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For Nursing Home Residents, Medicaid Cuts Could Mean Lower Quality Care

Live music is one of the favorite activities of residents at Menorah Park nursing home in Beachwood. 81-year-old Elaine Miller has been living here for nearly 2 years.

It took a fall and an injury a few years back to spur her realization that she would soon need to rely on nursing home care as she aged.

"I couldn’t imagine myself in long-term care," Miller said. "But that’s what it came down to. I can’t take care of myself. I can’t go to the bathroom on my own, I can’t shower on my own, I can’t do any of those things on my own."

But for many elderly and disabled people like Miller, the stress and fear of moving to a nursing home isn’t just about leaving the comfort of their homes. It’s also about financing that long-term care.

The average cost of nursing homes is $82,000 a year, according to Kaiser Family Foundation. And Medicaid has become the de facto long-term care system for elderly because of how much nursing homes drain people’s assets, according to Richard Browdie of the Benjamin Rose Institute on Aging.

"Medicaid now has become a middle class entitlement for long-term care," said Browdie. "Meaning that it takes a lot of resources to be able to go through an extensive long-term care need — without eventually needing to rely on Medicaid in some form or fashion."

93-year-old Helene Weinberger used up all of her funds to pay for the long-term care of her husband when he began declining after a stroke.

"We couldn’t buy nursing home care coverage, long-term care coverage, because he already had multiple sclerosis when he was much younger," said Weinberger. "Therefore, the presence of Medicaid was absolutely an imperative when I ran out of money for my husband's care."

One in three people turning 65 require nursing home care at some point, according to Kaiser Family Foundation. And experts fear potential changes in Medicaid funding would not only impact coverage, but also quality.

Medicaid cuts could result in fewer nursing home staff, which research has shown to be associated with lower quality care, as well as increased risk of bedsores, according to Browdie.

"There’s already been a great deal of economizing in the long-term care industry because Medicaid has always been under pressure," Browdie said. "There’s not a lot of fat in the Medicaid-funded long-term care system. So fewer staff always translates into a negative consequence for residents."

Back at Menorah Park, one of Elaine Miller’s favorite pastimes is watching the birds in the nature room.

She’s certain that she’ll likely need nursing home care for the rest of her life. And for the time being, Medicaid is her only security.

"I remember vividly thinking, what’s going to happen to me?" Miller said. "Where am I going next? I have no plans for the future. My future is here."

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