San Mateo County Grand Jury
• 2010-2011
Is the County Wedded To Long-Term Care? Issue | Background | Findings | Conclusions | Recommendations | Responses |
⚠️ Translation Notice: This content has been automatically translated. The original English text is the official version. Translation may contain errors.
⚠️ Este contenido ha sido traducido automáticamente. El texto original en inglés es la versión oficial. La traducción puede contener errores.
Findings and Recommendations 7 findings
F1
Patients with dementia and behavioral issues remain at BLTC for lack of alternative placements; releasing them without placements is prohibited by law.4 4 Title 42, Code of Federal Regulations, Section 482.43 and Title 42, United States Code, Section 1395x(ee). Additional California hospital discharge planning requirements are established at California Health and Safety Code Sections 1262.5 –1262.6. 3
No recommendations for this finding
F2
After spending time recuperating from medical conditions, patients often have lost their homes or other housing arrangements; therefore BLTC becomes their only residence and cannot release them until a safe and appropriate housing is obtained.
No recommendations for this finding
F3
The lack of available low-cost housing in the county makes it difficult for BLTC staff to find safe discharge for patients who no longer need skilled nursing care.
No recommendations for this finding
F4
Medi-Cal is the primary means of payment for approximately 94% of the patients at BLTC. A small number do not qualify for any insurance but still need skilled nursing care.
No recommendations for this finding
F5
Medi-Cal will pay only its “accepted fees,” a rate significantly lower than the cost to the hospital. Medi-Cal has cut its reimbursement rates over the last several years. There was a 2-year rate freeze for fiscal years 2009-10 and 2010-11.5 The State of California has now proposed an additional 10% cut for FY 2011-12.6 BLTC continues to run deficits annually.
No recommendations for this finding
F6
Many residents of BLTC no longer require skilled nursing, but placement at a lower level of care is not feasible because Medi-Cal will not pay for Residential Care Facilities, smaller Board and Care Facilities, or Assisted Living Facilities.
Related Recommendations (1)
R3
Continue to enlist support from locally elected state and federal legislators to obtain Medi-Cal waivers allowing Long-Term Care Integration to be administered by the County. 5 www.dhcs.ca.gov/services/medi-cal/Pages/LTCRU.aspx http://files.medi-cal.ca.gov/pubsdoco/newsroom/newsroom_12192.asp 6 aarp.org/bulletin MAY 2011 – "The Law" 4
F7
A Medi-Cal waiver for Long-Term Care Integration is pending in the State legislature and could be implemented as early as 2012 if passed. Conclusions The 2011 San Mateo County Civil Grand Jury concludes that:
No recommendations for this finding
Additional Recommendations 2
These recommendations are not explicitly linked to specific findings.
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R1Pursue appropriate renovations necessary to consolidate long-term care at the Medical Center main campus and close Burlingame Long-Term Care facility.
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R2Continue to seek assistance from locally elected state legislators to expedite Office of Statewide Health Planning and Development approval of the renovations required to provide long-term care at the main campus.
Conclusions 4
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CL1 Page 4Closing BLTC and providing long-term care services at the SMMC main campus would require renovation costs, but would be a wiser investment for the future.
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CL2 Page 4Given the financial drain of maintaining the aging and outmoded BLTC facility, there is a need for a renewed and innovative approach to County-sponsored long-term care.
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CL3 Page 4Long-Term Care Integration could place patients in settings more appropriate for the care they require at a lower cost.
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CL4 Page 4It is more fiscally prudent to consolidate long-term care at the SMMC Main Campus than to continue funding the aging and inadequate Burlingame facility.
No Responses Found 1
Government entities assigned to respond to this report. No response documents have been linked in our database.
San Mateo County Board of Supervisors
Elected County Office