LONG-TERM FACILITY OF THE FUTURE DESIGN

Long-term facility of the Future Design

Abstract

Long-term care (LTC) services are financed by Medicaid, Medicare, private long- term care insurance, private out-of- pocket spending and appropriations under the Older Americans Act. (XHTML Tutorial 2007) (Despite what many Americans believe, Medicare is not a major payer for LTC, as discussed later.) Yet the majority of long-term care services aren't paid for at all. They are provided by 52 million unpaid caregivers - primarily family members and friends of those needing LTC. Their services, if paid for, would have cost an estimated $375 billion in 2007 - almost double what the federal government spent that year on Medicaid. LTC serves both people who are over the age of 65 and people under that age. (Scriven 2004)

Table of Contents

Introduction4

Discussion4

Cost And Financing Of Long-Term Care4

Medicaid4

Medicare5

Private Long-Term Care Insurance6

Out-Of-Pocket Spending7

Likely Policy Debates Financing7

Workforce8

Quality Of Care And Resident Directed Care And Services8

Disparities9

Tips For Reporters10

Story Ideas11

Conclusion18

References20

Long-term facility of the Future Design

Introduction

Long-term care (LTC) generally brings to mind images of nursing homes and older people living in them who can no longer care for themselves. In truth, long-term care comes in many different forms and is provided in many different settings.

Discussion

Cost And Financing Of Long-Term Care

In 2008, the average annual cost of a private room in a nursing home was more than $76,000. The average cost for an assisted living facility in 2007 was $35,628. (Monster 2007) These costs vary widely from region to region and are highest in the Northeast. Costs also vary by certification status, size and type of ownership of the facility.

Medicaid

Medicaid is a public health insurance program funded by federal and state governments. (HTML Tutorial 2007) Medicaid is a major payer for long- term care because federal law requires that Medicaid programs in every state must provide nursing home care and home health care for the qualified poor.

Source: US. Administration on Aging (2006). “FY2006 U.S. Profile of QAA Programs.”

Medicaid accounts for almost half of national long- term care spending. Of that amount, most is for institutional care, though spending for non- institutional care is growing and reached 37 percent of Medicaid's share of LTC spending in 2005. (Carey 2005) Though over half of those who use Medicaid long- term care services are over 65, a third (34 percent) are disabled children and adults under 65.9 Beyond the basic federal requirements, Medicaid LTC benefits vary from state to state. Home and community-based services (HCBS) are provided under Medicaid waivers in all states but the programs serve limited populations, and vary greatly in scope from state to state. Since 2007, under a provision of the Deficit Reduction Act (DRA) of 2005, waivers are no longer required for some home and community-based services, (XHTML Tutorial 2007) such as case management, homemaker/home health aide services, personal care services, adult day health, and habilitation services. (Austin 2008)

Medicare

Though many people think that Medicare covers long-term care, in reality it provides only limited coverage of nursing home stays and home health ...