Assisted living, HCBS growing in use, Census Bureau report finds

The share of older Americans living in skilled nursing facilities (SNFs) is decreasing, whereas options such as assisted living and home- and community-based services (HCBS) appear to be growing in popularity, according to a new report from the U.S. Census Bureau commissioned by the National Institutes of Health.

The report, “65+ in the United States: 2010” (PDF), highlights trends among America’s older population and documents the variations in how long people live, how well they age, their financial and educational status, their medical and long-term care (LTC) and housing costs, where they live and with whom, and other factors related to aging and health. Among its findings:

• The share of the older population residing in SNFs declined from 4.5 percent in 2000 to 3.1 percent in 2010. The share in other LTC facilities, such as assisted living, has been increasing.
• Medicaid funds for LTC have been shifting away from nursing homes, with HCBS funding increasing from 13 percent of total funding in 1990 to 43 percent in 2007.

The report also found that many older Americans are unprepared to afford the LTC costs of a nursing home, noting that the average cost of a private room in a nursing home was $229 per day or $83,585 per year in 2010. Less than 20 percent of older adults have the personal financial resources to live in a nursing home for more than three years, according to the report, and almost two-thirds of them cannot afford even one year. In 2006, Medicaid paid for 43 percent of LTC.

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