Long Term Care Facilities

Current numbers show substantial growth from the eighties, and estimates suggest that the demand for long term care among the elderly will more than double in the next thirty years. (Feder, Komisar, and Niefeld) This growth will exacerbate concerns about balancing institutional and noninstitutional care, assuring quality of care, and most importantly adopting and sustaining financing mechanisms that equitably and adequately protect the elderly who need long-term care.

The challenges and impact of Baby Boomers on long-term care systems are going to modify the manner in which traditional health care, patient access, financial payments and treatment are delivered. Baby Boomers will have an extensive amount of care maintenance needs involving various rehabilitation conditions, acute and chronic illnesses, which will require a significant amount of thoroughly trained gerontologists, skilled nurses, nurse practitioners, social workers, community advocates, and family involvement. This article explores options sought to reduce the costs to society and Baby Boomers as innovative savings, tax credit options, and other alternative long-term care financing choices lessening the impact on the long-term care system.

Our elderly population is living longer than ever before and not all of them are entering into a nursing home. They are choosing to stay in their own home or their caregiver is choosing it for them. Some caregivers are choosing to move their ageing love one in the home with them. Whatever the case may be, there is an increased need for some type of home health as it applies to the elderly population. “Medicare will pay the full cost of professional help only if the physician

Long term care facilities use Joint Commission Accreditation as a benefit to show the quality and commitment to the health care organization. A long term care facility that is Joint Commission accredited will have a more appealing look to reimbursement centers and to the patient and families that they care for. Having this accreditation is also a risk management tool. The likelihood of a bad outcome is reduced if a facility is accredited by the Joint Commission. There is a team put together to come up with accreditation standards and to make sure facilities stay compliant with these standards. Performance is evaluated to ensure standards are followed.

Benefit provisions vary from one state program to another, but federal guidelines require all states to provide a minimum benefit package, including hospital inpatient and outpatient care, physician care, and many other services. In the area of long-term care, all states are required to pay for nursing home care, and they must also pay for home healthcare for those who are “nursing home eligible” which are those who would need nursing home care if they did not receive home care. And although federal guidelines do not require it, an increasing number of states also pay benefits for home and community-based services. These services may include personal care, home health aide services, rehabilitation, therapies, intermission care, homemaker services, and other services. In addition, a few states pay for long-term care services received in an assisted living residence. Unlike Medicare, with its highly restrictive conditions for payment of nursing home or home care benefits, Medicaid generally meets the need for long-term care (for those who eligible). Medicaid pays benefits for personal and supervisory care even if skilled care is not needed, and the program covers ongoing care needed to cope with a chronic impairment, not just care required for a short time to facilitate recovery from an acute illness or injury. However, there are some important limitations to Medicaid long-term care benefits: (1)

Long-term care is vital in the United States health care system. As the population ages, more people will need assistance to recover from illness or injury, and others will need end of life care to ease their passing. People who use long-term care are all ages. From young to old, people can receive it if they cannot care for themselves because of a condition, an illness, or an injury that requires assistance for a period of 90 days or more. The concern people face when looking at long-term care is the funding. Medicaid will likely be drained of funds long before the country’s aging population is past its peak and while there are some options of insurance coverage, not everyone may afford them.

Health care in the United States is currently facing a looming crisis that requires an urgent response of intervention. With the baby boomers population on the rise, there will ultimately be an increased need for long-term care (LTC) services. Pratt (2015) defines baby boomers as “the name given to the large number of people born in the period following World War II, between 1946 and 1964” (p. 17). According to Mikulaschek (2013), “Beginning in 2010, the roughly seventy-eight million baby boomers began turning sixty-five at a rate of three to four million per year leading to growing concerns over meeting their healthcare demands” (p. 86). This brings the number from about forty million in 2010 to seventy-two million in 2030 causing them to account for almost twenty percent of the total U.S. population (Mikulaschek, 2013, p. 96; Pratt, 2015, p. 17). This alarming rate will correspond to the increasing number of elderly individuals with chronic conditions who depend on LTC services for daily functioning (Pratt, 2015, p. 17). This influx of baby boomers presents the health care industry with a plethora of issues related to costs, quality, and access to the LTC services that this population so desperately needs.

This exercise point out some very important factors with regard to health care cost.  nursing homes and other health care delivery systems are faced with significant shortfalls in reimbursement for various reasons.  Medicare reimbursement often does not cover the full extent of treatment of individuals.  McPike (2008) notes that, “The insurance and hospital industries released a study today showing that underpayment by Medicare and Medicaid costs consumers and employers $88 billion more a year for health care as providers attempt to make up the difference.” Today with continue cutbacks in medicare reimbursement this number is significantly higher.  In an attempt to reclaim these losses, both self pay and privately insured patients are charge

Long-term care healthcare delivery will be a great/popular option for many of these senior citizens. The long-term care healthcare delivery system falls within the continuum of care. The continuum of care is a series of heath care services that are provided to a great number of older adults who are in need of them throughout the course of their life/older life. The care ranges from: personal care, custodial care, restorative care, skill nursing care, and sub acute care (Shi & Singh, 2012). Different providers work together within the continuum to provide the right care to those in need. The continuum of care, as stated in Long Term Care: Managing Across the Continuum, is “comprehensive, integrated, and client-oriented”(Pratt, 2010). All the services offered should be client-based and cater to the client’s needs and suitable care. The client should be able to obtain services when it is needed from the provider, making it comprehensive. All the different long-term care providers should be interconnected between one another, because their goal is all the same, which is to care for the client’s needs. The continuum of care consists of: nursing facilities, sub acute care, assisted living, residential care, elderly housing, and a variety of community-based services (Pratt, 2010). All these different providers work together to care for the individuals within the health care industry, creating the continuum and making it integrated. As the future progresses and a great amount of

Long-term care has and is continuing to become an important part of the continuum of care. Years ago Long-term care (LTC) was considered only to be for the elderly, but as time passes it is for anybody and everybody who needs it. Barton (2006) stated, “Regardless of the length of time (i.e., from weeks to years), long-term care is an array of services provided in a range of settings to individuals who have lost some capacity for independence due to injury, chronic illness, or condition” (p. 367). According to Barton (2006), it states that the services long-term care provides help the consumer with basic needs and shows the individuals how to do daily living activities, along with therapy and being able to

The necessity for long-term care is increasing which will require additional training and education for health care personnel, family members, and patients. Family members can have peace of mind knowing their family member will gain confidence in learning how to become accustomed to his or her new life while maintaining a quality continuum of care during and after treatment for physical, mental, or age associated illnesses.

The main concern about long-term care is providing the money to pay for individuals and care providers. “As a result, policymakers are considering several proposals for substantial reform. These fall under three categories: Shifting the focus of Medicaid long-term benefits to home care, expanding the long-term care and geriatric workforce, and restructuring the means of finance” (Gleckman, 2009). Federal and state have agreed that many individuals should think about long-term care insurance. In fact, federal and state have discussed providing tax credits and deductions for buying long-term care insurance.

Very few people possess an ample enough financial position to afford long-term care from their own funds. A few have prepared by purchasing annuities or long-term care insurance, but these numbers are small. By the time that most people enter long-term care they have multiple chronic diseases and have exhausted their personal wealth on direct medical care. The great majority of people depend upon

The long-term healthcare system has an infrastructure that is unfriendly and difficulty to navigate. With a growing number of frail older people living in the United States, the pressure to find a more affordable way to care for them will mount. Nearly 12 million people need some form of long-term care (LTC) and half are over age 65 (Wilber, 2014, Class Session 2). As mentioned in the article “Waiting in the Dark with Dad,” a large percentage of American healthcare costs fund medical procedures and medications to keep terminally ill people 65 and older alive (Lopez, 2014, p. 1). Steve Lopez experienced this with his 85-year-old father, Tony, who lived in a nursing home that was a place meant to keep his heart beating, but not actually improve his health and well-being. This is the harsh reality of the long-term care industry that many have faced, including experts in the field such as Dr. Robert Kane, author of It Shouldn’t Be This Way: The Failure of Long-Term Care. Long-term services and supports (LTSS) are supposed to maximize the quality of care and the quality of life for the individual (Kane and West, 2005, p. 169). When that focus is lost, it is the responsibility of healthcare professionals, like myself, to bring that issue back to the forefront of policy making.

Government programs, such as Medicare and Medicaid are designed to provide assistance to individuals outside of what the market provides. For instance, Medicare provides coverage to over sixty-million elderly and disable individuals in the United States (Medicare, 2015). One advantage of Medicare is that Part D, also know as the “doughnut hole”, is expected to decrease by 2020. In short, this is “where beneficiaries had to pay 100% of their costs until they reached the catastrophic coverage level” (Medicare, 2015). On the other hand, Medicare does not cover hearing aids, vision, or dental services; nor does it pay for “long term services and support such as extended stays in a nursing home” (Medicare, 2015). This is extremely counterproductive