes, assisted living facilities, and continuing care retirement communities will be required develop plans that address both the services participating seniors need and the preferences they have for the settings in which they live.

While most observers believe the regulation is well-intended, some fear that it may place an onerous burden on program and facility operators and, if not causing them to cease operating, could discourage others from entering a field that is viewed as a productive approach to meeting the needs of many seniors without the high cost of nursing home care.

Some also believe the regulation is geared more toward the disabled who participate in such programs than the elderly.

Under the regulation, states have five years to complete a transition toward compliance with the new requirements.  That transition includes review and approval of state transition plans by the federal government.

For years, the federal government focused on encouraging states to place a greater emphasis on home- and community-based services, as opposed to the institutionalization of seniors, but with this regulation, it is turning its attention to the quality of services delivered in home and community settings.

Because Medicaid pays for 40 percent of all long-term-care services provided in the U.S., it has enormous influence over the delivery of such services.

For a closer look at what the new regulation says, how it developed, and the arguments for and against it, see this Stateline report.

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