While many states have expanded their Medicaid home and community-based services (HCBS) for frail older adults, others continue to steer many enrollees into nursing homes. One big reason: They fear that enhancing home supports will encourage more older adults to enroll in Medicaid long-term care services (LTSS) and increase state costs. But a new study published in the Journal of [...]
We are beginning to learn which nursing homes are most likely to be hit with COVID-19. And while studies are preliminary and based on very limited data, they tell a troubling story: Location and the race of residents matter a lot. But they also tell a surprising story: Quality (at least as measured by Medicare), the share of Medicaid residents, [...]
The headlines are eye-opening: On Friday, the Kaiser Family Foundation reported that, as of as of April 23, there were more than 10,000 reported deaths from COVID-19 in long-term care facilities—in just the 23 states that publicly report this information. That may be shocking. But it should not be surprising. COVID-19 has exposed and amplified our profoundly flawed system of [...]
Last week, I suggested that in the wake of the coronavirus pandemic, nursing homes may need to take patients from over-burdened hospitals. At the same time, care settings such as assisted living facilities (ALFs) might have to accept nursing home residents who must be relocated to make room for those post-acute patients. Now, it looks like that is beginning to [...]
Large multi-agency, multi-state hospices are fast become the primary source of end-of-life care in the U.S. According to a new study, chains cared for nearly half of all hospice patients in 2011, a dramatic increase from a decade before when small organizations (mostly non-profits) provided three-quarters of all care. And my own review of their financial reports suggests the biggest chains [...]
Assisted living facilities (ALFs) may be going the way of cable TV. Still around, but with a limited future. Their residents are changing. Even as their needs become more complicated, they are demanding less institutional-like care. At the same time, assisted living will have to find its place in a world where medical and social care are becoming better coordinated [...]