Will There Be A Nursing Home Shortage? Part I

In the beginning...

From time-to-time, while researching topics for these blog posts, I encounter articles which jumble together all manner of facts and figures and end up delivering anything but a meaningful conclusion. Although I normally dismiss such flotsam, this past week the online newsletter The Fiscal Times published,  "The Coming Nursing Home Shortage" a confusing article asserting that reduced construction of nursing homes and the arrival of aging baby boomers will (inevitably) result in a shortage of capacity in nursing homes.  Although I believe the more relevant question is whether the entire elder care services infrastructure (i.e. home and community based services, assisted living and skilled nursing facilities) will be sufficiently robust to accommodate future needs, if the highly regarded Kaiser Health News found the article interesting enough to reprint (which they did), then I think it is worth my trouble to explore the subject a bit further.

Although article was national in scope, since Illinois is one of the 10 states (ranked seventh) which together account for 54% of the population over the age of 65, it seems reasonable to rely on Illinois trends for purposes of evaluating the article's claim.

Who decides where/when SNF's are to be built in Illinois?

In Illinois, to build a nursing home (i.e. SNF) one must first obtain a certificate of need  (CON) from the Illinois Health Facilities and Services Review Board. The Review Board is comprised of nine members, appointed by the Governor and confirmed by the Senate and its job is to assure that a proposed project is needed and financially and economically feasible. In general, the CON process allows the state to limit its overall health and medical expenditures and about 36 states still have CON laws. Unfortunately, the article failed to address whether applications for  CONs are trending up, down or constant. I think that is strike one against the theory of an impending shortage.

In the 2011 annual Illinois Long-Term Care Services Inventory, the Review Board projected that 105, 398 SNF beds will be needed to meet demand in 2018: an increase of approximately 2,500 beds (or 3%). However, this does not take into account that average nursing home occupancy in Illinois is currently 88%, which means there are currently over 10,000 empty SNF beds in the state. From 1995 to 2002, the number of nursing home beds in Illinois increased 2% (here), and in 2002 Illinois ranked 24th in the number of nursing home beds (100.3) per 10,000 population. So far, it doesn't appear that much of shortage will occur in the near future. I'll consider this strike two against the article's conclusion.

More reasons on why worries of future insufficient nursing home capacity are overblown in Part II.

What do you think?

Follow me on twitter: @aginginchicago





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  • Hi Bruce,
    My husband works for the The Renaissance Collaborative, an organization that has built the first of three planned senior housing buildings. The current building is for active seniors. The second building on the drafting table is for seniors raising grandchilren. If you look at the alarming stats on the increase of grandfamilies, I think you might agree that we should address that first.

    I also think we should spend time assessing how to allow people to stay in their own homes with support services. Not to mention the fact that we need to prompt seniors to stay independent as long as possible by staying healthier.

    Last but not least, please take a look at my latest blog post on Chase kicking a grandmother of 78 out of her home.

    Thanks for dealing with senior issues.

  • In reply to Danie:


    Thank you for you comments. The projects you describe sound very exciting.

    Please follow me on twitter @aginginchicago

  • Unfortunate as it may be, statistics hint that America's increase incidence of diabetes and heart disease may solve this problem.

  • In reply to Andy Frye:

    Mr. Fry,
    Thank you for your comment. Although both diagnosis can lead to decreased life expectancy, they can also lead to increased likelihood of long-term care placement. Please keep reading my blog and follow me on twitter @aginginchicago

  • Whenever the government controls supply it's guaranteed to lead to disaster so we're doomed. In addition, despite high unemployment, try getting someone to take care of your aging parents at a reasonable cost.

  • In reply to Gary Lucido:

    Mr. Lucido,
    Thank you for your comment. Certified nursing assistants are trained health care workers who do very difficult work (CNA's have among the highest rates of injuries of all job classifications) for very modest pay. It isn't surprising that despite the tough economy more Americans are not becoming CNA's.

    Please keep reading the blog and follow me on twitter @aginginchicago.

  • In reply to Bruce Lederman:

    So how much training is required?

  • In reply to Gary Lucido:

    Facts about becoming a certified nursing assistant in Illinois can be found at the Illinois Department of Public Health website. Please visit: http://www.idph.state.il.us/nar/cnafacts.htm

    Thank you again for following Aging In Chicago

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    Bruce Lederman has over 25 years experience in the senior care field as a direct care provider and thought leader. Bruce was CEO and president of his own firm that operated skilled nursing facilities in Illinois. He is a former nursing home administrator and has consulted to numerous elder care providers on planning for strategic growth as well as process improvement. Recently he served as board chair of CJE SeniorLife, a leading non-profit elder care provider in the Chicago area. Bruce is currently employed as chief strategy officer for a company providing skilled nursing services in communities throughout Illinois and Missouri.

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