The Future of Nursing Home Care in the U.S.

The latest research suggests that 200-300 nursing homes close per year in the United States. What is driving increased closure rates and what does it mean for the level of care seniors are receiving across the country?

Read more about the future of nursing home care in the U.S.

Closures of Nursing Homes in the U.S.

The financial pressures faced by nursing homes in the U.S. is mounting as they face reduced occupancy rates. The National Investment Center for Seniors Housing & Care (NIC) states that the nation-wide occupancy rate of nursing homes is 81.7%, a startling reduction when you consider the best nursing homes are still at maximum capacity.

Bill Kauffman, senior principal at NIC, tells the New York Times that drop poses a challenge. “The industry as a whole is under pressure, and some operators are having difficulty,” he says.

Those nursing homes that can’t fill their beds see reduced income and can’t always offer the same quality of care as nursing homes with full occupancy. This financial pressure combined with added stress due to government regulations causes many nursing homes to close their doors.

One specific challenge for nursing homes is maintaining staff levels. Some nursing homes are experimenting with 12-hour shifts so they can cut labor costs, yet this reduction of staff could impede the quality of care seniors in the community receive.

Not to mention that the skilled nursing care industry already faces staff shortages.

Leaving a Closing Nursing Home

If a nursing home is forced to close, those residents who remain may be left in the lurch, struggling to find a nursing home to take them on short notice.

Some states have laws against this, but still, the transition is not easy. Roger Wilday ran the Ledgeview Living Center, which closed in August 2018. He tells the Bangor Daily News that the closure was emotionally challenging for everyone.

“We had some [residents] that had been there up into 20 years. We had employees that had worked for us for 40 years.” Wilday says. “A lot of tears were shed over the 30 days we were working to close.”

Of the residents, Wilday says, “It was hard for them, it was their home… You’re disrupting their home and sending them someplace that they’re unfamiliar with.”

While leaving a closing nursing home is upsetting for residents who are torn from a support system that many feels like a second family, nursing home closures can indicate some positive trends in the industry. The closures may indicate that seniors are finding they can choose alternatives to nursing care or stay in their own homes for longer.

Solutions for Nursing Homes and Seniors

Nursing homes are working on thinner margins because a larger portion of Medicare dollars is going to services for seniors who are choosing to remain at home or to pursue other alternatives to nursing home care. Decades ago, nursing homes received 90% of the Medicare dollars for long-term care. Now, community and home-based options have cut into that percentage. In fact, these programs now receive over half of Medicare dollars, at 57%, while nursing homes receive the remaining 43%.

The increasing availability of community care and home options also drives down the demand for nursing home spots. While the top-tier of nursing homes remain full, those potential residents who can’t afford that care will continue to look for other options.

While many seniors may find that community care options are better for them, not all seniors will have these options. Seniors will continue to seek nursing home care and demand will likely increase again. With the changing demographics, it’s possible that nursing home closures are a temporary problem.

How can nursing homes stay in business until the demand for their services increases? Homes across the country are trying new strategies:

One is to attract residents for short-term care after injuries or surgeries. Few home environments can provide the medical care necessary after hospital stays, so nursing homes fit this supplemental role well.
With so many empty beds, another solution is for nursing homes to alter shared rooms into private rooms. Seniors may prefer this change, although they will pay more for it.

Still, even with these adaptations, nursing home closures remain a complex issue.

Research suggests that those nursing homes that gain a higher proportion of their funds from Medicare are more likely to close, meaning that policy decisions play a large role in their success or failure. Policy alternatives, including better training for managers, increasing Medicare vouchers and take-overs of fragile nursing homes serving rural communities, have all been suggested as paths forward.

Has a nursing home closed near you? What do you think the future of nursing home care looks like? We’d like to hear your stories and thoughts in the comments below.

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