The Nursing Home Reboot

What will U.S. long-term care (LTC) facilities look like a decade or two now?


Health policy analysts at the Robert Wood Johnson Foundation, Princeton, N.J., give that assessment in a brief on how institution-based LTC might evolve.

The analysts note that the U.S. population is aging and that government program LTC budgets are tightening.

Congressional efforts to create a voluntary LTC benefits program failed, and no other public program seems to be coming to take its place, the analysts warn.

Meanwhile, "most Americans do not want to live in traditional nursing homes," the analysts say. "They want to remain in their own homes. If and when they cannot live independently, they want options that look and feel more like home."

The analysts suggest that one solution might be helping elders stay at home, with access to a monthly "supportive care budget" that the elders themselves can help manage.

Another option might be to help more low-income people who are eligible for Medicaid nursing home benefits stay in assisted living facilities. Helping someone who is eligible for Medicaid nursing home benefits stay in an assisted living facility instead cuts costs an average of 62%, the analysts say.

The Robert Wood Johnson Foundation also has been funding efforts to test a third solution: Shifting toward use of smaller, more personalized, "green" homes, in place of the large nursing homes that dominate the market today.

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