Nursing Home Week a time to take pride

More than 25 years ago, former Vice President Hubert Humphrey noted that “the moral test of government is how it treats those who are in the dawn of life – the children; those who are in the twilight of life – the elderly; and those in the shadows of life – the sick, the needy, and the handicapped.” During National Nursing Home Week, May 9-15, Maine residents might pause and take pride in the compassionate care we are able to provide our elderly and disabled citizens.

Today, Maine has one of the most comprehensive systems of long-term care in the country, providing a wide range of options for our elderly residents and their families. However, strict MaineCare eligibility requirements limit nursing home access to the sickest and frailest members of our society. The result is that Maine’s nursing-home residents have the highest acuity rates in New England and the third highest in the entire nation.

To meet the needs of these residents, Maine’s nursing homes consistently rank near the top in national staffing ratios. In particular, our certified nursing assistants (CNAs) receive twice the amount of training mandated by the federal government and also provide the second highest number of direct care hours per resident in the United States.

This commitment to staffing levels is a prime reason that over the past three years, survey inspection results show Maine to have an enviable record of low occurrences of quality care deficiencies. National studies have repeatedly shown the positive correlation between above-average staffing levels, regulatory compliance, and overall quality of care.

A report recently released by the Maine Department of Human Services provides further testimony to the quality of care provided here in Maine. DHS utilized an independent research firm to measure resident satisfaction in forty Maine nursing homes in 2003. Market Decisions Incorporated and Rutgers University’s Institute for Health Care Policy and Aging Research used twenty-two measures of satisfaction in an oral survey of residents. The survey utilized a 1-10 rating system in which 1 equals low satisfaction and 10 equals high satisfaction.

To gauge overall satisfaction, residents were asked to rate 1) how likely they were to recommend their nursing home to a friend; and 2) how satisfied they were with the nursing home overall. Both items achieved an identical 8.8 rating on the 10-point scale, indicating high levels of satisfaction.

Further analysis indicated no significant differences between facilities based on location, size, for-profit, or non-profit status. Several specific areas rated above 9.0 on the scale, including the cleanliness of the facility, staff respect and courtesy, and resident safety and security. The Maine Health Care Association applauds DHS for reaching out to ask the residents themselves about the care they receive and looks forward to working with the department in additional resident and family focused measurement of quality care.

There is much to be proud of in Maine’s system of long-term care, but as the recent legislative session illustrates, budget shortfalls threaten our select status. With over 70 percent of Maine’s nursing home residents dependent on MaineCare for support, a lack of available funding places an entire system at risk. Nursing home reimbursement is still based on data collected in 1998, with no inflationary adjustment in the past two years. DHS’s own figures reported last year confirm that nursing home providers were under-reimbursed by close to $22 million.

Although much has been said about the increase in MaineCare expenditures in recent years, it should be noted that the portion of the program that has grown the least involves care for the elderly. In fact, spending on long-term care has increased at half the rate of the overall state budget during the past five years. Nursing home spending has failed to keep pace with the relatively low general rate of inflation, and certainly not the roughly 9 percent annual increases attributed to health care costs.

This year’s theme for National Nursing Home Week is “Embracing our Heritage.” I would submit that Maine has a long heritage of compassion and support for the health care needs of its elder citizens. Even in difficult times, we remain optimistic that the resources will be found to continue the care that we would all want for our parents and grandparents. After all, Maine has always done just that.

Richard A. Erb is president and chief executive officer of the Maine Health Care Association.