Legislation that would extend the discharge notice period to Wisconsin nursing facility residents who need to relocate could end up in the “unintended consequences” category of laws.
Senate Bill 155 would extend the notice period from 30 days to 90 days, but long-term care advocates in the state say the longer period could force facilities to cut off negotiations with managed care organizations (MCO) sooner to meet the proposed deadline.
Although a resident’s spend-down and then transfer into Medicaid more often happens in assisted living environments, nursing homes are also vulnerable, said Rick Abrams, CEO of the Wisconsin Health Care Association/Wisconsin Center for Assisted Living.
“Most times it works because everyone’s focused on the same goal: keeping the resident where he or she is,” Abrams told McKnight’s Long-Term Care News Friday, referring to the negotiations between facilities and MCOs. “But the longer the timeframe for notice, the less likely they are to keep negotiating. What [lawmakers] may be doing is creating an environment where it’s less likely that both sides will keep negotiating.”
Seeking exceptions
Abrams said he understands the bill was introduced with good intentions. Hearing that a loved one needs to find a new residential facility can be a stressful time for patients and their family members. But, increasing the discharge notice period may not accomplish what sponsors intend, he warned.
Nursing facilities in Wisconsin must get approval from the Division of Quality of Assurance — part of the Department of Health — for any resident transfer plans, whether the move is due to negotiations over Medicaid breaking down or because a facility is closing.
“That resident will not be discharged until a suitable community placement is found,” Abrams explained.
Exceptions to that include residents who become a danger to themselves, other residents or staff, or if a facility cannot provide the level of care required. Abrams said his association is advocating for an amendment that would preserve discharge exceptions.
“What if a facility has to close because of funds,” he said. “You don’t want the residents staying there for any longer than they have to if the facility is under-resourced and not receiving the care and services they need because the facility cannot provide them. This is more a complicated issue than simply increasing the notice of discharge from 30 to 90 days.”
The discharge legislation is currently pending in the Wisconsin state Senate’s Committee on Health, which held a hearing on it last month.
