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Health & Well-Being » Long-term Care

Why It's Important

With the convergence of longer life expectancy, the aging of the Boomers, and the shortage of nurses and children behind them to care for them, Boomers are going to need to be prepared for the fact that many will need substantial medical and non-medical care. In the meantime, adequate health coverage needs to include wellness and prevention and be accessible to all.

See Data By: Richmond MSA | Virginia | National

How Richmond Is Doing

According to Genworth's Cost of Care Survey, 2009, except for home-based health care, the costs of long-term care also are poised for steady increases.

The cost of labor is a key factor driving the price of care at facilities, though that has abated somewhat because of the availability of workers as unemployment has risen and because of higher retention rates.
Nationally, the average annual cost for a private room in a nursing home is $74,208 or $208 per day, a 4.7 percent increase over the past year and 4.3 percent more annually over the past five years.
In Richmond and Roanoke, the cost for a private room has risen 8 percent a year since 2005 and 5 percent a year in the Norfolk-Virginia Beach region.
The median annual cost for a private nursing home room in Richmond is $78,658.
In Richmond, costs for a private room in an assisted-living facility rose even faster, increasing 16 percent a year over the past five years to a median annual cost of $37,752.
Nationally, the cost for a one-bedroom unit in an assisted-living facility is $33,903 annually or $2,825 monthly, marking an increase of 1.4 percent over 2008 and 4.7 percent annually over the past five years.
A bright spot in the company's survey is the relatively flat cost of in-home care. The hourly cost for in-home care for non-Medicare-certified workers rose a half-percent to $18.50 from a year ago and increased 1.7 percent annually over the past five years.
In Richmond, however, the median rate is $19, which represents an annual growth rate of 5 percent since 2005. The cost ranges from $15 to $21 in Virginia.

(GENWORTH, COST OF CARE SURVEY, 2009)

How Virginia Is Doing

According to ODP Business & Residents' Studies, 31 percent of employers say they offer access to LTCI, and currently 28 percent of Boomers say they have it. However, this self-reported number is known to be higher than the actual number of Boomers with LTCI, who may often mistake health or other insurance for this coverage or assume that health insurance or Medicare covers long-term care.

Benefits offered by employers include health and LTCI

How the U.S. Is Doing

According to the 2008 MetLife Market Survey of Nursing Home & Assisted Living Costs, the Average rates for a private room in a nursing home remained essentially unchanged nationally from 2007, while semi-private rates increased 1.1%, from $189 daily or $68,985 annually in 2007, to $191 daily or $69,715 annually in 2008. MetLife Mature Market Institute reports that average assisted living rates increased by 2.1%, from $2,969 monthly or $35,628 annually in 2007, to $3,031 monthly or $36,372 annually in 2008.

Summary of National Findings
National Findings	Nursing Homes		Assisted Living Communities
National Findings	Private Room	Semi-Private Room	Assisted Living Communities
Rate Type	Daily	Daily	Monthly
2008 Average Rate	$212	$191	$3,031
2007 Average Rate	$213	$189	$2,969
$ Change 2007 to 2008	-$1	+$2	+$62
% Change 2007 to 2008	-0.5%	+1.1%	2.1%
2008 Median Rate	$200	$178	$2,900
2008 High Average Rate	$577 AK-Statewide	$566 AK-Statewide	$4,708 ME-Southern Maine
2008 Low Average Rate	$127 LA-Rest of State	$121 MN-Rest of State OK-Rest of State	$1,980 ND-Statewide
Note: Costs vary by regionand by the services included in the base rate costs.

(ODP BUSINESS LEADER, 2008)

According to a report by the Robert Wood Johnson Foundation on current patterns in long-term care:

Long-term care is a women's issue

Nearly two-thirds of older people with severe disabilities are female
Women represent two-thirds of all unpaid caregivers
Daughters account for seven out of every ten adult children who help their frail parents

Long-term care is a leading cause of catastrophic out-of-pocket costs for families and involves substantial government spending through Medicaid and Medicare

Only a small segment of the population is able to receive paid home care through Medicaid
Most others with disabilities rely on unpaid assistance from family and friends
It is not uncommon for individuals or couples to exhaust their financial resources paying for long-term care before they are eligible for government services
Few people carry long-term care insurance, which typically has high premiums, and even if they do, often this insurance has limited benefits that do not fully cover the cost of care

Although nursing homes and assisted-living offer options for long-term care, many frail, elderly adults continue to live in community settings either to maintain independence, comfort, social lives, or because the cost of nursing homes and assisted living is prohibitive.

Paid care in non-institutional settings is rare
Only 14.3 percent of frail older adults and 36.6 percent of older adults with severe disabilities received paid home care services in 2002

Unpaid caregivers often struggle with assisting their family members

Unpaid caregivers who assume primary responsibility for the personal care of a frail older adult average 201 hours of help per month
More than half of adult children helping their frail older parents are employed and one in three spouses caring for their partners have health issues of their own

(ROBERT WOOD JOHNSON, CHANGES IN HEALTH CARE

FINANCING & ORGANIZATION, 2007)