West Virginia Health Care Authority
2003 Long Term Care Task Force

The West Virginia Health Care Authority established a public-private Long Term Care Task Force during January-September, 2003 to review the long term care system and determine the current supply and future demand for the next 20 years. The Task Force used a long term care definition that included both nursing home and assisted living facilities and addressed three regulations governing long term care in the State: West Virginia Code, the 1982 West Virginia State Health Plan and Senate Bill 405.

• § 16-20-5 of the West Virginia Code states no hospital, nursing home or other health care facility shall add any intermediate care or skilled nursing beds to its current licensed bed complement.
• The Long Term Care Chapter of the 1982 State Health Plan uses a 30 nursing home beds per 1000 population age 65+ need formula and the Statewide Traffic Assignment Model (STAM) zones to identify the State’s Long Term Care Regions.
• Senate Bill 405, effective March 08, 2003, changed personal care homes and residential board and care homes to be assisted living residences. In an assisted living residence four or more individuals receive supervised personal assistance for walking, bathing, dressing, feeding or getting out of bed because of age or mental impairment and receive nursing assistance for not more than 2 hours of nursing care per day for a period of time no longer than 90 consecutive days per episode.

The Task Force reviewed relevant statistics, developed provider inventories, conducted an assisted living survey, reviewed long term care need methodologies, performed analyses and modeled projections to assist with their discussions about policy issues. Areas of policy focus related to the long term care delivery system to include the impact of current and future program eligibility, sources and use of reimbursement and regulatory functions.

Task Force findings determined Medicaid is the largest source of nursing home reimbursement; a nursing home bed construction moratorium has existed since 1988; the ratio of nursing home beds per 1000 age 65+ population was 35.1 in 2002; a voluntary nursing home bed reduction removed 199 beds from the available bed supply during June, 2000-June, 2002; a 95% occupancy level promotes nursing home viability; assisted living is not available in 20 counties; hospitals provide over 1000 skilled or swing beds available for long term care; the ratio of WV Medicaid Waiver slots to nursing home beds is 53%; and in 2020, 18.47% of the West Virginia population is expected to be over age 65.

At the last Task Force meeting two recommendations were developed.

The Bureau for Medical Services should review the reimbursement policies for nursing facilities, with consideration for service to the behavioral health population and additional staff training.

The West Virginia Health Care Authority should have further discussions with the Bureau for Medical Services and the Office of Health Facility Licensure and Certification to address the current and future treatment of closed nursing home beds.

More information about the Long Term Care Task Force is available here.

For the Task Force Membership, click here.