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Audit: Programs to reduce nursing-home stays need coordination

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ATLANTA — Two programs the state runs to minimize the cost and inconvenience of nursing-home stays aren’t fully effective because of lack of coordination, according to an audit released Monday.

Most patients prefer staying at home, and a Supreme Court decision requires the government to use home-based treatment whenever possible to keep the disabled and elderly from being isolated in institutions. Plus, treating people at home provides taxpayers a significant savings.

But examiners with the state Department of Audits & Accounts concluded the state wasn’t doing a very good job at avoiding nursing-home stays.

“In addition to unequal access to typical services, the current structure does not effectively allocate enhanced case-management services to those who may derive the most benefit,” the auditors wrote.

Georgia spends $1 billion yearly on nursing-home care for the disabled and elderly who have low incomes. At the same time, it spends $387 million providing home-based services, like assistance with bathing and eating.

Who winds up getting to stay in their homes or those of a family member and who gets shipped off to a nursing home depends on which of the two programs they apply to, auditors found. Since the programs run by different state agencies don’t share information, one routinely grants services to patients whose needs aren’t as serious as those stuck on the other agency’s waiting list.

And nursing homes usually admit urgent cases almost immediately while the state’s Medicaid providers take several weeks just to conduct assessments, determine eligibility and develop a treatment plan. Those put on a waiting list usually go eight months until they get attention, the study found.

One program is supposed to get referrals from nursing homes themselves, but more than one-quarter of them have never referred the first patient, the auditors discovered.

The two agencies running the separate programs offered no argument with the auditors’ conclusions. One of them, the Department of Community Health, said Tuesday it is revamping the way it measures success by tracking patients instead of individual programs. It’s also stepping up the way it communicates with physicians and others who inform families of their treatment options.

It also announced Monday that it is among four states getting a federal grant of $57 million to provide web-based training for those making referrals. It will also use part of the money to begin using the same aging and disability resource centers for evaluations as the other program.

“We are extremely pleased to receive this grant funding to create easier access to home- and community-based living arrangements for some of our most vulnerable populations,” said Community Health Commissioner David A. Cook.


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