Earlier this week, John Oliver released a video criticizing the Long-Term Care industry, pointing out some awful actors’ appalling practices. The video’s link is below but be warned; there is very explicit language that he uses throughout the video.
First, let me highlight that the industry does have serious flaws with particular companies that are more profit than care-oriented. Many others focus on care and are not putting money first. These facilities care deeply for their residents and go beyond the call to take care of them.
Mom was in a good facility.
That was the case with my Mom, who recently passed a month short of her 95th birthday. The staff in her facility loved her and were genuinely sorry to see her go. The facility followed all precautions for COVID, much to my annoyance as I could not be with her, but we understood why. Staff cared for her when we couldn’t be there then arranged in-person visits when the situation allowed. She will be greatly missed.
Visiting guidelines are being addressed and relaxed so residents are not isolated for such a long time. Some States are adjusting to allow significant caregivers, i.e., family, access, and hospice care. That should have happened earlier, but unfortunately, politics got in the way.
The numbers are staggering
The industry numbers Oliver points out are staggering; listed below are some of those statistics. After tearing into the industry, he suggests some solutions starting around minute 19. With more people needing care, potentially for longer than before, we need to focus on how to get that care to them.
Home and Community-based Services (HBCS) is one way to do that. The bill in front of the Senate has $400B set aside to assist in those services. That amount of money can do many good things to help people care for their elderly parents. As Oliver stated, though, there needs to be “rigorous guardrails and oversight” to ensure the money goes actually to provide care.
Honor our parents
If we value our elders, our parents, we need to take a serious look at providing care to that 90% who want to stay in their homes, or yours, as they age and eventually die. We also need to know how to manage that transition for our elders while keeping their dignity in place.
Think through this now while you have the time.
Make a plan with your family while you have time.
Start the conversation now while you have time.
Below are some of the statistics Oliver points out in the video.
- Number of Americans over 65 is expected to double in the next 40 years to 94.7MM.
- Two-thirds of those over 65 will need long-term care at some point.
- A majority of people receive care at home.
- 80% of that care is provided by unpaid caregivers, i.e., family.
- Cost of lost wages for unpaid caregivers is about $67B.
- There are 2.1MM people in nursing homes and residential care communities today.
- Residents and staff in those homes account for 33% of COVID deaths.
- GAO reports that 83% of nursing homes had been cited for infection prevention and control deficiencies. (5/29/2020)
- -About one-half had persistent problems cited across multiple years.
- Median annual wage for nursing assistants is $30,120 per year.
- About 70% of nursing homes are for profit.
- Average cost for a private nursing home room is $100,000 per year.
- Medicare covers the first 20 days of nursing home care after an eligible hospital visit and reduces the payment until 100 days, after which you are responsible for all costs.
- Qualifying for Medicaid requires less than $8,000 in assets, depending on the state you reside.
- Medicaid pays half the daily rate of Medicare.
- CMS identifies nursing homes with problems over multiple years called Special Focus Facilities.
- There are 88 facilities on the list with another 400 facilities that qualify; the low number is due to resources needed to inspect these facilities.
- The US government has a website for nursing home ratings. Of the 5-Star rating system for facilities, only one, Health inspections, uses outside inspectors. Staffing and Quality metrics are self-reported.
- About one-third of people in Long Term Care facilities are in Assisted Living Facilities cost around $51,600 per year.
- About 81% are for-profit and are mostly paid out of pocket.
Here is the video link – be warned, there explicit language is used.