Long-Term Care in California: Ready for Tomorrow’s Seniors?

By: Charlene Harrington , Edwina Newsom

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.

A horizontal bar chart titled "Use of Long Term Care 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.

A bar chart titled "Beneficiaries Receiving Nursing Facility Services."
 

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.

A bar chart titled "Assisted Living Facility Beds."
 

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).

A horizontal  bar chart titled "Nursing Facility Quality Measures with High Rankings."
 

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.

A chart titled "Freestanding Nursing Facilities by Profit Margin."

 

For further data and analysis on this topic, visit resources from the Office of Statewide Health Planning and Development, CalQualityCare.org, and these reports and datasets from the Centers for Medicare & Medicaid Services.

The complete report and all the charts found in the report, as well as the 2009 edition, are available under Document Downloads.