The $1 billion Medicaid misstep

A recent state audit found that only 49% of the nearly $1 billion in federal Medicaid funds spent on government-owned nursing homes between 2016 and 2024 was used for care , with the remaining 51% kept by the hospitals for administrative costs and other expenses. State Auditor Tina Cannon described this as 'outrageous' and 'not reasonable.'

According to the audit, the Upper Payment Limit program intended to improve the quality of care in these nursing homes. However, the investigation revealed that the funds were not being used as intended.

As Utah's population ages,the state's elder care systems are becoming increasingly important. The lack of transparency and accountability in the use of Medicaid funds is a major concern for advocates and lawmakers.

Understaffed and at risk

About a third of Utah's nursing homes are understaffed, with 'below average' or 'much below average' staffing ratings from the Centers for Medicare and Medicaid Services (CMS). this understaffing puts residents at higher risk of neglect and abuse.

The investigation found that understaffing is a major issue in Utah's nursing homes, with many facilities struggling to provide adequate care to their residents.

Advocates are calling for a minimum staffing standard to address understaffing and ensure that residents receive the care they need.

The wandering epidemic

Hundreds of older adults have wandered away from long-term care facilities in recent years, often with cognitive deficits like dementia. Nearly 230 cases of such incidents have been identified since 2019, based on a combination of federal nurrsing home inspection reports, police reports, call logs, Silver Alerts, and news coverage.

The investigation revealed that wandering incidents are a major concern in Utah's long-term care facilities, with many residents at risk of harm or exploitation.

Advocates are calling for increased transparency and accountability in the reporting of wandering incidents, as well as improved training and support for caregivers and families.

The barriers to reporting

The investigation also revealed that long-term care residents and their families often face significant barriers to reporting neglect, abuse, and exploitation. This lack of reporting can lead to further harm and suffering.

Advocates are calling for increased transparency and accountability in the reporting of neglect, abuse, and exploitation, as well as improved support for caregivers and families.

The investigation found that many residents and families are reluctant to report incidents due to fear of retaliation or fear of being labeled as 'difficult' or 'problematic'.

What auditors flagged in the May filing

The state's Medicaid program covers about 80% of the cost of long-term care services for older adults. However, the program has faced criticism for not covering all necessary services, leaving residents and their families with significant out-of-pocket costs.

According to the investigation,the Medicaid program has been criticized for not providing adequate coverage for necessary services, such as dental care and vision care.

Advocates are calling for increased transparency and accountability in the Medicaid program, as well as improved support for caregivers and families.