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Statistics on Nursing Homes and Their Residents

(5/2/13)- It is estimated that there are more than 1.5 million nursing-home beds nationwide that includes skilled nursing facilities as well as long term care quarters. Medicaid accounts for about 70% of most nursing homes' revenue, and Medicare payments constitute about 20% of their revenue.

The recent federal sequestration that took place on April 1, as part of the across-the-board budget cuts meant that Medicare reimbursement rates were automatically cut by about 2%.

The sequestration will result in $11 billion in lost revenue to all Medicare providers.

(4/18/13)- As we all know after having undergone the experience, there are times when we can no longer take care of a loved one at home, and therefore must consider the thought of having that person taken care of in a nursing home.

The 10th annual "cost of care" report from Genworth Financial, a seller of long term care policies and financial products collected information from 15,000 long-term care providers nationally in January and February.

The cost of nursing home care has increased more than 4 % a year over the last decade to a median annual cost of $83,950 according to the report.

Over the same period, the costs for homemaker services and home health aides have remained about the same. Writing on a personal level, I know that in March of this year, the home aide agency that I was using in New York City, for a relative of mine increased its hourly rate from $21 an hour to $22.50 an hour.

The home-aide agency that I used took care of all the withholding from the salary of the aide, and made sure that the home-aide was a certified one.

Nationally, the median cost is $19 an hour for a home health-aide and $18 an hour for homemaker services. According to the report, this translates to a rise of about 1% a year for the last 5 years.

The cost to receive care in an assisted-living facility is rising much more rapidly. The median annual cost is $41,400, a 4.3% annual increase over the last 5 years. The comparable cost for a private nursing home room is $83,950, a 4.5% annual increase over the past five years.

(11/22/09)- Below you will find the latest statistics we could obtain from the CMC, which oversees the Medicare program. These statistics are from the year 2008. If any of our readers has later statistics, please let us know, so can list them on our site

The total number of nursing home residents in certified nursing facilities as of 2007 was 1,368,230. (Note: Not all facilities are surveyed by state agencies during each calendar year. These data exclude residents in uncertified beds.)

A breakdown of this number indicates that New York led in the number of residents with 108,749, followed by California (97,530), Texas (89,698), Pennsylvania (79,422), Ohio (77,751), Illinois (76,065) and Florida (69,978).

In the United States, there were a total of 4897 hospitals (Note: Data are for community hospitals, which represent 85% of all hospitals. Federal hospitals, long term care hospitals, psychiatric hospitals, institutions for the mentally retarded, and alcoholism and other chemical dependency hospitals are not included.)

The five states with the most hospitals are Texas (409), California (355), New York (202), Florida (200), and Illinois (190). The states with the least hospitals are Delaware (6), Rhode Island (11), and Vermont (914).

The percentage of the top ten deficiencies given in 2007 to nursing facilities for problems which can result in a negative impact on the health and safety of residents were: Accidental environment 37%, food sanitation 35%, quality of care 29%, professional standards 28%, comprehensive care plan 22%, housekeeping 20%, Incontinence/urinary care 19%, pressure sores 19%, unnecessary drugs 19%, and infection control 18%. (Note: Data are for community hospitals, which represent 85% of all hospitals. Federal hospitals, long term care hospitals, psychiatric hospitals, institutions for the mentally retarded, and alcoholism and other chemical dependency hospitals are not included)

(9/1/09)- In 2005, there was one geriatrician for about every 5,000 people over 65, according to the American Geriartrics Society. That ratio is expected to expand to one for every 8,000 patients by 2030. Geriatricians must participate in a two-year fellowship program after medical school to become certified.

In 2007, only 253 of 400 fellowship slots were filled, and only 91 of the physicians graduated from medical school in the United States.

(2/5/09)-We are posting the following statistics because of frequent emails we get from viewers of our site who appear to be doing research in this area. These are not current statistics. We would appreciate hearing from our site visitors any current changes to these statistics or any other statistic that could prove important to researchers. We will post the changes as soon as we receive them and give credit to the source, if permission is given to do so. Thank you in advance to those who respond to this request.

Nursing facility providers in the United States

1,813,665 total nursing facility beds;
16,995 total nursing facilities;
13 percent of facilities are hospital-based;
52 percent of facilities are part of a chain ("Chain" facilities are owned or leased by a multi-facility organization. The remaining facilities are individually owned and operated);
107 facility bed size (average);
83 percent nursing facility occupancy rate

The elderly population

The elderly population, ages 65-74 is 7 percent (18,759,000 people) of the total population;
The elderly population, ages 75-84 is 4 percent (11,145,000 people) of the total population;
The elderly 85 and older are 1 percent (3,625,000 people) of the total population; and
The total elderly population, aged 65 and older is 13 percent of the total population.

Nursing facility ownership in the United States

66 percent for profit;
27 percent not-for-profit;
7 percent government.

(6/23/08)- About 1.5 million Americans live in nursing homes, and about 22% of the 5.3 million people 85 or older had a nursing home stay in 2006. There are an estimated 16,000 nursing homes in this country, and in an attempt to improve the quality of life within these homes the Centers for Medicare and Medicaid Services (CMS) is adding a rating system to its database so that the consumer is helped in evaluating these facilities.

Approximately 70% of persons with dementia die in nursing homes. (Mitchell SL. et al A national study of the location of death for older persons with dementia. J Am Geriatr Soc. 2005;53(2):299-305.)

(12/26/07)- According to statistics from the Centers for Medicare and Medicaid Services, nursing-home patients, on average, receive a half-hour of care per day from a registered nurse, plus 38 minutes from a licensed practical nurse and two hours and 18 minutes from a nurse's aide.

Figures compiled by the CDC in 2006 for the year 2003 indicate that over 40% of all deaths in the United States occur in hospitals (1.157,491 million individuals out of 2,452,154 total deaths; 544,890 die in nursing homes/long term care facilities and 584,251 die in their homes, while 5,448 die in hospice facilities, with the rest unreported) . (CDC. MortalityTables 2003.

Heart failure is the leading cause of hospitalization in the elderly. It develops in about 1 in 5 persons during their lifetime and in about 1 in 8 of those who have not sustained a myocardial infarction. Within one year of heart failure 24% to 28% of patients die, while 45% to 59% die within 5 years. (Consultation, July 2007, 47(8): 729-733) 

(8/8/04)- The costs continue to rise steeply for "long distance elder care". In a study done by the MetLife Mature Markets Institute, Westport, Ct. and the National Institute for Caregiving, a Bethesda, Md. nonprofit it was estimated that long-distance caregivers average about $392 a month, compared to $196 seven years ago.

The expenses include travel, medicine, phone bills, medical supplies, meals and home maintenance. An estimated seven million Americans are long-distance caregivers. A long-distance caregiver is defined as someone who care from afar for a chronically ailing person. Among the 80% if the long-distance caregivers who are employed, 44% have rearranged their work schedules. Thirty-six % missed days of work, with an average of 20 work hours a month lost to caregiving duties.

There are approximately 18,000 nursing homes in the United States, two-thirds of which are operated for profit, with 55% owned by large nursing home chains. There are about 1.7 million nursing home beds in the United States. This represents less than 6% of the total number of Americans over the age of 65. It suggests that the vast majority of elderly will most likely spend their final years in their community residence.

Males who reach the age of 65 can expect to have an average life expectancy of 15.5 more years and females 19.2 years. For those who reach 85, the average life expectancy for males is 5.2 years and females 6.8 years. The over 85-year-olds represent about 1.5% of our population and is expected to grow to 4.65% in 2050.

While only twelve percent of nursing home residents are between 65-74, 45% are over 85 years of age. It is estimated that anyone over 65 years of age will have a 43% chance of spending some time in a nursing home. About 24% of these individuals will spend less than a year in residence at a nursing home.

According to a 1996 publication of AARP, many of the medical problems older people have relate to chronic conditions. They include the following: 32/100 persons had arthritis, 34/100 had hypertension, 32/100 had heart disease, 29/100 had hearing impairments, 17/100 had cataracts, 16/100 had orthopedic impairments, 15/100 had sinusitis, and 10/100 had diabetes. The AARP survey also indicated that 23% of Americans over age 65 had some difficulty with activities of daily living.

More than 50% of nursing home residents have no living close relative, which may be related to the estimate that 60% of nursing home residents have no visitors.

The cost of caring for a disabled older adult in the community has been estimated, according to an article in Gerontologist (Harrow et al 1995), as $9600, while institutional care was estimated by Spillman et al, 1995, at $30000.

Congestive heart failure is the most common reason for hospitalization in people aged 65 and older in the United States. The prevalence among the 80-to 89-year-old age group is 9.1%. Adult onset diabetes mellitus affects approximately 20% of Americans aged 80 and older, and dementia affects more than 30% of people in this age group.

It would seem obvious that there is an urgent need for cost-effective programs for chronic disease and disability prevention, which would be offset against the cost for treating the disabled.

References

Harrow BS, Tennstedt SL, McKinley JB. How costly is it to care for disabled elders in a community setting. Gerontologist 1995; 35:803-813.

Spillman BC, Kenyan P., Lifetime patterns of payments for nursing home care. Medical Care 1995; 33:280-296.

AARP (1996) A profile of older Americans. Washington DC

As many of our viewers know, both Harold and I have proudly done this site in memory of our mom, Nina Rubin. It is done strictly as a public service to hopefully aid our viewers in gaining knowledge about seniors. There are no ads on the site, and anyone can view it without any charge. We are blessed at having many of our viewers help us with additional information to what we gather ourselves. Both Harold and I are deeply appreciative for whatever additional information you can supply us with. What follows are two emails from two of our viewers to whom we say thanks

The following email was from Liz Schilling who at the time was the "Interim Librarian" at the American Health Care Association. Liz, since the sending of her original email to us, has now become the "Senior Librarian" at the Association. We would like to express our thanks to Liz and congratulate her on becoming the Senior Librarian.

Allan,
A big thank you to you and your brother, Harold, for helping me so quickly with locating information on yearly nursing home admissions.

After searching some more on the Web, I found information on nursing home admissions per year (1,537,000) in the Medical Expenditure Panel Survey at
the following site: http://www.meps.ahrq.gov/Puf/PufDetail.asp?ID=61. Of course, admissions include the people checking in, leaving for
hospitalization, etc. and checking back into a nursing home (same one or different nursing home).
Thank you so much for your very kind help,

Liz Schilling, Interim Librarian
American Health Care Association
Washington, DC
202-898-2842

The following is a copy of an email from a viewer who is associated with the National Citizens Coalition for Nursing Home Reform. We would like to thank her for this update on some of the statistics on nursing homes and their residents:

Dear Mr. Rubin (Harold),
Here are some excerpts from the draft document I mentioned using the latest available statistics
:

According to the National Center for Health Statistics as surveyed from July to December 1999, there were 1,628,300 nursing home residents.

Between 1993 and 1999, most states experienced a decrease in nursing home population, the most significant in MD and NJ. However, a few states showed significant increases, namely FL and WV. The picture looked very different in 2000 and 2001, which showed significant increases from 1999 in a number of states especially along the east coast including DE, MD, NC, NJ, SC, and DC. Only two western states, AZ and SD, and one midwestern state, OH, showed a similar trend. (This is from Charlene Harrington's work.)

The 1999 National Nursing Home Survey reports 18,000 nursing homes.
Of all facilities, 67% were proprietary, 27% voluntary nonprofit, and 6% government and other. There were an estimated 1.9 million nursing home beds in 1999, 94% were Medicaid certified, 84% were Medicare certified and 3% were not certified

Since 1980, the percentage of the nursing home population aged 65 to 84 has declined and the percentage of residents over age 85 has increased. This mirrors the trend in the total population regarding percentage of various age cohorts receiving nursing home care.

Age Group Percentage of Nursing Home Population Age (1999)

65-74yrs. --12%
75-84-yrs. -32%
85+ yrs. 46%

Average Length of Stay (Point-in-Time Measure)

2.4 years varying with gender, age, ethnicity and type of facility; also influenced by the increasing use of short-term stays following hospitalization
2.51years for females
2.29 years for males
1.86 years for Hispanics
2.62 years for persons over age 85

For 1999, Certification of all facilities breaks down as follows:

Nursing Facilities (Certified by Medicaid only) 2,100
Skilled Nursing Facilities (certified by Medicare only) 600
SNF/NF (Certified by Medicare & Medicaid) 14,700
Other Facilities (Not certified) 500

I hope you find this information helpful.

From a viewer associated with the
National Citizens Coalition for Nursing Home Reform

202-332-2275
dokrent@nccnhr.org
http://www.ltcombudsman.org

"NCCNHR is a national, nonprofit membership organization founded in 1975 by Elma L. Holder to protect the rights, safety, and dignity of America's long-term care residents."

Here is another email that we at therubins received from another one of our viewers, Liz Schilling, Interim Librarian at the American Health Care Association.

Allan,
A big thank you to you and your brother, Harold, for helping me so quickly with locating information on yearly nursing home admissions.
After searching some more on the Web, I found information on nursing home admissions per year (1,537,000) in the Medical Expenditure Panel Survey atthe following site:
http://www.meps.ahrq.gov/Puf/PufDetail.asp?ID=61. Of course, admissions include the people checking in, leaving for hospitalization, etc. and checking back into a nursing home (same one or different nursing home).
Thank you so much for your very kind help,
Liz Schilling, Interim Librarian
American Health Care Association
Washington, DC
202-898-2842

FOR AN INFORMATIVE AND PERSONAL ARTICLE ON PRACTICAL SUGGESTIONS WHEN SELECTING A NURSING HOME SEE OUR ARTICLE "Selecting a Nursing Home"

Harold Rubin, MS, ABD, CRC, Guest Lecturer
updated May 2, 2013

To e-mail: hrubin12@nyc.rr.com or allanrubin4@gmail.com

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