Last week the United Hospital Fund published a comprehensive new report that examines how nursing home care in New York has changed in the last two decades. The report is a good read for all New York families who are seeking to better understand how these facilities operate and what options are available today for loved ones in need of extra help on a day-to-day basis.
The main take-away from the study is the fact that nursing homes in New York are evolving from “primarily providing residential care for seniors to focusing on both post-acute services and long-term care today.” Put another way, these facilities are providing more diverse services, helping those who need short-term rehabilitation aid as well as providing more permanent homes for those with chronic medical issues.
In addition, since the 1990s, nursing homes have become more and more integrated with many other services.
Demographic details are also changing. According to the study, as a percentage, fewer New Yorkers over eighty five years old are relying on nursing home support now than in the past. This is likely a product of more diverse options and expanded home health support for this group. Nursing homes are no longer the only game in town.
Coinciding with this change, the nursing home population itself seems to have more severe medical issues now than in the past, including more “functional limitation, chronic disease, mental illness and obesity.” This detail goes hand-in-hand with the reality seniors have more options. It is becoming more and more common for only those seniors with the most severe ailments to have long-term stays in these skilled nursing facilities.
Interestingly, the report also noted how the New York Medicaid system is still, by far, the larger payer of this care. The study notes that about 76% of all nursing home payments are made by Medicaid. Medicare payments have also increased–as a result of more short-term stays–but the primary role of Medicaid remains. It is for this reason that all New Yorkers are advised to plan as early as possible to protect assets from the risk being lost with the “spend down” requirement imposed by Medicaid.
The entire study, viewed for free online here, is worth a look.