Florida's hospitals are spending tens of millions of dollars a year to provide ventilator-based care because nursing homes do not receive incentives to care for such patients.
In just two cases, patients ran up bills totaling $11 million, the St. Petersburg Times reports. Both had been stabilized and no longer required acute care, but their respective hospitals could not find nursing homes that would take them.
There are only about 20 nursing homes in all of Florida that can care for ventilator-assisted patients--for a population of nearly 20 million residents. The facilities do not receive incentive payments to care for such patients. Menwhile, Medicaid payments for inpatients end after only 45 days, making it cheaper for the state government over the long run to keep them in hospitals, which mostly are tasked with collecting payment from the patients' families or estates.
"The bottom line is, ventilator care is real expensive," said Erwin Bodo, a consultant and former head of the Florida Association of Homes and Services for the Aging, which represents long-term care facilities. "Most facilities literally cannot afford to take a ventilator case," he told the Times.
In Maryland, where a premium is paid to nursing homes for nursing cases, the main lobbying group for nursing homes estimates that it costs $925 a day more to provide such care in an acute care hospital--nearly $340,000 a year, in total.
Florida lawmakers occasionally have paid nursing homes to care for ventilator patients, but most observers believe that is not likely to continue due to the current fiscal environment.