The New York Times covered the issues stemming from declining nursing home occupancy on Friday, detailing how shrinking numbers of residents has led to empty beds and hundreds of closures.
Nicholas Castle, a researcher at the University of Pittsburgh, told the Times that 200 to 300 nursing homes close in the United States each year. And according to federal data, the number of residents dropped from 1.48 million in 2000 to 1.36 million in 2015.
In the second quarter of this year, skilled nursing occupancy was measured at 81.7% by the National Investment Center for Seniors Housing & Care (NIC). The Times noted, however, that this number can hide considerable local variations; in some states, more than a third of beds were empty in 2015, according to the National Center for Health Statistics.
Bill Kauffman, senior principal at NIC, noted regulatory requirements aimed at controlling costs as a factor in the struggles of nursing homes. Among those pressures: hospitals, facing financial penalties for readmissions, that designate patients as “under observation,” which means that Medicare won’t cover subsequent skilled nursing care; surgeries moving from inpatient to outpatient surgical centers; and the growth of Medicare Advantage (MA) plans.
“They have a keen interest in lowering costs, so maybe they divert people from skilled nursing to home care,” Kauffman told the Times. “If you do go to a nursing facility, instead of a 30-day stay, maybe the plan wants the patient out in 17 days.”
People also tend to use community alternatives when they can, Ruth Katz, senior vice president of public policy at LeadingAge told the Times. In addition, federal policy has shifted funds to home- and community-based services; nursing homes now get 43% of Medicaid’s long-term care expenditures, compared with 90% going to institutions 30 years ago.
The 31 largest metropolitan markets have 13,586 fewer nursing home beds now than in late 2005, the Times noted, citing NIC data.
Written by Maggie Flynn