Wisconsin Leads Nation In Nursing Home Beds Lost

In the face of continued reports predicting increased need for care resulting from aging or disability a report reveals that the number of available nursing home beds in the U.S. continues to decline. Several states reported double digit declines in the number of available beds compared to the prior year.

The report from the American Association for Long-Term Care Insurance indicates the number of available beds nationally at the beginning of 2009 was 1.67 million, a two percent decline from the prior year. The decline in Wisconsin was 19.8% compared to the prior year.

Financial executives predict that if population and economic trends continue, the nation may face a two-class system of providing long-term care for millions of aging and disabled individuals. "Those with savings or private insurance will have options available," predicts Jesse Slome, executive director of the industry trade group. "We are likely to see a two classes of care with an increase in the number of skilled care facilities established exclusively for individuals who are not dependent on government programs, Medicare and Medicaid."

Skilled nursing facilities that depend on government payments face a projected Medicaid shortfall in 2009 of $15.64 a day per-resident. "You can not provide quality service when you are losing almost $6,000 per-resident on an annual basis," Slome explains. "At some point you can not make up the shortfall in government programs by charging higher rates to those with the ability to pay privately." While experts report that the under-funding is not increasing sharply for 2009, it is expected to expand wider in 2010 as state budget shortfalls continue to affect available dollars from state-funded Medicaid programs.

Nursing homes that depend on Medicare and Medicaid payments are facing serious financial difficulties. Both programs funded by Federal and State taxes have cut benefit payments over the past year. As a result of financial deficiencies, in Wisconsin 17 percent of nursing home facilities are reportedly in bankruptcy.

States recently received $87 billion in increased federal medical assistant percentage (FMAP) funding as a result of the economic stimulus package. Nursing home industry officials report that many have not used the funds to increase Medicaid rates paid to facilities. Instead, they have used it to balance their budgets. Looking forward, a total of 48 states face budget shortfalls.

According to the American Association for Long-Term Care Insurance's annual update, majority of long-term care spending (49%) is financed by the Medicaid program which is funded jointly by the federal government and states. Medicare, which currently provides health care to older Americans, financed about 22% of costs according to the Congressional Research Service.

"In a next few years, residents of Wisconsin and most other states will realize that only those who have set aside sufficient savings or who purchased long-term care insurance may have access to non-government supported facilities," Slome explains. "Unfortunately, for many, it will be too late to health-qualify for long-term care insurance."

The number of certified licensed nursing facility beds in the United States was 1.669 million as of January 1, 2009 the organization reports. At the beginning of 2003, there were some 1.7 million nursing home beds, a net decrease of 31,000. Texas had the largest number of nursing home beds (122,635), California had 121,950 followed by New York with 120,101. Alaska had the fewest beds with 725.

States reflecting a double-digit percentage decline in the number of nursing home beds are Wisconsin (down 17.9%), Minnesota (down 15.9%), and Rhode Island (down 11.0%). The District of Columbia reported a drop of 13.9%.

Several states actually had an increase in the number of nursing home beds. Texas reported an increase of 11.9% adding 904 beds. Delaware reported a 12% increase, with a total of 4,787 available beds. Nevada reported an increase of 11.2%, with a total of 5,613 beds.