Nursing facility utilization is declining
By Robert P. Dean
Over the last several years, nursing facility usage has been declining in Massachusetts and throughout most of the United States. The number of nursing home residents per 1,000 people age 75 and older fell by 19.9% between 1997 and 2007. Here in Massachusetts, the Department of Public Health (DPH) recommended in May that the current freeze on new nursing home construction in Massachusetts be extended for five more years. According to the DPH there is at present a surplus of over 10,000 nursing home beds in Massachusetts, and there will be no new bed need through 2015.
One of the major factors that is contributing to the decline of nursing facility utilization is the expansion of home and community-based services for individuals who need long-term care services. Here in Massachusetts, in-home services are available through the State Home Care, Enhanced Community Options (ECOP), and Choices programs, each of which offers a progressively higher level of care as appropriate. In fact, the ECOP and Choices programs provide services to frail seniors who are clinically eligible for nursing facility placement but choose instead to receive their long-term care services in their own homes. Such in-home services include assistance with basic personal care needs such as bathing, bathroom assistance, getting dressed and ready for the day, and with homemaking. Meals on Wheels are also available for frail, homebound seniors who are unable to prepare their own meals or attend a senior lunch site. Here in Berkshire County, we are serving more than 1,000 seniors a month in our State Home Care, ECOP, and Choices programs. These home and community-based services are far less expensive than nursing facility placements, and can help prevent or delay these more costly placements.
Another factor that has contributed to the decline in nursing facility usage over the last several years is the expansion of community residential care and housing options such as Assisted Living, Supportive Housing, and Service Enriched Housing. Assisted Living Facilities provide a housing option for individuals who are unable to live alone safely, yet can maintain a higher level of independence than in a nursing home. Assisted Living Facilities vary widely in the number and size of units, and there may be a variation in the services provided beyond the basics of meals, housekeeping, and personal care assistance. Supportive Housing at Providence Court in Pittsfield is a collaboration between Elder Services and the Pittsfield Housing Authority to provide all residents of Providence Court with on-site services and supports, which allow them to continue to live as independently as possible. Crossway Village in Lee is the first housing with enriched services project developed by Elder Services. These enriched services help the residents to maintain their independence in a supportive living environment. Construction is currently underway on Crossway Tower, which is adjacent to Crossway Village, and will offer additional units of housing with enriched services when completed.
While nursing facilities must continue to maintain a vital place on the continuum of long-term care services, it is important that the Commonwealth continues to invest in home and community-based services and housing options for seniors, and that seniors have as much choice as possible as to where they will receive their long-term care services.
Happy Father’s Day.
Editor’s Note: As a result of reduced funding, statewide managed intake for the State Home Care program began in September 2009. In May 2010, more than 2,000 seniors - 85 of whom are Berkshire County residents - were on the statewide State Home Care program waiting list.
Robert P. Dean is Executive Director of Elder Services.
