Countians fighting Medicaid cuts Nursing home clients could lose eligibility

November 03, 1992|By Donna E. Boller | Donna E. Boller,Staff Writer

Severe laryngitis kept Mary Smaligo of Hampstead home from her teaching job on Friday, but she could still write letters asking state legislators not to cut off her mother's nursing home care.

Carroll County nursing home administrators and residents with relatives in nursing homes are gearing up to fight proposed Medicaid cuts that would eliminate eligibility for an estimated 2,000 Marylanders.

About 30 residents of local nursing homes would lose Medicaid coverage, reported Carol Purkins, the county's long-term care ombudsman.

The proposed cuts would make Maryland residents with incomes higher than $1,055 a month or assets of more than $2,000 ineligible for Medicaid.

Individuals have been contacting members of the General Assembly's Administrative, Executive and Legislative Review committee, which must approve the proposed cuts.

Two nursing homes, Carroll Lutheran Village and Westminster Nursing & Convalescent Center, plan to provide transportation to Annapolis for an AELR hearing that had been tentatively set for Nov. 10. The hearing has been postponed until the state Department of Health and Mental Hygiene works out proposed regulations for the legislators to consider.

Mrs. Smaligo's mother has been in the Health Care Center at Carroll Lutheran Village for 18 months. Her monthly income would be around $100 over the $1,055 limit, but she has already spent all her assets.

"She can't 'private pay,' " Mrs. Smaligo said.

Mrs. Smaligo said she doesn't know how she and her husband John, who is pastor of St. Mark's Lutheran Church in Hampstead, would manage to take her mother into their home. The family includes a 10-year-old and two 5-year-olds, "and let's face it, that's not good for her high blood pressure," Mrs. Smaligo said.

Her mother also is going blind, which means that she could easily stumble over a toy in the house. And she would be alone each morning while Mrs. Smaligo is teaching.

In Gamber, Mary Jane Rouse has already received a response to her letter to Delegate Richard N. Dixon, D-5A. She said Mr. Dixon assured her that current nursing home residents are likely to be "grandfathered" into Medicaid eligibility.

"But what happens when we have to apply for Medicaid again next year?" Mrs. Rouse asked.

She also wonders what will happen when the cost of living adjustment built into Social Security goes into effect in January, putting other residents over the limit.

Both of Mrs. Rouse's parents are at the Westminster Nursing & Convalescent Center, but only her father has income that would put him over the proposed Medicaid limit.

"He's $51 a month over" the limit, Mrs. Rouse said.

Her father receives Social Security and three small pensions from jobs at the lamp division of Westinghouse in Baltimore and the Johns Hopkins University Applied Physics Laboratory in Columbia, where he retired 15 years ago at age 65.

Mrs. Rouse said she could not care for her father at home. He has suffered several strokes, cannot stand or walk on his own or communicate. He requires bathing and feeding.

"It's not like Daddy could go to a lesser care facility," she said. "They want [patients to be] ambulatory."

Sue Able's 72-year-old mother is blind and crippled by arthritis. She has been at Pleasant View Nursing Home for just over two years, but she may not be able to stay if the Medicaid cuts go into effect. Her monthly income would be $65 over the cutoff.

"There's no way we or she could pay for full-time care," Mrs. Able said. "The only way I could do it is to bring her home and try to take care of her."

Mrs. Able said she can neither afford to give up her job nor afford to pay for full-time care at home for her mother. "I really wouldn't know what to do if she had to leave the nursing home," she said.

State officials said they had no choice but to cut Medicaid as part of budget reductions to meet a $500 million Maryland budget shortfall. Nursing home costs account for a disproportionate share of the state's $2 billion annual Medicaid budget.

Nursing home residents represent only 6 percent of all Medicaid recipients, but consume 20 percent of the costs.

If the cuts go into effect, nursing home administrators face a difficult choice: evicting patients or absorbing the costs.

"Let's face it, the nursing home people are going to lose a lot of money. Can they go on doing that for a long time?" ombudsman Purkins said.

Golden Age Guest Home owner James C. Talbott said he has just two of 50 patients who would lose Medicaid benefits immediately if the cuts go into effect. But he questions how nursing home administrators can absorb the costs for patients who cannot pay without seeing some effect on the quality of care.

"I hope the governor can find some other cuts," Mr. Talbott said. "This isn't fair to these old people."

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