IHP 620 Short Paper 8-2

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Southern New Hampshire University *

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620

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Medicine

Date

Apr 3, 2024

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docx

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Uploaded by amiralindbloom

Long-term care (LTC) facilities differ from hospitals because of their focus on extended support and care for individuals who are elderly, or experiencing chronic conditions or disabilities that affect their ability to perform their activities of daily living (National Institute on Aging, 2017). Long-term care facilities are generally designed to provide a home-like environment and a sense of community, promoting social interactions and comfort to residents. This is accomplished by the provision of services by caregivers who aid residents in performing daily activities such as bathing, oral hygiene, dressing, and grooming. Hospitals are acute care facilities that focus on diagnosing and treating medical conditions, as well as handling emergencies, surgeries, and critically ill patients. Although long-term care facilities are classified as acute care hospitals, patients usually are transferred from intensive or critical care units and stay longer than 25 days where the goal is to help them recover before returning home (Medicare.gov, n.d.). A Certificate of Need (CON) is a legal document required by governmental regulations prior to the construction of a new healthcare facility. The first CON statute was passed in 1964 in New York and was soon followed by adoption in almost all states by the early 1980’s. Currently, 35 states still require a CON before certain health facilities can be built or expanded (Conover & Bailey, 2020). The goal of the CON is managing healthcare costs by limiting duplication of services, improving healthcare standards, and expanding healthcare accessibility, especially for socioeconomically disadvantaged households (National Conference of State Legislatures, 2023). An example of this is that some states require that facilities provide financial assistance, ensuring that medical services are provided to low-income individuals as a condition of obtaining a CON. CON statutes impact the establishment of new LTC facilities as well as the expansion of existing businesses, ensuring that economic necessity has been demonstrated. They also help maintain equitable access by preventing cream-skimming by ensuring the requirement of serving

diverse populations and providing services for individuals who are unable to pay. CON statutes promote the development of healthcare facilities in rural areas. They are reducing the number of competitors and improving their chances of steady revenue in the process. Since the 1980s, Medicare has seen a sharp increase in demand, particularly for home healthcare and skilled nursing facility care (Pitsor, 2019), affecting the current cost-reimbursement payment rate as a result. States with CON laws have seen slower growth in home healthcare spending than states without them (Pitsor, 2019). CONs gained greater market power and became less susceptible to competitive forces like shifts in payment and the implications that may arise. By the year 2030, researchers anticipate that the number of individuals aged sixty-five years and older is projected to exceed seventy million (Spetz, 2015). It is also predicted that by 2050, one-fifth of the total U.S. population will be sixty-five and older (Congressional Budget Office, 2013). Based on these growth forecasts, there is likely to be a surge in the number of aged individuals who will likely have functional and cognitive limitations such as mobility issues, incontinence, hearing loss and more that require care. It is estimated that more than two-thirds of 65-year-olds will need assistance with dealing with a loss in function (Congressional Budget Office, 2013). These projections are already raising concerns about the ability of the long-term care workforce to keep up with the need for patient care. An increase in the number of jobs in the long-term care field will need to be implemented to help keep up with the need. The increase in the aging population will result in several additional financial considerations, including higher social security payments, rising health insurance premiums, increased concern over non-covered medical bills like prescription drugs, and rising long-term care costs. Of these, long-term care services have resulted in the fastest-growing costs of all these cost factors (Knickman & Snell, 2002). While wealthier individuals may have the ability to afford the

expenses that come with becoming older more easily, these costs will be higher than the typical American household’s income. According to Genworth's annual cost of care survey, assisted living expenses average $4000 per month, or $48,000 annually, and rising (Gleckman, 2019). Government assistance will likely be more necessary than ever because of this.

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