By Samantha Young | Kaiser Health News
California is revamping how it rewards nursing homes to get them to improve patient care.
Rather than limit bonuses to top-performing facilities, the state will hand out additional Medicaid payments next year to nursing homes — even low-rated ones — that hire additional workers, reduce staff turnover or improve quality of care. Facilities will be scored on their performance so facilities that do more will earn larger bonuses. And to ensure an acceptable level of care, the state will sanction facilities that fail to meet clinical and quality standards for patients.
The switch is part of a multipronged effort by Gov. Gavin Newsom and state lawmakers to entice nursing homes to do better after the devastating toll of covid-19. Facilities that improve working conditions for their staff will also earn higher daily Medicaid payments.
“When you’re investing in the workforce, then you have the appropriate levels of care to provide services,” said Lindy Harrington, deputy director at the Department of Health Care Services, which administers Medi-Cal, the state’s Medicaid insurance program for people with low incomes and disabilities.
Patient advocates and industry officials described the changes as an improvement, but they expressed skepticism about whether they would work. They said the bonuses fall short of what’s needed to address chronic understaffing and the closure of rural facilities.
Last year, lawmakers allocated $280 million for the bonus program — just a fraction of the more than $6 billion that nursing homes take in every year from Medi-Cal. The safety-net health program insures two-thirds of nursing home residents in the state. Meanwhile, the money nursing homes could get by improving working conditions for their employees is comparable to temporary funding that facilities received from the state during the pandemic — which means funding essentially remains flat overall.
“The overwhelming majority of…
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