“Adults aged 85 or more years in 13 states used assisted living at a statistically significant higher rate than the national average in 2014, according to data recently released by the Centers for Disease Control and Prevention’s National Center for Health Statistics as a supplement to the 2014 National Study of Long-Term Care Providers. The highest use occurred in states in the Northwest and Midwest. Whereas the national rate (of residents aged 85 or more years living in an assisted living community or similar residential care community on any given day per 1,000 persons) was 62 in 2014, the rate was 166 in Oregon and 165 in Washington, according to the report. The other states where use was above average among those aged at least 85 years were Minnesota (125), North Dakota (118), South Dakota (111), Nebraska (108), Idaho (105), Montana and Wisconsin (90 each), Pennsylvania (89), Maine (86), Utah (79) and Vermont (72).”
LTC Comment (from Stephen A. Moses, President, Center for Long-Term Care Reform):
Oregon and Washington have pushed Medicaid funding of residential care for years. The explanation of higher-than-average assisted living use in the Midwest is a little different. The upper tier of states get very cold in winter making it hard for older people to manage at home. So nursing homes were used in those states much more than in the south. As Medicaid-financed nursing homes became so undesirable, more and more people chose assisted living instead, even though they were much more likely to have to pay out of pocket. That in a nutshell is why expanding Medicaid financing to ALFs is so risky. It pulls more people onto Medicaid by offering more desirable care and meager Medicaid financing risks ruining assisted living as it did custodial nursing home care.