nursing facilities Archives - Long Term Care Insurance Expert | Honey Leveen

Good News: LTCi Keeps People out of Nursing Homes!

July 30, 2019 by Honey Leveen Leave a Comment

One of the greatest fears among seniors is having to move to a nursing home. In fact, a study reports that seniors fear nursing homes more than they fear death. They don’t want to lose their independence.

And the majority of family members polled have serious concerns about their loved one suffering from neglect or mistreatment in nursing homes.

When I began selling LTCi in the late-1980s, assisted living was a new industry and facilities were hard to find. Most long term care took place in nursing homes or at home. In those days, some LTCi policies did not include assisted living coverage because it was so unknown.

Well, I’ve got some good news to share!

LTCi Can Keep People Out of Nursing Homes

Things are very different today. The 2019 Millman Long Term Care Insurance Survey is out, reporting on the current landscape of the LTCi landscape. It contains lots of good news for LTCi policyholders.

In 2013, 60% of policyholders avoided nursing homes. In 2017, only 30% of LTCi claims were for nursing homes.

People being cared for in assisted living live longer than in any other setting. LTCi claims for assisted living are now the longest and most expensive claims paid.

I expect this significant drop in nursing home admissions to continue. At least for those who are protected by their long term care insurance. Today, every traditional LTCi policy on the market will cover assisted living. This was not true years ago. Assisted living is now mainstream, popular, rapidly growing, and profitable. Happily, there are so many more choices are available.

Claims Are Getting Paid and In Record Time

The good news continues!

In 2017, payments to LTCi policyholders came to $11 billion for claims. This is a 55.9% increase in claim payments in the previous year. And claims are being paid 8% faster which means families are getting relief in a more timely manner. Expect this trend to continue.

Remember, LTCi ownership is a “long” game. The average age of LTCi purchase is 57. However, people don’t usually need to file a claim until they’re in their late 70s or well into their 80s. People who buy LTCi are realists, willing to plan for a future that’s years away.

If you’re someone who enjoys reading detailed insurance analysis, you can find the full report by clicking the image, below. And if you’re someone who likes planning for an easier future, click here to receive your free, no-obligation for long term care insurance coverage.

2019 Milliman Long Term Care Insurance Survey

Are Assisted Living Facilities Keeping Up With Needs?

March 26, 2019 by Honey Leveen Leave a Comment

Assisted living facilities and their residents don’t tire of blaming each other for sub-standard care.

An article in the New York Times reported the tragic and avoidable death of a 90-year-old resident, suffering from dementia. A resident of Brookdale Charleston Senior Living, she wandered outside — and not for the first time.

Nobody noticed her absence for seven hours. She was found in the pond behind the facility, dead from puncture marks to her ear, temple, jaw and cheeks. Her pacemaker was discovered inside one of the alligators that lived in the pond.

The assisted living facility has already settled the family’s claim for wrongful death and is now facing an additional suit for emotional distress.

Sharing the Blame

I believe that the residents, their families and the facilities can share in the blame.

Undertrained Staff

Assisted living is not federally regulated. Nursing homes are. State enforcement and sanctions are often lax and not very stringent.

Many experts agree that much of the problem stems from inadequate staffing which I’ve blogged about in the past. Adequate funding will easily resolve these shortcomings. An simple recommendation, but more difficult to implement.

Assisted living started as a service for people who were more independent. Residents who need help with activities of daily living (ADLs). Some residents were experiencing early cognitive challenges. Just a generation later, assisted living often accepts people with far greater needs. Needs they may not be prepared to fully accommodate. I often see this, and it disturbs me.

The Facility’s Profit Motive

Many assisted living facilities are for-profit entities, earning handsome returns to their investors. I have some friends who manage the marketing at some of these organizations. They often tell me that they are pressured by management to fill as many apartments as they can.

Facilities cannot offer this needed care at an affordable price point that fills apartments and attain financial returns that please their investors. As the saying goes, “No one can serve two masters.”

The Resident’s Budget

The residents (or their families) pay for assisted living out of their own pockets, unlike nursing homes. Medicare or Medicaid do not contribute. They have a high appeal, as they emphasize independent living instead of intensive medical care.

Many residents are unable to afford the higher cost of fully trained and properly staffed facilities, so they let their budget determine the quality of care they receive.

People want to deny the almost certain fact that they might ever need long term care (LTC). When they inevitably do need LTC, it is common for them and their family to downplay the true extent of their needs.

So they choose the posh, upscale environment so many assisted living facilities have, instead of one that may be better-equipped to actually care for the resident.

What happens when the residents and their family realize that they’re not getting the care they need? They might experience the tragic consequences like the resident in the NYT article. They might move to another facility more appropriate for their escalating needs.

Decide to Plan

When planning for your future needs, wouldn’t it be nice to make your decisions based on quality of life and not settle for a sub-standard solution just because of your financial limitations?

Choose quality! Click here to receive your free, no-obligation quote for your own Long Term Care insurance policy.

Medicaid’s Woes Highlighted

October 14, 2016 by Honey Leave a Comment

This past month I’ve come across a few articles describing Medicaid’s woes, and highlighting peoples need to plan for funding their own long-term care, now!

This Washington Post story describes why our system is incentivized to discharge patients when they are still very needy, but their Medicare-paid re-hab benefits are exhausted. Medicaid can then often pick up costs, but it pays facilities poorly. This incentivizes facilities to admit the least needful and costly patients. In addition, “The Medicaid system is overly cumbersome and too slow to provide benefits.”

The true heroines of long-term care, paid home care providers, earn an average of $10.11 an hour, states this September New York Times article. About a third of these caregivers rely on food stamps and 28% rely on Medicaid for health insurance. Annual caregiver job turnover rate is 40-60 percent.

The article continues by stating caregivers at Medicaid-funded facilities got their pay raised to minimum wage: $7.15 per hour last year. Such caregivers are often overwhelmed with the sheer number of patients they must care for. “Ms. Walker left her job at a nearby nursing home because “sometimes you had 12 to 15 people to take care of,” she said. “You’re trying to feed everybody, give them baths, but a lot of people got neglected.”

This testimonial about Medicaid’s flaws on the receiving end of care is heart-wrenching, “When Roy Potter was weakened from postpolio syndrome and his wife, Joan, could no longer help him out of bed, a nursing home was “unthinkable,” said Ms. Potter, 83.

For a year, they paid private aides $14 an hour to come to their home in Mount Kisco, N.Y. When they could no longer afford that, Mr. Potter qualified for Medicaid, which pays the preponderance of home care costs in this country.

Over the next two and a half years, more than a dozen agency aides — some caring and competent; some not; some disappearing without explanation — cycled through their home, as did a number of short-term substitutes.

“A new person would come, and I’d have to walk them through everything all over again,” Ms. Potter said.

She grew increasingly anxious about whether an aide would show up. “Every morning I’d hold my breath until the doorbell rang,” she said. “Several times, I had to get in the car and drive to the agency and say, ‘Who is coming today?’”

Last year, when federal overtime provisions took effect, the agency cut back helpers’ hours.

She and her children succeeded in keeping Mr. Potter at home until he died in April, at 86, but finding and keeping help proved a continual battle.

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