Nursing Home Use By Medicaid Senior Plummeting

images (68)

For 15 years, long-stay nursing home care by seniors enrolled in Medicaid has been plummeting. Although the reason behind it isn’t clear, there is likely a number of reasons. 

(Related: Long-Term-Care Insurance Dilemma)

First, state Medicaid programs have been shifting care from nursing facilities to home and community-based settings; this is a step that many seniors prefer and often save money in the long run. Medicaid continues to spend more total dollars on nursing home care than on home care, but nursing facility use my Medicaid-eligible seniors has plummet one third, from 1.4 million in 1995 to just over 1 million in 2010.

(Related: Health Insurance Scams On The Rise)

The  second reason is that seniors’ enrollment in Medicaid is growing very slowly even though the overall older population is growing exponentially. The number of people 65 and older increased by more than 80 percent from 1975 to 2010 and the number of those over 85 (who are the most likely candidates to require long-term supports and services) has tripled. With that said, Medicaid enrollment by seniors increased by just 18 percent from 1975-2010. This comes at great contrast so younger Medicaid beneficiaries, who have increased by more than 200 percent. 

And a third reason could be that nursing homes would prefer providing post-acute and rehabilitation services opposed to long-stay care. This could be due to the fact that Medicaid pays an average of only about $125 per day for a long-term care resident, while Medicare pays $500 or $600 per day for a post-acute short-stay patient. As a result, a number of nursing home operators are shifting beds from long-term care to more lucrative rehab and post-acute.

(Related: Updates to the National Plan to Address Alzheimer’s Disease)

Christopher J. Berry is a Michigan elder law attorney Dedicated to helping seniors, veterans and their families navigate the long-term care maze. To learn more visit or call 248.481.4000