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Fact Sheet: Long Term Care

- The need for long-term care affects nearly every American family. Six of every 10 Americans have experienced a long-term care problem, either within the family or through a close friend.

- There are 10.6 million people living in communities and 1.6 million living in nursing homes who have had some limitations in activities of daily life because of chronic illness or
disability.

- Trends indicate that one in four persons over the age of 25 will have at least one stay in a nursing home during their lifetime.

- All states have received home and community-based services (HCBS) Medicaid waivers to deliver community based care beneficiaries at risks of institutionalization in a nursing
facility.

- Medicaid pays for 46 percent of nursing home costs and 42 percent of home care costs but only after individuals have spent down their assets in order to qualify for the program.

- Medicare covers 12 percent of nursing home costs—paying only for stays of fewer than 100 days—and one-fourth of home-care.

- One-quarter of nursing home and home health services are paid out-of-pocket.

- Pre-existing conditions and affordability preclude most older persons from obtaininglong-term care insurance. Fewer than 10% of older Americans have purchased long-term care insurance.

- Federal tax credits and tax deductions for long-term care insurance are insufficient for addressing the need for a long-term care system, and at the same time, they would deplete public resources.

- Long-term care is especially a women’s issue: the majority of care recipients and caregivers, informal and paid, are women. Women represent 7 of 10 unpaid caregivers, three-fourths of nursing home residents, and two-thirds of recipients of home health care.

- Ninety-three percent of home and nursing home aides are women. Certified nursing assistants (CNAs) provide 90 percent of the hands-on care in nursing homes. Home health and personal care aides provide the vast majority of paid direct care in the home and community. Low levels of pay, limited opportunities for advancement, and lack of benefits create an average annual staff turnover rate in nursing homes of 76 percent and higher. Nurses’s aides are also subject to a high incidence of back injuries.

Alliance Position
The Alliance for Retired Americans supports a social insurance model for a long-term care system that provides a range of quality care services for all who need it, whether seniors or persons with disabilities of any age. The system should be affordable and based on health and physical needs, not income or asset levels; protect an individual’s right to choice of provider and care environment; guarantee enforcement of quality assurance measures; include educational efforts to promote informed decision-making; and acknowledge the important contribution of paid and unpaid caregivers.

The Alliance calls upon federal and state governments and long-term care providers to recognize the essential role of front-line long-term care workers in ensuring quality care, by guaranteeing them the right to organize and bargain collectively with provisions for effective enforcement, living wages and employment conditions and the dignity, rights and respect that quality care requires.

The Alliance supports expanded funding for the federal Family Caregiver Support Program as well as national enactment of financial and other support for family caregivers.