New Assisted Living Study Shows Industry Trends Medicaid Prevalent Along with Multiple Chronic Conditions

A new report Residents Living in Residential Care Facilities: United States, 2010 shows that:

• The majority of residents living in residential care facilities in 2010 were non- Hispanic white (91%) and female (70%). More than one-half of all residents were aged 85 and over.
• Nearly 2 in 10 residents were Medicaid beneficiaries, and almost 6 in 10 residents under age 65 had Medicaid.
• Almost 4 in 10 residents received assistance with three or more activities of daily living, of which bathing and dressing were the most common.
• More than three-fourths of residents have had at least 2 of the 10 most common chronic conditions; high blood pressure and Alzheimer's disease and other dementias were the most prevalent.

The study from the Department of Health and Human Services looked at state-regulated residential care facilities (RCFs)--such as residents of assisted living communities--and the report presents national estimates of these residents by selected resident characteristics.

Deeper Dive

• More than one-half of residents were aged 85 and over (54%), and more than one-quarter of residents were aged 75-84 (27%). The remaining one-fifth of residents were about evenly split between those aged 65-74 (9%) and those under age 65 (11%).
• The median length of stay among all current residents at the time of interview was 671 days, or about 22 months.
• Medicaid paid for at least some of the RCF services for 19% of residents.
• Younger residents were more likely to have Medicaid than older residents. Almost 6 in 10 residents under age 65 had Medicaid (56%) compared with 39% of residents aged 65-74, 16% of residents aged 75-84, and 10% of residents aged 85 and over.
• In 2010, the mean national total monthly charge per resident for residential care was $3,165.
• About three-quarters of all residents received assistance with bathing (72%), over one-half received assistance with dressing (52%), more than one-third received assistance with toileting (36%), one-quarter received assistance with transferring (25%), and more than one-fifth received assistance with eating (22%).
• Thirty-eight percent of RCF residents received assistance with three or more of these activities of daily living (ADLs), an additional 36% received assistance with one or two of the ADLs, and 26% did not receive assistance with any ADL.
• The 10 most common chronic conditions among residents were high blood pressure (57%), Alzheimer's disease or other dementias (42%), heart disease (34%), depression (28%), arthritis (27%), osteoporosis (21%), diabetes (17%), chronic obstructive pulmonary disease and allied conditions (15%), cancer (11%), and stroke (11%).
• More than one-quarter of RCF residents had ever been diagnosed with 4-10 of the most common chronic conditions (26%); one-half of residents had ever been diagnosed with 2-3 of the most common chronic conditions; 18% had ever been diagnosed with one of these chronic conditions; and the remaining 6% had never been diagnosed with these conditions.

What concerns me with these aging trends is the Medicaid issue. With 20% of older residents and 60% of others on Medicaid, you wonder how long facilities can sustain this mix, which will most likely grow. And with that growth will come shrinkage of self-pay residents. The second issue I always worry about is the appropriateness of the care setting given the multiple chronic conditions present in this population. With nursing homes in some ways abandoning residential care, that leaves few options for our elders. So assisted living gladly takes them but are they prepared to care for them?

Weigh in industry leaders.

Learn more ~ or join the conversation!

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .