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The Gerontologist Advance Access published online on September 13, 2009
The Gerontologist, doi:10.1093/geront/gnp132
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© The Author 2009. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Florida's Model of Nursing Home Medicaid Reimbursement for Disaster-Related Expenses

Kali S. Thomas, MA1,2, Kathryn Hyer, MPP, PhD2, Lisa M. Brown, PhD3, LuMarie Polivka-West, MSP4 and Laurence G. Branch, PhD3

2 Florida Policy Exchange Center on Aging, School of Aging Studies, University of South Florida, Tampa
3 Department of Aging and Mental Health Disparities, University of South Florida, Tampa
4 Florida Health Care Association, Tallahassee

1 Address correspondence to Kali S. Thomas, MA, Florida Policy Exchange Center on Aging, School of Aging Studies, University of South Florida, 13301 Bruce B Downs Blvd, MHC 1300, Tampa, FL 33612. E-mail: kthomas{at}bcs.usf.edu


  Abstract

Purpose: This study describes Florida's model of Medicaid nursing home (NH) reimbursement to compensate NHs for disaster-related expenses incurred as a result of 8 hurricanes within a 2-year period. This Florida model can serve as a demonstration for a national model for disaster-related reimbursement. Design and Methods: Florida reimburses NHs for approved disaster-related costs through hurricane interim rate requests (IRRs). The state developed its unique Medicaid per diem rate temporary add-on by adapting its standard rate-setting reimbursement methodology. To understand the payment mechanisms and the costs that facilities incurred as a result of natural disasters, we examined the IRRs and cost reports for facilities requesting and receiving reimbursement. Results: Cost reports and IRR applications indicated that Florida Medicaid spent close to $16 million to pay for hurricane-related costs to NHs. Implications: Without Florida's Hurricane IRR program, many facilities would have not been reimbursed for their hurricane-related costs. Florida's model is one that Medicare and other states should consider adopting to ensure that NHs receive adequate reimbursement for disaster-related expenses, including tornadoes, earthquakes, floods, blizzards, and other catastrophic events.

Keywords: Public policy, Organizational & Institutional issues, Long-term care, Institutional care/residential care

Received May 22, 2009; Accepted August 12, 2009

Decision Editor: Kathleen Walsh Piercy, PhD


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