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Nursing Home Trends
View Stats and Trends for the Skilled Nursing Industry

Evaluating a Nursing Home Facility

In a research report written by American Health Care Association (March 2014), it shows that skilled nursing home facilities have fewer residents who need certified beds, but those residents who live in nursing homes have more need for care. This measure indicates the total number of certified beds in the nursing home. Some nursing homes combine Medicare, Medicaid, and private pay beds.

*Please check with the nursing home to find out what types of beds are available.

Certified Beds estimated: 1,684,482 beds in Mar '04 to 1,663,537 in Mar '14

Patients in Certified Beds estimated: 1,441,930 in Mar '04 to 1,368,986 in Mar '14

Certified Facilities estimated: 16,179 in Mar '04 to 15,650 in Mar '14

Median Nursing Facility Occupancy for Certified Beds Over Time - indicates how many residents in certified beds were living in the nursing home at the time of the inspection. Occupancy Rate This measure shows the percentage of certified beds occupied by residents at the date of the examination. It's obtained by taking the number of residents occupying certified beds at the time of the inspection divided by the total number of certified beds in the nursing home. 88.5% in Mar '04 to 85.6% in Mar '14

Evaluating the Direct Care Staff - Hours Per Patient Day computed as the total number of hours worked by direct care staff in each category divided by a 35-work week and by the number of residents.

Direct Care Staff: 3.32 in Mar '04 to 3.72 in Mar '14

Nurse Aide: 2.29 in Mar '04 to 2.44 in Mar '14

Licensed Practical Nurse: 0.70 in Mar '04 to 0.46 in Mar '14

Registered Nurse: 0.33 in Mar '04 to 0.46 in Mar '14

Nursing Facility Average ADL Dependence Over Time - measures the resident activity of daily living dependence. Activities of Daily Living (ADL) are activities done during a typical day such as getting in and out of bed, dressing, bathing, eating, and using the bathroom. Independent residents can execute one activity of daily living independent of direct care staff or with only "set up" assistance. Residents needing assistance can partially achieve the activity but requires considerable assistance from direct care staff to complete.

Residents who are dependent for an activity are incapable of executing a simple act and depend on the staff for help. This measures how dependent a resident is on the staff to accomplish dressing, bathing, transferring, toileting and eating, then divided by the total number of residents.

3.91 in Mar '04 to 4.18 in Mar '14

Source: Nursing Homes Data Trends

Nursing Home Trends

Why the downward trend in number of nursing homes certified beds?

In the past, a nursing home was the place elderly adults wound up living the rest of their days.

Now, through new programs, for those who qualify for Medicaid can receive Medicaid funded services at home and in their communities.

So now, elderly adults are able to go home and stay home.

For the elderly adults who don't qualify for Medicaid funded home care, the Office on Aging can help them locate community services and other funding for in-home care.

The Office on Aging also offers non-medical help like transportation, meals, and homemaker services to residents 60 and older, regardless of income, under the federal Older Americans Act. Check with your local Office on Aging to locate community services for elderly in your area.

Recent Trends in Nursing Home Care

Trends in Nursing Homes
Trends in Nursing Homes

The belief is that nursing homes are a place for old people. Today, that's not an accurate picture of what it really is.

When was the last time you visited a nursing home? Not lately?

Well, a visit would prove that perception incorrect and you'd walk away quite surprised.

Past: Nursing homes were a place where people went to spend their final years.

Today: Nursing homes increasingly serve patients' (young and mature) short-term rehabilitation needs.

  • Rehabilitation is a big part of what nursing homes do today. In some states, one-fourth or more of the residents in one come to one after hospitalization for an acute problem like stroke or hip fracture. Most return home fully recovered or at least able to live independently. Wait-lists: In the past, getting into a nursing home meant adding your name to await-list.
  • Because of short-term care, residents leave making wait lists shorter or non-existent. But check with you local nursing homes, in some states long wait lists do exist. As noted in the research study above, certified bed occupancy rates are going down. The rate of nursing home real estate development increases due to the surge of older boomers.
  • There's an increase of nursing home facilities in preparation for the aging baby boomers. Improved care: Today, nursing homes provide services and medical procedures offered in hospitals. Physical therapy, occupational therapy and speech therapy are now provided by nursing homes.
  • Nursing homes no longer just offer nursing care for the elderly. Due to post-acute care needs, nursing homes add hospital-like services to assist patients post-surgery. More variety: Skilled nursing facilities now offer upscale communities and provide care exclusively to residents.
  • Nursing homes have changed from the older institutional setting to contemporary, comfortable, and home-like. Some even offer arts and cultural events for residents and sports and games and crafts. Individualized care: More nursing homes focus on resident-centered care.
  • individualized care is a goal of the new nursing home facility. Today, facilities advocate for culture change in long-term care. Residents get involved in their care plan and even operations of the home. Radical changes incorporate all-purpose workers who cook, clean, and help with daily activities.

Paying for Nursing Home Care

The greatest revenue for nursing homes today is Medicare for short-term rehabilitation and Medicaid for long-term care.

Medicare covered the cost of 12 percent of the patients receiving care in skilled nursing facilities and Medicaid covered 73 percent (2010).

Despite the financial challenges facing nursing homes, they'll continue to provide both, long-term and short-term care offerings and delivering quality care.

Carol Marak
Carol Marak

After seven years of helping her aging parents, Carol Marak has become a dedicated senior care writer. Since 2007, she has been doing the research to find answers to common concerns: housing, aging and health, staying safe and independent, and planning long-term.