Private unit considered for mentally ill seniors

3-26-2015 Iowa:

The Iowa Health Care Association, which represents most of the state's nursing homes, has shown interest in helping set up a small private facility for senior citizens with mental illnesses that make them aggressive.

Although no such program has been formally proposed, the association recently sent the Iowa Department of Human Services an estimate of what it might cost.

The association figures that to start such a facility, a nursing home would need $300,000 for remodeling costs, plus about $422 per day for each resident. The per-day rate is less than half the $857 that state administrators say they're now spending on patients in a geriatric mental health program at the public institution at Clarinda, which is closing. But it is more than twice the $160 per day the state Medicaid program pays nursing homes on average to care for other elderly residents.

Health Care Association Executive Director Steve Ackerson said in an interview that the estimated cost was "a ballpark figure." He said the state has not given his group details about the potential residents, including their diagnoses and their history of aggression and other difficult behaviors.

Ackerson noted that the state talked a few years ago about setting up a special facility for hard-to-place elderly residents, such as those who were aggressive. His association made a proposal at the time, but the idea never gained traction. For the new proposal, he said, "we just basically brushed up what we submitted two years ago."

Department of Human Services spokeswoman Amy McCoy said her understanding was that her agency recently asked Ackerson's association to propose a facility to handle elderly sex offenders. Ackerson said that was not his understanding. Both said there was no written request for a proposal.

Ackerson said he doubts any private nursing home would accept the four sex offenders who are living in the geriatric mental health unit at the Clarinda institution. While some private care facilities now house registered sex offenders, most of those people are bedridden, he said. "But an active sex offender? No way," he said. If a nursing home took such a person, he said, "Would you want your mother in that building?"

Ackerson said a private agency might be able to set up a small separate facility for elderly people whose mental illnesses cause nonsexual aggression. He predicted no agency would want to house such a program in a wing of a regular nursing home, however, for fear that they would scare off other residents.

Ackerson said his association has advised nursing home administrators to be very careful in deciding whether to accept any of the Clarinda institution residents into their existing facilities. But he added that it's possible some could be handled safely by existing nursing homes, depending on their history of aggression. ..Source.. by Tony Leys