The coronavirus pandemic which is now well into month number six has revealed some severe fault lines in American society, and nowhere are those problems more obvious than in U.S.nursing homes.In this AARP report published a few months ago, investigative reporter Joe Eaton describes some of the major challenges facing the nursing home industry and discusses some of the fundamental changes these institutions and their owners are going to have to make if they want to survive.
We think this article is a must-read for retirees and their families.We also hope it causes some who have ignored the question of senior housing until now to sit up, take notice, and start planning.Nursing Homes Are Facing Unprecedented ScrutinyAs COVID-19 ravages the U.S., Eaton writes, many of the nations 15,600nursing homesare among the most dangerous places to be.In the early months of the pandemic, more than a third of those who died from the virus were residents or workers at nursing homes, according to multiple analyses.
He adds that in at least 18 states,nursing homes accounted for more than halfof all COVID-related deaths.These catastrophic outcomes have finally brought the nursing home industry, which has long operated out of public view, into what AARP calls the center of scrutiny.AARP vice president Elaine Ryan believes the outbreak will push nursing home residents and their families to question whether many facilities should survive.As Ryan told reporter Eaton, I think as the data becomes clearer, families and individuals are going to rethink if nursing homes are the best and safest places for them to be.
Nevertheless, as everyone familiar with the size, structure and funding of nursing homes seems to acknowledge, bringing about fundamental change will be difficult.The AARP article lists at least five challenges that make nursing home reform particularly difficult.Well hit the highlights, but we suggest you read the AARP article here to get the full picture.Challenge #1: Nursing Home Standards Are Not Properly EnforcedAccording to AARP, Medicaid pays out more than $40 billion annually to help people live in nursing homes.However, according to Richard Mollot, executive director of the Long Term Care Community Coalition, government safety standards which looked robust on paper are often not enforced.
Mollot cites the example of low staffing levels: inspectors seldom hand out citations for low staffing, and if a fine is ever assessed, its so small that its cheaper to just pay it instead of hiring a staff person.Mollot believes that federal and state regulations should require at least one registered nurse on staff at all times, as well as an expert responsible for preventing the spread of infections that plagued nursing homes long before COVID-19, says AARP.If nursing homes fail to meet the mark, they should be fined or shut down.Recently the federal government, in a belated response to the pandemic, announced stricter infection control, standards for nursing homes, along with stricter finds for non-compliance.
Its a start, at least.Challenge #2: Many Seniors Believe They Lack the Means to Allow Them to Age at HomeSurveys of seniors show time and time again that almost all would rather age in their own home.However, if they choose to, theyll likely get little help from Medicaid, according to AARP.Current law mandates that states use their Medicaid dollars solely for nursing home services, effectively cutting off stay-at-home options for countless older Americans.
If a state wants to divert some of those funds to provide care outside of a nursing home, such as for home care or community services for the elderly, it needs to file for a federal waiver a long, difficult process.That makes providing home care more difficult.The result is that people feel forced to live (in the words of one AARP executive) in such close proximity to people who are not family or friends that the inevitable result is neglect, isolation, depression and medical deterioration.But Rajiv Nagaich of AgingOptions has a somewhat different priority, emphasizing the imperative of planning ahead.
Unless you have a plan to avoid a nursing home, you can expect more of the same bad outcomes, he says.Thats why a housing strategy is a key component of comprehensive retirement planning.Well explore this more in a moment.Challenge #3: The Environment in Many Nursing Homes is UnhealthyAARP writes that the coronavirus outbreak has demonstrated the failure of infection when residents share rooms, toilets and showers, and when staff is forced to rush from room to room.
Its also bad for quality of life.But thats the nature of most nursing home accommodations, and making improvements will require new regulations and more Medicaid reimbursement.Still, if we fail to act, were only perpetuating the problem, experts say.We have consigned poor, frail, elderly people to a place where none of us would choose to be, says Robert Kramer the National Investment Center for Seniors Housing and Care.
We now want something different, but are we willing to pay for it?Challenge #4: The Nursing Home Workforce is Underpaid and Staffing is InadequateIn spite of the well-deserved attention paid to health care professionals during the pandemic, nursing home workers generally remain underpaid, and the homes where they work are chronically understaffed, says AARP.The national average pay for caregivers is about $13 an hour, according to Lori Porter of the National Association of Health Care Assistants.Her group argues that only by increasing both wages and staffing can the current care crisis in nursing homes be alleviated.Staffing shortages put residents at risk as workers are forced to cut corners, the AARP article warns.
Investigations by the Department of Health and Human Services reveal that many nursing homes have skipped background checks and hired caregivers with criminal backgrounds.This lack of procedural oversight makes abuse and neglect virtually inevitable.Challenge #5: Long-Term Care Insurance Remains Out of Reach for Most SeniorsMedicaid pays an average of $6,180 per [nursing home] resident per month, says AARP, an amount very few Americans can afford on their own.Unless a senior has plenty of money or a cooperative family, long-term care insurance is considered to be the primary funding alternative.
But coverage is pricey, and many companies have left the LTC business entirely, which is why only 7.2 million Americans have policies in force.Proposals for a federal long-term care insurance program that would help Americans save and pay for care late in life have made no headway in Congress.How Can the Nursing Home Industry Move Forward?Many experts quoted in the AARP report said they hope the pandemic sparks what one official calls a 9/11 moment that will cause people to demand change.But no one knows what form it might take.
One idea advocated by AARP is to force Medicaid to think outside the nursing home box.Medicaid should be more focused on home and community-based care, another AARP executive said.And Medicare has to cover home health care to a greater degree.
Officials say such shifts would allow care for frail elders to move from hospital-like complexes to smaller facilities with more individual care, or to their own homes.Reforming the long-term care insurance market is another goal many are advocating, so that more Americans can afford the type of care they wish for in their final years.At the same time, nursing homes have to be made safer: Congress needs to put teeth into laws requiring infection control in nursing homes, says the article, with a new level of accountability in resident care.Dramatic change is hard.
But if it is to ever happen, now is the time, one housing expert told AARP.This pandemic has made us painfully aware that we cant ignore our most vulnerable people.The Real Key to a Solid Estate Plan: an AgingOptions LifePlanWhen it comes to retirement planning, most people focus on one fairly narrow issue: money.Financial planning is an important component of retirement planning.
But people heading towards retirement often make the mistake of thinking that a little financial planning is all thats required, when in fact most financial plans are woefully inadequate.This article describes the urgent need to plan ahead for your senior housing needs, but too many ignore the housing issue entirely until the family is forced by a health crisis t0 make a snap decision.Speaking of medical coverage, will yours be adequate, or will that health crisis knock your financial plan off course? Are you adequately prepared legally for the realities of retirement and estate planning? And is your family equipped to support your plans for the future as you age? The best way we know of to successfully blend all these elements together finance, medical, housing, legal and family is with a LifePlan from AgingOptions.Thousands of people have discovered the power of LifePlanning and we encourage you to the same.Simply visit our website and discover a world of retirement planning resources.
Make certain your retirement planning is truly comprehensive and complete with an AgingOptions LifePlan.Age on!(originally reported at www.aarp.org)
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