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Life Health > Long-Term Care Planning

5 must-know adult day care shopping tips

By Allison Bell

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If you are already working as a professional long-term care (LTC) financing advisor, or as a family caregiver, you may be reading this article mainly to critique it.

You might be able to write a better version of this article, incorporating detailed reviews of the 1,000 biggest adult day care facilities in your market, in your sleep… while ordering a slow cooker online. 

See also: 4 ways to know when to refer clients to an LTC services specialist

If you haven’t been working as a professional LTC advisor: Congratulations! You’re now an “informal LTC advisor.”

Thanks to the aging of the world’s population in general, and the U.S. population in particular, we’re all starting to hear, and ask, questions about what we should do about loved ones who need help with handling complicated daily medical needs, or help with the activities of daily living.   

See also: Rosie the caregiver: 10 ways to help her rivet our LTC ship together

One basic lesson many Americans are now learning is that LTC services can come in many different gradations, ranging from having a supermarket deliver groceries every week to a frail 85-year-old who has trouble driving, to full-blown skilled nursing facility care.

For many family caregivers, especially those who have full-time jobs, using adult day care services, rather than home health care or care in a residential facility, can be a way to maximize their care delivery capacity and to get as much care value as possible out of each dollar coming from savings, current income, and private insurance benefits. 

See also: Genworth creates LTC planner site

Earlier this year, CareScout found that the median cost of 50 weeks of U.S. adult day health services is just $17,000. That compares with a median annual cost of $91,000 for a private nursing home room.

One challenge is that shopping for adult day services can be even more complicated than shopping for ordinary medical care, or for child care.

Nothing can ever replace talking privately with recent users of a provider’s services, but, for a look at five things your clients ought to know when they shop for adult day care services, read on.

Ancient Egyptian ruins

1. When it comes to technology, they tend to be more into clay tablets and papyrus than into the digital age.

Some adult day care services show up everywhere on social media services like Twitter, Facebook and Google Plus.

They have big, thriving message board forums online. 

When state and federal agencies open up adult day care regulatory proposals up for public comment, they comment up a storm.

But analysts at the federal Centers for Disease Control and Prevention (CDC) found when they looked at the 2014 National Study of Long-Term Care Providers survey data that adult day care providers are not actually very good at installing electronic health record (EHR) systems.

Only 23 percent use EHR systems at all. Just 8 percent can use their EHR systems to connect with hospital EHR systems, and barely 6 percent can connect their EHR systems with physicians’ EHR systems.

If your clients want to find adult day care services that can interface seamlessly with doctors, hospitals and private insurance providers — to use the magic of technology to improve the quality of care and reduce the cost — they may have their work cut out for them. 

See also: Intel executive: Let my health records go 

Balloon rising, balloon falling

2. Adult day care providers’ financial performance varies widely.

Outsiders might think that U.S. adult day care providers should have an easy time bringing in new business and generating big profits, given all the headlines about the aging of the population, but reality is more complicated.

For one thing, the biggest users of paid LTC services are ages 75 or older. Today, the people who are ages 75 or older are all members of the small “Silent Generation” (the generation of people born during the Great Depression or World War II); members of the greatest Generation; or very old members of what’s sometimes called the “Interbellum Generation.”

The baby boomers won’t start turning 75 until 2021.

The number of Americans over age 75 is already growing, because of increases in the average life expectancy of older people, but it won’t start growing rapidly until the 2020s.

Gary Walker, president of Walker Marketing, said in a presentation summarized on the website LeadingAge, an LTC provider group, that he found survey data suggesting that the majority of adult day care centers simply want to break even, and that about 17 percent lose money. He found that providers see marketing as one of their top three challenges.

The bad news: The marketing challenge may give adult day services providers anxiety attacks. Centers with severe problems could suddenly decide to shut down on major holidays, in the summer, or forever.

The good news: The providers may welcome a chance to talk to you and your LTC planning clients. Your clients may eventually be their clients.

See also: 5 jolts from the White House aging conference prelims

Food group illustration

3. For-profit centers are more likely to offer special programs for people with diabetes or heart disease.

CDC analysts report, in another statistical snapshot based on a different batch of the survey data they used in the EHR use snapshot, that for-profit adult day centers are substantially more likely to offer special programs aimed at people with diabetes, heart disease or depression than nonprofit centers are.

About two-thirds of both nonprofit and for-profit centers offer programs for people with dementia.

But 72 percent of the for-profit centers offer programs for people with diabetes; 67 percent, for people with heart disease; and 61 percent, for people with depression.

Only 58 percent of the nonprofit centers offer programs for people with diabetes; 52 percent, for people with heart disease; and 59 percent, for people with depression.

See also: Diabetes on the decline

Women looking in a photo album

4. Nonprofit centers are more likely to focus on serving people with dementia.

Even though for-profit and nonprofit centers are about equally likely to have programs for people with dementia, about 18 percent of the nonprofit centers actually focus on serving people with dementia, compared with just 10 percent of the for-profit centers.

See also: 5 cheapest states for adult day health care

Older people playing cards

5. The nonprofit centers get a lot more of their revenue from sources other than Medicaid.

The for-profit adult day care centers get 65 percent of their revenue from Medicaid and just 13 percent from either private insurance or the customers’ own private resources.

The nonprofit centers get just 41 percent of their revenue from Medicaid. They get 21 percent from private insurance and private out-of-pocket spending.

That means the nonprofit may be more used to dealing with payers such as long-term care insurance (LTCI) providers, and they may be better equipped to handle the paperwork involved with collecting on LTCI claims.

But for-profit adult day care center managers with qualms about depending heavily on Medicaid for revenue might be interested in finding out how they can make themselves more attractive to the clients and insurers you work with.

See also: 5 things agents should know about adult day services

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