many Kentucky families drive for hours

Senior citizens from Northern Kentucky are increasingly being forced into nursing homes in Southwest Ohio, leading to a stream of loved ones and federal money crossing the river, an Enquirer investigation has discovered.

This results in Ohio taxpayers picking up nearly half the costs and many of the displaced Kentuckians getting fewer visits from relatives forced to make long drives.

Boone, Campbell and Kenton counties have fewer than 1,500 nursing home beds certified for Medicaid/Medicare patients, an offshoot of what some say is an outdated nursing home certification process by the state. The situation is even worse for patients with conditions such as dementia and Alzheimer’s, with only a handful of qualified spots for such patients in Northern Kentucky.

That contrasts sharply with the four main Ohio counties of Greater Cincinnati, which have a large surplus of nursing home facilities and nearly 12,000 certified beds, including several specializing in patients with declining mental health.

So even though these individuals may have spent their entire lives in Northern Kentucky, Ohio is picking up the bill – at least for Medicaid patients. Nearly 90 Medicaid patients from Boone, MileWeb Exclusive Features Campbell and Kenton counties had to leave the region to find a bed in 2011, a number that has climbed over the last two years, according to experts. And that number does not include the many patients on the federally supported senior health care system Medicare heading across the river to find a nursing home bed.

β€œI deal with up to 100 families a month, and I would say that between 10-20 percent wind up going across the river,” said Ron Culyer, president of Fort Thomas-based CarePatrol of Northern Kentucky, a nursing home referral and placement service.

Exact numbers on the cost aren’t available, but by some calculations, Ohio is paying more than $6 million annually for Kentucky Medicaid patients (with about 60 percent of that coming from federal funds and the rest from state coffers). That’s money Ohio shells out based on the average daily allotment given nursing homes.

Beyond the money involved, many Kentucky families drive for hours to tend to their loved ones across the river, meaning patients may not get as many visits as normal.

For Paul Smith of Taylor Mill, it means he can make the two-hour round trip to see his father at a Mount Healthy nursing home only about once a week.

β€œThe best nursing home is the one that makes it easier for families to visit their loved ones, and right now, the system certainly makes this hard,” said Ken Rechtin, executive director of Senior Services of Northern Kentucky, a Covington-based nonprofit assisting the low-income elderly.

The lack of beds is especially pressing in Boone and Campbell counties, two of the state’s fastest-growing areas. Boone County has only 26 certified beds per 1,000 residents older than 65, and the number in Campbell is 34 per 1,000, according to Miami University’s Scripps Gerontology Center. The national average is 42 per 1,000, and the statewide average in Kentucky is 44. Center officials say a good standard is at least 40 beds per 1,000.

Meanwhile, Butler, Clermont, Hamilton, and Warren counties in Ohio all have more than 60 certified beds per 1,000 residents over 65. The four counties have nearly 12,000 certified beds, according to the Ohio Department of Aging. Many of the recently constructed β€œassisted living” facilities are taking in Medicaid patients from wherever they can get them, and some Ohio facilities actively market their openings to customers in Northern Kentucky.

Unlike Ohio, Kentucky requires potential nursing home operators to go through a β€œcertificate of need” process, which officials say keeps Medicaid costs down and makes sure supply meets demand.

β€œIf you wanted to be cynical, you could also say that Kentucky probably doesn’t mind very much that people are leaving the state, because then they don’t have to pay for those patients,” said Robert Applebaum, director of the long-term care research project at the Scripps Center.
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