COVID-19 dealt a huge blow to nursing homes nationwide. The good news is that after a difficult couple of years, the pandemic finally seems to be drawing to a close.
But this is no time to rest.
Stakeholders must now examine the current state of the industry and design measures to address both the pandemic’s short and long-term effects, and the new challenges that are springing up.
Nursing home stats are a good place to start. Let’s take a look at some of the latest figures and what they mean for the future of eldercare in the U.S.
Important Nursing Home Stats You Should Know in 2022
The COVID-19 pandemic was a game-changer for the nursing home industry. Many things will not be the same moving forward. Here are ten nursing home stats that shine a light on the present and future of nursing home care in the United States:
1. A Record 1.3 Million People Now Live in Nursing Homes
According to the latest Centers for Disease Control (CDC) data, in 2016 there were 15,600 nursing homes nationwide with a total of 1,347,600 residents.
This figure is only going to increase as Americans live longer. Life expectancy in the U.S. has grown from 69.7 years in 1960 to 79.4 years in 2015. By 2060, that number is projected to reach an all-time high of 85.6 years.
In addition to people living longer, the older segment of the population is increasing as baby boomers age and birth rates decline. In 2018, there were 52.4 million Americans aged 65 and over. By 2040, they are projected to reach 80.8 million, or 21.6% of the total population.
The National Center on Elder Abuse (NCEA) expects a 50% increase in the number of elders needing nursing home care as early as 2030. If we want to meet that level of demand, we need to start increasing capacity now, both in terms of facilities and nursing home staff.
2. Nearly 70% of Nursing Homes Are For-Profit
The vast majority of nursing homes are for-profit (69.3%), and more than one in two are affiliated with corporate chains (57.6%).
A 2020 MarketWatch study found that 11% of nursing homes in the U.S. were owned by private equity firms. Real estate investors have also entered the market after the Housing and Economic Recovery Act of 2008 made it possible to buy healthcare facilities.
Private Equity’s entry into the nursing home market has led to a proliferation of complex ownership structures. Many nursing homes have separate operating and asset and property entities to shield parent companies from liability and regulatory oversight. As a result, the profits of many facilities remain unclear, and there is little transparency into Medicare and Medicaid spending. This is starting to change.
In California, Bedsore.Law Founding Partner Ernest Tosh helped lawmakers and advocacy groups craft SB 650, The Corporate Transparency in Elder Care Act of 2021, that was signed into law by Governor Newsom on October 4, 2021. The bill requires skilled nursing facilities to provide consolidated financial reports and documentation of the corporate structure to the public and state regulators with the Office of Statewide Health Planning and Development (OSHPD) starting in 2023.
In addition to California, Bedsore.Law is working with lawmakers in Pennsylvania, New Jersey and Maryland to increase financial and ownership transparency.
Nationally speaking, the Centers for Medicare & Medicaid Services (CMS) will need to create better audit and reporting mechanisms to ensure nursing home financial reports, parent companies and all related corporations are fully disclosed.
3. Nursing Homes Have Lost 241,000 Employees in Two Years
In 2016, a total of 945,700 nursing employees – including registered nurses (RNs), licensed practical and vocational nurses (LPNs and LVNs), and aides – worked in nursing homes.
This may seem like a lot but is far from enough. The pandemic exacerbated existing nursing home staffing issues to a point where 23% of facilities reported personnel shortages by January 2021. In some states, that percentage exceeded 50%.
It only got worse with time. By March 2022, the sector had lost 241,000 jobs or 15.2% of its workforce since the start of the pandemic. At this juncture, regulators will need to provide higher wages and better working conditions to ensure adequate staffing in the future.
4. Bedsores in Nursing Homes Rose by 31% During the Pandemic
Bedsores, also known as pressure sores, pressure ulcers, or decubitus ulcers, are wounds caused by repeated pressure on the skin. The condition can be hard to treat and could lead to serious and potentially fatal complications like septic shock. Those with reduced mobility, such as bedridden people or wheelchair users, are at a higher risk of developing bedsores, which is why they should be repositioned often.
Bedsore stats are an essential indicator of the quality of nursing home care. In 2004, some 159,000 people, or 11% of nursing home residents, had bedsores. Only 35% of those with more severe bedsores (Stage II or higher) received special wound care services.
As can be expected, the pandemic did little to alleviate the problem. Quarterly CMS data indicate that pressure sores in nursing homes grew by 31% between Q4 2019 and Q2 2021.
5. Almost One in Two Nursing Home Residents Have Depression
The CDC reports that out of all long-term care service users, nursing home residents were most likely to have depression. Nearly half of them (46.3%) were diagnosed with depression in 2016. This was even after 87.6% of nursing homes offered mental health or counseling services.
The good news is that regulators are taking action to improve the delivery of mental health care in nursing homes. The Department of Health and Human Services (HHS) recently unveiled a $15 million funding opportunity to create a Substance Abuse and Mental Health Services Administration (SAMHSA) program for nursing homes and other long-term care facilities.
6. Elder Abuse Is Widespread but Remains Underreported
The NCEA notes that, while very few studies have looked into the prevalence of elder abuse in long-term care institutions generally and nursing homes, in particular, the available data indicates high levels of:
- Psychological abuse (33.4%)
- Physical abuse (14.1%)
- Financial abuse (13.8%)
- Neglect (11.6%)
These projections likely underestimate the actual figures. For every reported incident, there are nearly 24 undetected cases due to fear of retaliation, shame or embarrassment, fear of institutionalization, dependency on the offender, physical limitations, or cognitive impairments. A lot more effort is needed in researching, understanding, and reporting elder abuse in nursing homes.
7. Over 153,000 Nursing Home Residents Have Died From COVID-19
COVID-related deaths now appear to be declining. However, the pandemic has brought to light a dire need for nursing home reforms before the next public health emergency strikes, including:
- Improving staffing levels
- Ensuring safer working conditions
- Improving nursing home and resident hygiene
- Providing adequate personal protective equipment (PPE)
- Reducing resident room crowding
8. Most Nursing Home Lawsuits Are Settled Out of Court
National lawsuit statistics are not available. However, elder abuse and neglect were frequent enough to prompt the U.S. Department of Justice to investigate 30 nursing homes across nine states suspected of providing “grossly substandard care” in 2020.
A 2003 study found that 88% of nursing home lawsuits settled out of court and did not go to a jury trial. The average recovery at the time was $406,000. That figure has likely increased significantly in the intervening years.
9. Three in Four Nursing Home Residents Are White
The CDC nursing home stats indicate that 75.1% of residents are non-Hispanic white persons. To an extent, the disproportionate utilization of nursing facilities by race and ethnicity could be explained by cultural differences, such as a preference for larger, multigenerational households and family caregiving.
That said, concerns remain that socio-economic disparities, unequal geographical distribution, language barriers, and a lack of information also come into play. More efforts are needed to guarantee equitable access to nursing home care for ethnic and racial minorities and lower-income groups.
10. Medicare Only Covers up to 100 Days of a Nursing Home Stay
A surprising number of Americans are under the impression that Medicare will cover their stay in a nursing home.
Medicare does not pay for long-term care. It only covers up to 100 days immediately after a hospitalization which lasts a minimum of three days. Medicare pays 100% of the cost for the first 20 days. For days 21 through 100, the resident has a daily copayment of $194.50 in 2022. From day 101 on, other funding must be in place.
National monthly median costs in 2021 were $9,034 for a private room and $7,908 for a semi-private room. Depending on the location, the prices can be much steeper. It can also be hard for nursing home residents to predict how long they will need to live in a facility, so they must budget their retirement savings carefully.
Have You or a Loved One Developed Bedsores in a Nursing Home?
At Bedsore.Law, bedsore litigation is what we specialize in. We represent nursing home residents with Stage III and IV bedsores due to abuse, neglect, or poor care.
Our expert attorneys have more than seven decades of combined experience protecting the rights and dignity of older adults and their families across the country. We do everything in our power to ensure that our clients get justice and the compensation they deserve.
If you or a loved one has developed bedsores due to inadequate care in a nursing home, contact us today to discuss your options. You do not have to be just another entry in pressure sore stats records.