Trends in Long-Term Care - U.S. Senate Special Committee on Aging

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If you notice, there is a wide variation of costs aga<strong>in</strong>, and if you
also notice, contracts are consistently higher than noncontracts.
I don't know why. Probably they sell them on better service or someth<strong>in</strong>g;
however, I can say that we do have deficiency reports on the
various homes, which show that the beds are not changed. That is a
lot of l<strong>in</strong>en for beds that are not changed.
We are also told, as the reason for higher cost of l<strong>in</strong>en, that we have
more people, a greater percentage of our people are <strong>in</strong> beds than are
<strong>in</strong> other homes, stay <strong>in</strong> beds, not ambulatory patients.
If you take a look at the first three bars, the one on the left is the
highest cost. They have 18 percent of their patients not ambulatory,
and the one on the right of those first three bars, has 63 percent of
their patients nonambulatory.
Yet their costs for l<strong>in</strong>ens are far less than the one only for 18
percent.
More people are <strong>in</strong> bed all the time, but it costs them less money to
ma<strong>in</strong>ta<strong>in</strong> than it does at the other home.
Here is, I would say, a pretty phenomenal example of it, the same
th<strong>in</strong>g, 34 percent of the people <strong>in</strong> this home are nonambulatory, 28
percent of these people are nonambulatory, this would be more like it,
except this is a 128-percent difference <strong>in</strong> the cost, where a 6-percent
difference <strong>in</strong> the number of people exists.
Aga<strong>in</strong>, I have no answer, only questions.
Senator Moss. Well, thank you, Mr. Lee.
That poses some questions there that will take some ponder<strong>in</strong>g, as
to why those differences exist, and it <strong>in</strong>dicates that there is not any
standard that is fairly well accepted throughout the nurs<strong>in</strong>g home <strong>in</strong>dustry
on costs like l<strong>in</strong>ens, and ma<strong>in</strong>ta<strong>in</strong><strong>in</strong>g a bed, and th<strong>in</strong>gs of that
sort.
Mr. LEE. That is correct, Senator. There is no real valid explanation
for the variation of costs with<strong>in</strong> a* 50-bed home and a 150-bed home.
There is no explanation of it at all, for a 400- or 500-percent variation.
Senator Moss. To what extent are people, are patients <strong>in</strong> nurs<strong>in</strong>g
homes able to remove themselves, if they want to go to another nurs<strong>in</strong>g
home?
I realize we are talk<strong>in</strong>g of old, sick people, but suppose there is one
that is bad, and they know of one down the street that is better, to what
extent can they change their place?
Mr. MOAN. I th<strong>in</strong>k I could answer that a little better.
A few years ago, there was a study performed. which I do not th<strong>in</strong>k
was ever released publicly, which was done. as to the rights, or the
perceived rights of the people <strong>in</strong> a nurs<strong>in</strong>g home, and the people <strong>in</strong>
the county jail.
The results of that test, or that survey, was that prisoners <strong>in</strong> jail
felt they had more rights of freedom than do patients <strong>in</strong> nurs<strong>in</strong>g
homes.
We have received letters from people sav<strong>in</strong>g. please help me get out
of this nurs<strong>in</strong>g home, <strong>in</strong>dicat<strong>in</strong>g that the people <strong>in</strong> nurs<strong>in</strong>g homes, the
patients believe they cannot leave, and believe they have no freedom
of choice.
That fact, their right to leave, their right to choose a nurs<strong>in</strong>g home,
are never brought to the awareness of the patient, and as a practical