Data Reveals Access Crisis For Maryland Families Seeking Home Care Nurses For Disabled Patients

Thursday, October 4, 2018 Nursing Profession News
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Rural residents have the most difficulty filling home nursing hours prescribed by physician

BALTIMORE, Oct. 4, 2018 /PRNewswire/ -- The State of Maryland has uncovered data demonstrating

that families authorized to receive home nursing services for their children and loved ones living with severe disabilities are often unable to access the care that has been prescribed by their doctors.

A task force appointed by Gov. Larry Hogan to study "access to home health care" for medically disabled children and adults in Maryland released data at a meeting last week disclosing that families are only able to receive home nursing services for 83 percent of the hours prescribed and authorized to meet the medical needs of patients.

"Physicians have determined that home nursing care is needed for these patients to live safely at home with their families, but too often nurses aren't available," said Shannon Grace Gahs, a Maryland resident who works for BAYADA Home Health Care. "For people who have significant medical disabilities, who have multiple seizures an hour, who have rare metabolic disorders, who are reliant on technology to breathe or eat—home health care is the only way they can remain at home with their families and out of institutions. Every hour they go without care puts their health and safety at jeopardy. We are finding that they can't access this care nearly one-fifth of the time."

The state data indicates that availability of home nursing services vary by county, with families in the rural locations having a more difficult time filling home nursing hours.  For instance, in 2017 families could only fill 63% of the prescribed hours in Somerset, 66% in Worcester, 73% in Carroll, 74% in Queen Anne's, 76% in Frederick, 76% in Calvert, 78% in Harford, 79% in Charles, 79% in Kent and 79% in Washington counties.

Patient advocates and providers say Maryland's access problems stem from the state's low Medicaid reimbursement rate for home nurses, which are substantially less than surrounding jurisdictions, creating opportunities for nurses to make more money crossing the state border and taking jobs in those locations.  Patient advocates, as well as nursing providers, are seeking a boost in the reimbursement rate for home nurses. Last spring, the General Assembly passed legislation calling for a task force to study the issue, and Gov. Hogan authorized it.

"With a growing shortage of nurses and increasing opportunities for nurses, I would say they are going to follow the money," Dawn Seek, executive director of the Maryland-National Capital Homecare Association, told The Baltimore Sun in a front-page story on September 16.

In the same article, Jill Pelovitz, of Severn, said she depends on several at home nurses to care for her teenage daughter who suffers from a rare genetic disorder that causes life-threatening seizures, breathing problems and other complications.

"We are always wondering at what point a nurse is going to go somewhere else where they can make more money," Ms. Pelovitz said in the article.

Another parent, Mia Matthews of Baltimore, told The Sun how disruptive it is when nurses don't show up for their shift.  She received care for daughter, Channing, until the 2˝-year-old died last spring.  Channing suffered from severe breathing difficulties, and needed 24-hour care to assist with a ventilator and tracheostomy tube.

"Some nurses didn't show and we would have to stay up all night," Matthews was quoted as saying in The Sun. "It was just something we had to do."         

Ms.  Matthews attended the task force hearing, stressing the need to improve both the availability and the quality of home nursing care through a reimbursement hike and increased training requirements.

During the task force hearing, Alyssa Brown, Deputy Director of Planning Administration at Maryland's Office of Health Care Financing, presented data showing that over the last 10 years the Medicaid reimbursement for home nursing care had only increased from $31.64 to $35.20, making the state's current rate lower than reimbursements in D.C. ($50), Pennsylvania ($44.08), and West Virginia ($44.08). Other data has shown that Delaware also has a higher reimbursement rate than Maryland.

"Nurses are going to take $10 an hour more, especially in areas of the state where they can just drive 30 minutes or so across the border to take the higher paying assignment," said John Warmkessel, a business development specialist at Professional Nursing Services.  "We've been fighting this battle for higher reimbursement rates for a long time.  The fact that there is a task force studying the issue is progress."

Nicole Landers, Assistant Director of Nursing at Comprehensive Nursing Services, noted that the minuscule reimbursement increases over the last 10 years haven't kept up with inflation, adding that the quality of care is impacted when there is a smaller pool of available nurses.  "When we don't have enough nurses to send out, it impacts quality. This is what we have experienced over our many years of providing nursing care in Maryland."

Contact: Michael K. Frisby 202-828-1242/


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SOURCE BAYADA Home Health Care

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