2020 Edition — Long-Term and End-of-Life Care in California

Is California Meeting the Need?

Jen Joynt, Independent Health Care Consultant


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As the baby boom generation ages, California’s population of adults age 65 and older continues to rise and is projected to represent 20% of the state’s population in 2030. The aging of California’s population coupled with the projected growth of seniors living with limitations in activities of daily living will likely increase the need for long-term care services.

Long-Term and End-of-Life Care in California: Is California Meeting the Need? describes the state’s supply and use of long-term care services, Medicare and Medi-Cal spending on services, and quality of care.

Key findings include:

    • Medicare and Medi-Cal accounted for the majority of spending on long-term care services.
    • Medi-Cal offers a variety of home and community-based programs to help seniors and persons with disabilities and chronic illnesses live independently outside institutions by assisting with daily needs.
    • California nursing facilities performed similarly or better than the national average on a number of quality measures.
    • California nursing facilities averaged a higher number of deficiencies than nursing facilities nationwide, and nearly one in five received a deficiency for actual harm or jeopardy of residents in 2017.
    • In California, both assisted living beds and users increased from 2012 to 2016 — 30% and 28%, respectively.
    • Between 2008 and 2018, the number of home health agencies in California increased by 50%, while home health visits increased by 40%.
    • The number of hospice agencies licensed in California quadrupled from 2008 to 2018, and the number of hospice days doubled.
    • In a 2019 survey of Californians, 65% of respondents reported that their loved ones would have preferred to die at home, while only 39% were able to do so.

 

Long-Term Care and COVID-19

With the COVID-19 pandemic, long-term care facilities are under heightened scrutiny, as these facilities represent high-risk settings for COVID-19 outbreaks due to the advanced age and underlying health conditions of their residents. In addition, the close living arrangements and frequent contact between residents and staff can exacerbate the spread of the disease.

As of June 20, 2020, more than 2,200 skilled nursing facility residents have died of COVID-19 in California. In addition, nearly 400 residents of adult residential facilities and of residential care facilities for the elderly have died of COVID-19. Together, long-term care residents accounted for 49% of all COVID-19 deaths in California.

The full report, and all the charts found in the report, are available for download below. These materials are 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.