Paula Span reports for The New York Times on how nursing home beds are becoming harder to find. Nursing homes are closing or cutting the number of usable beds they make available. They are establishing waiting lists.
People needing long-term care are without a place to go. Over the last five years, New York State has lost 24 nursing homes and more than 3,000 beds.
As the population ages, there is likely to be a shortage of nursing home beds. David Grabowski, a researcher at Harvard Medical
“We’re seeing a serious problem and it’s heading in the wrong direction,” said David Grabowski, a health policy researcher at Harvard Medical School, reports that nursing home capacity fell five percent in the five years between 2019 and 2024. He sees the situation as only deteriorating.
The likeliest reason for the reduction in nursing home beds is that Medicaid reimbursements are too low. Medicaid is the largest payer for nursing home beds. And, Medicaid reimburses nursing homes at less than the cost of providing the nursing home care.
Most nursing homes are now for-profit. They can only sustain themselves if they have a reasonable balance of Medicare and private pay patients, along with their Medicaid patients. But, Medicare only pays for short-term stays in nursing homes. And, most people cannot afford to pay privately for nursing home stays.
Nursing homes are generally short-staffed and pay low wages, which adds to the problem of getting nursing home care. The Trump administration’s immigration policies have made staffing nursing homes all the harder, particularly in Florida, New York and Massachusetts.
Staff turnover at nursing homes is high. Not surprisingly, data from 2024 show that more than half of nursing homes had waiting lists for new patients. Rural communities have suffered some of the greatest losses of nursing homes and nursing home beds because rural nursing homes are harder to staff.
At the same time that it can be hard to find a nursing home bed, many people understandably avoid nursing homes for fear that the quality of care is poor. Reports abound of poor quality nursing homes. The Office of the Inspector General found that more than one in four nursing homes–27 percent–had quality violations that could endanger patients. Beware: Medicare star-ratings for nursing homes are a farce.
Of late, more people are getting care at home or in an assisted living facility. Even people with Medicaid are tending to get their care at home. More than 60 percent of Medicaid expenses on long-term care are now for home and community care; forty years ago 10 percent of Medicaid expenses were for home and community care.
In many cases, hospitals must keep patients longer while they wait for a nursing home bed. All this said, there are a variety of housing options for older adults. Check them out here.
Here’s more from Just Care:
- Don’t trust Medicare nursing home star ratings
- Medicare Advantage: Beware of inappropriate nursing home stay denials
- Medicare coverage of nursing home care is very limited
- Beware of chain nursing homes
- Roundup: Housing options for older adults
