Leslie Ross, Department of Social and Behavioral Sciences & Institute for Health and Aging, UCSF
Edwina Newsom, Department of Social and Behavioral Sciences & Institute for Health and Aging, UCSF
Charlene Harrington, Department of Social and Behavioral Sciences & Institute for Health and Aging, UCSF
The leading edge of the baby-boom generation is beginning to flood California’s long-term care system. And the population of residents 65 and older is projected to triple by 2060. This report describes the state’s supply and use of long-term care services, including Medicare and Medicaid spending on services, and quality of care. The oversight and regulation of long-term care services varies by provider, resulting in limited information — especially quality data — about assisted living facilities, personal care providers, and other home- and community-based services.
Key findings include:
Use of all long-term care services has increased in California, with the largest growth occurring in home- and community-based services.
Medicare and Medicaid beneficiaries in California used long-term care services at a lower rate than that of the nation, with the exception of Medicaid patients’ use of personal care services, which was nearly four times higher in California than in the US.
California’s per capita supply of residential care beds for the elderly was larger than the nation’s. The state’s supply, however, has not kept pace with population growth since 2004.
California’s performance on care quality in nursing facilities and for home health services was mixed, with top-of-the-nation performance on some measures (for example, nursing facility residents losing too much weight) and bottom-of-the-nation performance on others (for example, home health care patients able to feed themselves).
Gross revenues for California’s freestanding nursing facilities grew over 50% between 2003 and 2010. One-third of these facilities had profit margins of 9% or higher in 2010.