Last week the New York Times discussed changes in the nursing home industry that may affect how some local residents conduct elder care planning. In a time when nursing home care is becoming more expensive–and Medicare and Medicaid funding shrinks–many facilities are experimenting with at-home models of care. Our New York elder law attorneys understand that the nursing home is a rarely the location that seniors would prefer to age if they had a choice. Now, however, many health care experts and senior advocates are joining the call and explaining that nursing homes are rarely medically necessary or financially smart.
Instead, more and more resources are being put into advances in home care. Instead of living in an institutional-like facility, the new model essentially uses traveling doctors, social workers and therapists to provide care at the senior’s home or adult day-care centers. An at-home senior care program run by CenterLight Health System in New York City now has over 2,500 participating residents. New York State Medicaid program director Jason Helgerson explained that in the past the state “was institutionalizing service for people, many of whom didn’t need 24-hour nursing care. If a person can get a service like home health care or Meals on Wheels, they can stay in an apartment and thrive in that environment, and it’s a lower cost to taxpayers.” It is no surprise then that the state of New York plans to shift upwards of 80,000 Medicaid participants into at-home, managed care models over the next three years.
The Archdiocese of New York–one of the state’s largest nursing home providers–recently announced a shift away from nursing home ownership. In the announcement, Cardinal Timothy Dolan explained, “Seniors and others who have chronic health needs should not have to give up their homes and independence just to get the medical care and other attention they need to live safely and comfortably.”
Though still early, initial studies suggest that these at-home managed care situations both provide better care and cost less. All those working on New York elder law understand that quality, low-cost care is going to become increasingly prized in the next few decades. The aging of the population will demand a sharp increase in elder care services. It is highly unlikely that the demand can be met by sticking with the brick-and-mortar, old-fashioned nursing home model. In fact, nationwide, over the past six years the total number of nursing homes has actually declined by 350. Right now there are 634 New York nursing homes, a decrease of 15 homes in the last five years.
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