On December 7, NPR had a short segment during Morning Edition describing the impact of lack of staffing — and therefore lack of “beds” — in nursing homes and rehabilitation care facilities, which in turn means hospitals are stuck keeping the patients. Further, Medicaid often won’t pay for hospital care for individuals who “only” need nursing home care.
Listen to the 3-minute segment that uses hospitals in Vermont as the focus: Limited Nursing Home Beds Force Hospitals to Keep Patients Longer.
The story hints at several subtle issues, including Medicaid funding priorities, especially as Medicaid involves joint federal/state funding, and how health care handles “inability to pay” by residents. This last semester I’ve taught a stand alone course on Nonprofit Organizations Law and students are often surprised to learn that the single largest — and highest income — segment of the nonprofit world is health care, especially hospital-based health care. Students ask how a “charity” accounts for earnings and losses — and we discuss the fact that no organization, nonprofit or for profit, can afford to operate very long without adequate revenues to stay solvent. The NPR story reflects a theme that my course often raises — what does it mean to be “charitable”?