Will There Be A Nursing Home Shortage: Part II

In my most recent blog, I began refuting a recently published article which asserted that the United States is facing a nursing home shortage. Since Illinois is one the 10 states with the largest (and fastest growing) elder population, I'm using the Land of Lincoln as the benchmark against which we can compare the value of the proposition.

Who is currently living in Illinois nursing homes?

Way back in October I blogged about the recently published AARP report "2011 State Long Term Services and Support Scorecard." Although Illinois received an overall ranking of 23, for purposes of this discussion, should focus exclusively on the "percent of long term care residents with low care needs" indicator to understand a critical failure in the Illinois long-term services and support infrastructure.

Illinois, as permitted by the Medicaid program, has an established "level of care" criteria that must be demonstrated in order for someone to be admitted to a nursing home in this state. Here, AARP reports that the level of care criteria is minimal: meaning that people are admitted to to a nursing home who could be cared for in a less restrictive setting. In the AARP report, Illinois ranked 49 out of the 50 states with the highest number of residents with low care needs (25.1%). Interestingly, this corresponds to a 2009 study prepared for the Illinois Department on Aging which found (in part) that more funding for home and community based services could enable older adults to have their service needs met in the community (here). Seemingly, some residents of Illinois nursing home could reside in the community if existing resources were orientated towards that goal.


Based upon expected trends on increasing the capacity of home and community based long-term services and supports as well as health care reform's emphasis on expense reduction, it is unlikely that a nursing home shortage will be experienced in the next 5-10 years.

However, whether or not the current skilled nursing facilities can be adequately modified to address future life safety requirements as well as consumer and programatic expectations is an interesting topic worthy of further discussion. For example, health care reform's emphasis on creating seamless integration of post-acute services into the healthcare delivery system may require the development of skilled nursing facilities (or transitional care units) which look and feel much more like a hospital then the traditional nursing home.  Many skilled nursing provider associations have long argued for access to low-cost financing in order to improve their existing physical plants. Certainly an idea worthy of discussion and further consideration.

What do you think?

My next blog will focus on the recent publication of the "Coordination Strategy for Post-Acute Care and Long-Term Care Performance Measurement Final Report" issued by the National Quality Forum.

Please follow me on twitter @aginginchicago


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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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