In 46 states there are laws mandating health care providers such as hospitals and nursing homes pay a provider tax to assist with the care of Medicaid recipients. So as not to put an unfair burden upon the states in the care of their indigent citizens the Federal government matches Medicaid dollars generated by the state.
States experiencing budget shortfalls may look to increase revenue in creative ways. Legislative authorization to collect additional revenue from providers is a mechanism to generate new in-state Medicaid funds thus resulting in increased federal dollars. In return providers may see increased reimbursement in the care of Medicaid patients.
Illinois is currently awaiting CMS approval of a provider tax. Illinois will be reimbursing providers for Medicaid recipients receiving therapeutic diets as scored on the MDS 3.0.
Illinois’ decision guarantees business as usual for Medicaid recipients. Currently the majority of nursing home residents are on therapeutic diets for treatment of diabetes, congestive heart failure, and heart disease.
While Illinois holds fast to the hospital model of nursing home care other states are moving toward a more home-like model. Meals are served restaurant or family style allowing residents to select the foods they wish to eat. Diets are ordered based on personal preference rather than diagnosis. The goal of care for the elder in a nursing home – avoid consequences.
CMS supports the resident’s right to choose. F325 states, “A resident has a right to make informed choices about accepting or declining care and treatment. The facility can help the resident exercise those rights effectively by discussing with the resident the resident’s condition, treatment options (including risks and benefits, and expected outcomes), personal preferences, and any potential consequences of accepting or refusing treatment. If a resident declines specific interventions, the facility must address the resident’s concerns and offer relevant alternatives.”
Our reimbursement structure may preclude a more liberal approach to nutrition care of the elderly in Illinois, but F325 still allows for our elders to select the foods they wish to eat.
Health Care Providers and Industry Taxes/Fees. National Conference of State Legislators: November 10, 2011. Available at http://www.ncsl.org/?tabid=14359 Accessed January 04, 2012.
Appendix PP. Centers for Medicare and Medicaid Services. Available at https://www.cms.gov/manuals/Downloads/som107ap_pp_guidelines_ltcf.pdf Accessed January 4, 2012.
New Practice Dining Standards. Pioneer Network: August 2011. Available at http://pioneernetwork.net/Data/Documents/NewDiningPracticeStandards.pdf Accessed January 4, 2012.