Literature Review

Nursing Home and CCRC Spending Grew 5.6% to $191.3B in 2022—After Dropping 7.8% in 2021Skilled Nursing NewsDecember 13, 2023Nursing homes and continuing care retirement communities made up $191.3 billion of national health expenditures in 2022, an increase from $181.1 billion in 2021, reaching levels close to the onset of the Covid-19 pandemic. Pre-pandemic, such expenditures sat between $162 billion and $174.1 billion between 2016 and 2019, according to a survey published by Health Affairs. 

Assaults on healthcare workers now carry enhanced criminal finesMcKnight’s Senior LivingDecember 12, 2023Michigan is the latest state to codify protections for healthcare workers assaulted on the job, which one senior living association said will positively impact the state’s workforce shortage problem. Gov. Gretchen Whitmer (D-MI) recently signed into law two bills that create enhanced criminal fines for assaults, aggravated assaults and assaults with a deadly weapon against health professionals or volunteers while on the job. ... In signing the bills, Whitmer said healthcare workers face “rising rates of bullying, viciousness and violence.” 

VyncaCare CEO Schulte—Redesign Serious Illness Care for Patients’ Changing NeedsHospice NewsDecember 12, 2023The needs of today’s seriously ill patients necessitates the development of new, longitudinal care models that integrate the patient-centered principles of hospice and palliative care, Dr. Darren Schulte, CEO of VyncaCare, told Hospice News. Vynca launched as an advance care planning technology platform and expanded into the palliative care provider space through its 2021 acquisition of California-based Resolution Care. 

Kroger Health boosts investment in senior primary careModern HealthcareDecember 11, 2023Kroger is testing a strategic shift for its in-store clinics and moving into primary care for seniors. This month, its Kroger Health unit transitioned eight of The Little Clinic sites in Atlanta to focus on seniors, in addition to their regular services. If the change proves successful, Kroger wants to expand it to other existing locations and potentially new markets, said Jim Kirby, Kroger Health’s chief commercial officer. “We want to make sure that we’ve got the model right, and that we’re seeing the outcomes from the patients that we expect,” he said. “We want them to have that relationship with us, [so] that we can go deep with them, and we can do the best job we can to quarterback their care.”

Are nursing homes headed for an 80% direct-spend rule?McKnight’s Long Term Care NewsDecember 12, 2023A national union on Friday skewed comments made by Health and Human Services Secretary Xavier Becerra to imply federal regulators had proposed an 80% direct care spending requirement for the nursing home sector.

Aging population requires ‘bold leadership’ to protect human dignity—LeadingAge to House SpeakerMcKnight’s Senior LivingDecember 11, 2023The growing population of older adults requires “bold leadership” to ensure aging with dignity, as well as access to care and support, according to an open letter from LeadingAge to Speaker of the House Mike Johnson (R-LA). The changing demographics and need to support older adults where they live and receive services presents a unique opportunity for Johnson to demonstrate leadership and commitment to “protecting human dignity,” according to the letter from LeadingAge President and CEO Katie Smith Sloan. ... “The US healthcare system is navigating a new and unfamiliar landscape in the wake of the COVID-19 public health emergency,” Sloan wrote. “Three years of sustained stress and increasing workloads have caused a dramatic shift in staffing patterns and an alarming rise in burnout across health professions.”

Summit County nursing homes testing robots to address staff shortagesAkron (OH) Beacon JournalDecember 6, 2023Two Akron-area nursing homes—Copley Health Center and The Village of St. Edward—are turning to robots to help alleviate staffing shortages in their facilities. The robots are part of a pilot program facilitated by the Direction Home Akron Canton Area Agency on Aging & Disabilities. Each facility has adopted different procedures for their robot to help with. Examples of tasks the robots perform include meal and package delivery, hydration carts and cleaning food trays and dining areas.  ... So far during the pilot program, the two robots have traveled more than 163 miles and have made over 2,220 deliveries to residents. Though the robots are used daily and have been well received by staff and residents, they are not intended to replace human contact, according to the news release.

NPA Says House of Representatives’ Passage of Bill to Provide Veterans Additional Access to the Program of All-Inclusive Care for the Elderly Will Improve Their Lives; Urges Swift Senate PassagePRNewswireDecember 6, 2023Washington, DC—On the second anniversary of the passing of the Honorable Bob Dole (R-KS), the National PACE Association praises the U.S. House of Representatives for passing the Elizabeth Dole Home Care Act (H.R. 542) by a vote of 414-5, which will give veterans increased access to the Program of All-Inclusive Care for the Elderly across the nation. We urge the Senate to pass this bill soon so more veterans can enjoy the highest quality of life possible as they age by receiving any care needed at home or in the community. The legislation would establish formal partnerships between Programs of All-Inclusive Care for the Elderly (PACE) and nearby Veterans Affairs Medical Centers located within their geographic service areas. This policy change would broadly increase access for veterans to the innovative PACE model of care so they may continue to live at home, despite needing a nursing home level of care.

More people with dementia opting to age in place over senior livingMcKnight’s Senior LivingDecember 7, 2023People living with dementia are more likely to choose aging in place over an assisted living or a continuing care retirement community, according to a new study. A research letter in the Journal of the American Geriatrics Society reported that over the last two decades, a variety of factors have shifted where people with dementia live, including family caregiver availability, declining marriage and birth rates, alternative residential care arrangements, Medicaid expansion of home- and community-based services and the long-term care workforce crisis. Researchers said their study showed that the COVID-19 pandemic noticeably altered living arrangements for individuals living with dementia, increasing the number of those opting to age in place. ... What concerned researchers was increasing functional impairment and levels of unmet needs among those living alone or in a residential care setting, including assisted living and CCRCs, “given the limited regulatory oversight and lack of uniformity in services available in these settings.”

Patient-centered medical homes can reduce care cost of chronically ill patients, study findsMcKnight’s Home Care DailyDecember 5, 2023High-cost patients receiving care through patient-centered medical home programs are less likely to remain high-cost in the long term, according to a recent study published in the American Journal of Managed Care. ... The researchers compared the healthcare expenditures and health outcomes of thousands of PCMH and non-PCMH patients across Maryland during the state’s Multi-Payer PCMH program. They found that high-cost patients, such as those with chronic conditions, frailty or greater rates of hospital or ambulance usage, experienced better health outcomes with less health service utilization. 

Dying Broke: The High Cost Of Help Desperate Families Search for Affordable Home CareNew York TimesDecember 2, 2023... Frank Lee’s search for trustworthy home health aides—an experience that millions of American families face—has often been exhausting and infuriating, but he has persisted. ... There is precious little assistance from the government for families who need a home health aide unless they are poor. The people working in these jobs are often woefully underpaid and unprepared to help a frail, elderly person with dementia to bathe and use the bathroom, or to defuse an angry outburst.[Editor’s Note: This article is part of The New York Times’ “Dying Broke” series examining how the immense financial costs of long-term care drain older Americans and their families. For additional coverage, see the accompanying article in this package, “What to Know About Home Care Services: Finding an aide to help an older person stay at home safely takes work. Here’s a guide.“]