4 Things You Should Know About Today’s Nursing Homes

Nursing home written on a sticky noteCurrently there are more than 1.1 million Americans residing in nursing homes (over 19,000 in Connecticut) and it is estimated that more than 3,000 new nursing homes could need to be built to keep up with demand.

Among the factors leading to the need for increased high-quality nursing home facilities and care are industry-wide staffing shortages, rising costs, and an aging (baby boomer) population.

Consider these expected population trends and the nursing facility numbers in Connecticut and nationwide:

Whether you find yourself or a loved one in a situation where nursing home care may be the only viable option, there are some things you should know.

1. Know and understand the different types of nursing homes and care facilities.

Nursing homes, also known as skilled nursing facilities, offer round-the-clock medical care and are generally required for people in need of full-time assistance – most often elderly, chronically ill or people living with disabilities. Assisted-living facilities differ in that they help people in need of daily medical and self-care, but not to the level offered in a nursing home.

Continuing-care communities offer different levels of care depending on need.  For example, today’s continuing-care community may house multiple areas including those able to live independently (like a retiree college campus); another area that is an assisted-living wing; and yet another wing like a nursing home setting that may include memory care or other traditional nursing home services.

Nursing home facilities can also vary in that some offer both long- and short-term care options.  While the average length of stay in a Connecticut nursing home is 2.5 years, others may enter a nursing home to rehabilitate from an operation or other medical issue and stay for a shorter time.

2. Nursing home care is expensive – especially in Connecticut.

According to a 2021 Cost of Care Survey by Genworth, the average private room in a nursing home costs $297 per day, or $9,034 per month; semiprivate rooms had a median cost of $260 per day, or $7,908 per month. Meanwhile in Connecticut, which has the second highest nursing care costs in the country, the average monthly cost for a semi-private room runs about $13,764, while a private room’s average cost is over $15,000.

Nationwide, about half of the total nursing home costs are paid by Medicaid, but in Connecticut, as of 2022, Medicaid remained the dominant source of payment, covering 71% of residents. It is important to note that Medicare pays for up to 100 days of care per benefit period but longer stays are not covered by Medicare or private health insurance, although they may be covered by long-term care insurance or Medicaid.

The best way to prepare for long-term care costs and to help protect your assets is to start planning early.  You may be able to hold on to more assets than you think and prevent all your money from going to the nursing home. But first you’ll need to understand the rules and timing of Medicaid planning, so it is highly recommended to work with a qualified elder law attorney.

3. Use Available Data to Help You Find a Quality Nursing Home.

AdobeStock_576126046-300x200Nursing homes are required to provide data on a large range of items related to their care.  One statistic that should be paid attention to is staffing. Unfortunately, more than half of U.S. nursing homes have lower nurse staffing levels than what is recommended, and one-quarter also having dangerously low staffing overall. According to the National Consumer Voice for Quality Long-Term Care, there should be over 4.1 hours of nursing care per day for each resident, yet only 26% of nursing homes are able to provide that level.

One source to find nursing home information along with a ratings system (5 stars being the best) is www.medicare.gov/care-compare.  Among the categories that are monitored and compared are COVID vaccination rates, emergency preparedness, staffing and turnover, and health inspections.  Another source of helpful information is the AARP’s nursing home checklist which helps you ask the right questions.

4. Take Notice of a Nursing Home’s Form of Ownership.

Research has shown that a nursing home’s ownership type makes a difference in the quality of care given to residents.  According to Kiplinger’s July 2023 Retirement Report about 70% of U.S. nursing homes are operated for profit, about 25% are nonprofit, and the remaining are owned by government entities.

While there are pros and cons under each ownership arrangement, in general, nonprofit nursing homes have better staffing levels, averaging 4.28 hours of staff attention per resident per day, while for-profits averaged 3.56 hours. Research conducted by Weill Cornell Medical College also indicated that nursing homes owned by private-equity firms (which comprise an estimated 5% of for-profit ownership) offer lower quality long-term care, including an increased rate of short-term mortality and higher COVID infection and death rates.

AdobeStock_412490214-300x200In addition to some of the factors included here, it is also important to remember that:

  • Nursing homes need help from the outside too as families and loved ones are essential support systems for the patient and the facility. A nursing home is a resident’s home and that means a family caregiver cannot be prevented from being with them.
  • Reforms to the industry may be afoot. Recently, the Biden administration has introduced efforts to improve overall nursing home care including more transparency in ownership and calls to create minimum staffing requirements.

While having a loved one be able to age in place is often preferable, utilizing a nursing home may still be necessary for some people. Therefore, to select the best possible nursing care environment for someone in need that you care about, it is helpful to educate yourself about different nursing home choices, use reliable available data to do your research, plan ahead financially and legally to the extent possible, and be willing to provide and accept help as needed.

If you need help with planning for long-term care, please contact our attorneys.  We would be happy to discuss your options and form a plan for the future.

Related Posts:

A Good Reason NOT to Sign a Nursing Home Agreement for a Loved One While You’re At the Nursing Home

How to Stay Out of a Nursing Home (And Get the Care You Need at Home)

Nursing Home Rights: Know Them, Stand Up for Them

Beware of Signing a Nursing Home Agreement

Making the Right Move: Understanding the 6 Senior Living Options

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