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Two Standards of Preparedness

One of the saddest sub-stories about the Titanic is the preference given to first class passengers for the few lifeboats. 61% of first-class passengers survived, but only 24% of third-class passengers did. We don’t like class-based biases like that.

But I worry that we are creating a divide in preparedness with the new Medicare/Medicaid Conditions of Participation. Long-term care facilities that accept Medicare are required to have a rather robust preparedness plan, including training and annual exercises. But a private pay facility can ignore those same requirements. Group homes (Intermediate Care Facilities) that accept Medicaid will be required to abide by the same preparedness rules, but private pay facilities will not.

The result will be that our poorest seniors will actually have a stronger safety net than those with personal assets or insurance. Our poorest teenagers with psychological problems will be protected better than those from families with means.

And while state regulations generally apply to all facilities, regardless of payment, these regulations vary from almost-Medicare-level to non-existent. Yes, some accreditation agencies like The Joint Commission and CHAP (Community Health Accreditation Program) are rolling CMS requirements into their own accreditation standards, but those are voluntary and so far, sporadic.

My mom is in a private pay assisted living facility. When I raised the question of preparedness to the administrator, I was assured: “We are well prepared.” However, there is no requirement for him to share that preparedness plan with me, as there would be if my mom were in a Medicare facility.

Does this bother you, too?

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Topics: Medicaid, Seniors

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