Louisiana Rejects Proposal to Shift Skilled Nursing Residents to Home Care

The Louisiana Legislature on Tuesday rejected a bill that would have shifted the state’s long-term Medicaid model to a managed care system in an attempt to move more skilled nursing residents to the home-care setting.

The Senate Health and Welfare committee voted down Senate Bill 357 in a 6-2 vote, The Advocate of Baton Rouge, La. reported. The bill would have allowed Louisiana to use private insurance companies to make decisions about whether Medicaid recipients should be cared for in their own homes, with support and staffing, or in a nursing home.

Committee Chairman Sen. Fred Mills, who owns an interest in a nursing home, and other senators raised concerns about the reliability of managed care as a way to deal with seniors, even though most of the state’s Medicaid population is on managed care.


In the state, 28,000 people are on a waiting list for home-based staffers who provide assistance with tasks such as cleaning and cooking, according to The Advocate.

Supporters of SB 357 said the bill would be revenue-neutral, at minimum, but was likely to produce savings for the state over the next few years because Louisiana charges managed care companies a 5.5% tax — which could potentially result in $100 million in revenues.

State Sen. Jay Luneau  was skeptical of that claim and expressed concern about diminishing care for the elderly, as seniors receive more limited hours of help from home health providers, compared with 24-hour assistance within walking distance in nursing homes.


The bulk of Louisiana’s Medicaid funds go to nursing homes in the state, with skilled nursing facilities receiving $8.7 billion and payments to privately-operated Medicaid nursing facilities growing by 54% between 2006 and 2016, according to a Louisiana Legislative Auditor’s Office report. Occupancy rates rose by less than 1% in that time period.

The Louisiana Nursing Home Association, which represents 250 nursing homes in the state, argued SB 357 would lead to a reduction in care quality. The state’s nursing homes, however, rank among the worst in the U.S., according to the AARP’s 2017 long-term care scorecard The Advocate said. They also have financial protections ensuring regular rate increases, the publication added.

“Today, many members chose to ignore the tens of thousands of older adults in their districts who want to live at home, while offering no alternative or plan to help them,” AARP of Louisiana lobbyist Andrew Muhl told the paper.

Written by Maggie Flynn

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