Skilled Nursing Facilities (SNF)

Nobody wants to live in a nursing home. Yeah, yeah. We get it. The NY Times offers up an opinion echoing what Politico writers and all older adults believe -- until the need actually arises. You’ve read those echo chamber opinions (and about the Green House alternatives with 10 residents each) for the past 19 years. The traditional nursing home model of 100+ residents (funded by Medicare for rehab and Medicaid for long term stays) was declared dead in 2009. Still, there are at least 1.4 million seniors who live in traditional nursing homes today. Why? You know why. Older adults with dementia or other high-care health issues, economies of scale for staffing, cost of private pay assisted living, cost of private pay home care, no near-by or any family members. No news there. Changing the subject, here are four blog posts from July 2021:

Aging in place – it’s emerged (again) during these Covid-19 times. Déjà vu all over again. But ‘aging in place’ is still a challenge and maybe a pipe dream for seniors in their late 70’s or 80’s.  Consider a few issues for starters:  chronic health conditions, mobility limitations, stairs, snow/ice, driving, dangerous hills for walking, cognitive issues, and social isolation.  You get the idea.  Then there is the cost of 24x7 home care, same as assisted living (which is $67K/year in Massachusetts, for example) or even Genworth’s 44-hours of home care ($53-54K annual).  That may work for the most well-to-do seniors.  But families are still in a position of finding and then managing the care workers, even with agency assistance. So Mom or Dad stays at home as long as feasible and even beyond – and that’s why the home care industry today is booming. And competing for the same workers as senior living firms pay their CNAs. 

Since the start of the Covid-19 pandemic, tech nice-to-haves have become critical.  Between boosting the deployment of telehealth technologies, once-delayed initiatives became instantly late. Consumers are on board with telehealth, and engagement technologies like smartphones and tablets are offered through Medicare Advantage, plus a wave of other pandemic-related tactics and free offerings appeared.  Thousands of smart speaker devices have been delivered to senior living communities.  Note that PACE programs for frail and low-income elderly are now directed by CMS to use remote technology for "activities that would normally occur on an in-person basis," such as scheduled and unscheduled participant assessments, care planning, monitoring, communication, and other activities.”