Feds: No Medicaid Reimbursement For Prisoners At Rocky Hill Nursing Home

9-5-15 Connecticut:

ROCKY HILL — The nursing home at 60 West St. seemed to offer a solution to a vexing problem for the state of Connecticut: reducing burgeoning long-term care costs for sick and elderly prison inmates and mental patients.

State officials were confident Medicaid would pick up 50 percent of the cost of care if prison inmates were moved into a privately owned nursing home.

So far, that has not happened, and may never happen.

The Centers for Medicare & Medicaid Services, a division of the Department of Health and Human Services that administers Medicare and Medicaid, upheld a 2014 decision this summer denying Medicare/Medicaid certification to the nursing home.

The state is appealing but in the meantime, the determination leaves the state responsible for the full cost of the inmates' care.

The owner of the nursing home, SecureCare Options, receives $500 per patient, per day, a fee established at the time the patients were first admitted in May 2013, plus payment for services such as rehabilitation, that otherwise would be reimbursable.

As of Thursday, 58 patients were being cared for at 60 West St. All but three were placements by the Department of Mental Health and Addiction Services or Department of Correction, according to Gian-Carl Casa, undersecretary for legislative affairs for the state Office of Policy and Management.

I'm in search of long term care placement in a facility for a sex offender who also has medicaid as primary payer.

1-4-2015

I'm a social services assistant. I've had no luck with calling and asking the facilities that I am aware of. I would appreciate any advise.

Answer:

What state are you in? What is the primary ailment of the the person? Does he have dementia? Is he a veteran? If he's a vet, I would call the nearest Veteran's hospital to see if they have any referrals.

I'm in NC and I would contact the Murdock Hospital in Butner, NC. They treat and house many types of patients, even those who are inmates. I would imagine they have referrals for other psychiatric facilities. I think that's where I would start, since it may be difficult to obtain acceptance at a regular long term care facility.

You might also call your local jail and ask them where they send inmates who have mental health issues. If this person does not have mental health issues, but just age related decline or physical ailments, I'm not sure what I would do. That's a tough situation.

I'm curious as to what you find out.

Answer:

Proctor Hospital opened a geriatric psych unit in 2012. Either there or at Methodist Medical Center in Peoria.

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Medicaid: Information on Inmate Eligibility and Federal Costs for Allowable Services

10-6-2014 National:

In 2013, the Medicaid program financed health care services for more than 72 million individuals, and an additional 7 million beneficiaries are expected to enroll in 2014 as a result of states choosing to expand Medicaid eligibility as allowed under the Patient Protection and Affordable Care Act (PPACA). Most of these newly eligible individuals will be low-income adults, a population that may include individuals who are inmates in state prisons and local jails.

In the 27 states that opted to expand Medicaid eligibility as allowed under PPACA, the majority of inmates are likely to have incomes that would qualify them for Medicaid, a circumstance that did not generally exist before 2014, since Medicaid eligibility for adults has generally been limited to certain categories of low-income individuals, such as pregnant women and individuals who are aged or disabled. For example,