2009 Edition — Long-Term Care in California

Facts and Figures

Charlene Harrington, Department of Social and Behavioral Sciences & Institute for Health and Aging, UCSF
Theodore Tsoukalas, Department of Social & Behavioral Sciences, UCSF


In 2007, more than a million Californians used long-term care (LTC) services, including institutional and home- and community-based services (HCBS). That number is expected to skyrocket as the number of Californians 85 and older and working-age individuals with disabilities increases. Individuals who receive long-term care include adults and children with disabilities and the elderly. Alternatives to institution-based care include: residential, home health, hospice, and personal care services programs.

This report highlights the changes taking place within California’s long-term care system.

Key findings include:

  • Although California spends $3.8 billion on Medicaid nursing home services, the state’s nursing homes continue to have a large number of federal deficiencies, state citations, and complaints.
  • California Medicare beneficiaries use fewer home health and hospice services than the national average.
  • The use of Medicaid HCBS in California has increased, while the use of nursing home services remained about the same between 2003 and 2007.
  • Institutional care for medicaid represents 20% of all beneficiaries and 50% of all spending in California.
  • California had a higher percentage of Medicaid long term care beneficiaries receiving home- and community-based care than the national average, 80% versus 62%.

The full report is available for download below. This material is part of CHCF’s California Health Care Almanac, an online clearinghouse for key data and analyses describing the state’s health care landscape. See our entire collection of current and past editions of Long-Term Care in California.