Can Nursing Home Transfer Be Delayed If Home and Community-Based Waiver Personal Care Services Are Increased?Gerontological Society of America (2012)
There is a pressing need to retain the dually eligible elderly in the community.This research compared the use and cost of personal care services (PCS) and nursing home placement (NHP) among 7302 older adults aged 65 and older in a statewide home and community-based waiver program. A model was developed to estimate costs of increased PCS to compare savings associated with remaining the community versus NHP. The second to last and last Minimum Data Set-Home Care assessments and Medicaid claims files were examined. Median hours of PCS and savings based on average cost were calculated. Median hours of PCS were 34. The rate of NHP for clients above the median hours of PC was 25%. Adding PC hours for those with <34 hours, could possibly reduce NPH to 25%. For example, a total of 3777 hours of PCS need to be added for those below the median, to sustain a 25% rate of NHP. This would keep 33 clients in the waiver. Cost of adding these PCS is $59,186 (3777*$15.67). Monthly cost of NHP is $115,500 (33*$3,500), compared to $30,822 (33*934) in the waiver. Total savings of $25,492 per month could be realized by retaining 33 clients in the waiver program. Adding PCS hours to waiver clients whom are below the median number of hours of PCS could help retain clients in the home setting, where they most want to be, and allow for tremendous cost savings.
Publication DateFall 2012
Citation InformationSandra Spoelstra. "Can Nursing Home Transfer Be Delayed If Home and Community-Based Waiver Personal Care Services Are Increased?" Gerontological Society of America (2012)
Available at: http://works.bepress.com/sandra-spoelstra/12/