A Better Solution for the Quality of Long-Term Care

Yesterday, representatives of the National Senior Citizens Law Center (NCSLC) hosted news conferences in Kansas City, Columbia, and St. Louis to bring attention to the dubious quality of many of Missouri’s long-term-care nursing home contracts.

The group argues that many of these contracts violate minimum care obligations, which are mandated by state and federal law. For example, many nursing home contracts limit the facility’s responsibility for their residents’ health or personal items, and also require a resident’s family or friends to accept personal financial liability for long-term care. Though these requirements do not necessarily violate existing law, they are fine-print issues that trap the families of many residents with unexpected bills.

I have no doubt that there are nursing home abuses. But I always question why the most effective response to such abuses is a legislative one. There are two negative effects that come out of every "minimum care" piece of legislation Missouri passes: 1) It mandates certain levels of service that may or may not be important to actual nursing home residents and their families, thus driving up overall nursing home costs; 2) It encourages many nursing homes to lower their standards to the "minimum state requirement," adversely affecting the overall level of nursing home care.

Many violations highlighted by the NSCLC are well-publicized issues that consumer groups have encouraged families to be aware of. There are also elderly law consumer advocacy groups that offer pro-bono legal advice for help in finding nursing home contracts that properly meet a family’s individual needs.

The St. Louis Business Journal reports that St. Louis nursing home costs are the second-lowest in the country, with an average annual cost of $42,877. Nationally, the annual cost of nursing home care is $65,200, with average annual costs in some states reaching as high as $191,385. These are not small fees, and I would expect that many residents struggle to stretch their savings to cover that cost during 10 or 15 years of potential care. By passing additional minimum care laws, we risk pushing those costs even higher, forcing many elderly Missourians to forego nursing home care altogether.

I sympathize with the NSCLC — it’s disturbing to think of nursing home abuse. But passing new legislation (or even enforcing existing legislation) is not the answer. It’s great to promote consumer advocacy and raise awareness. It’s important to provide legal aid to families that helps ensure they enter nursing home contracts that properly reflect their needs. But mandating minimum levels of service will only increase costs that are already inflated, while ensuring an overall decreased level of care. And that will do nothing to provide better care for Missouri’s elderly population.