More Funding for Community Based Care for Elderly in Health Reform

A new report by Families USA titled “Helping People with Long-Term Health Care Needs: Improving Access to Home- and Community-Based Services in Medicaid” describes one new aspect of the Health Reform relating to community based care for elders.
The new law creates a new Medicaid option for states to provide home- and community-based attendant services and supports.
Health reform establishes a new Medicaid state plan option called the Community First Choice Option, starting October 1, 2011. This option covers community-based attendant services and supports to help Medicaid beneficiaries with daily activities and health-related tasks.
States that take up this option will receive a 6 percentage point increase in their federal match for costs associated with the program.
For more information click here:
http://www.familiesusa.org/issues/long-term-services/health-reform/

Factors Leading to Nursing Home Use

In July 2010 the Mathematica Policy Research, Inc. funded by the Administration on Aging published an Issue Brief on Aging in Place: Do Older Americans Act Title III Services Reach Those Most Likely to Enter Nursing Homes? Title III programs include congregate and home delivered meals, case management and homemaker programs among others. In their study they identified the follow factors as leading to increased risk of nursing home entry:

1. Demographic characteristics: Older individuals and those who are non-Hispanic white
2. Socioeconomic status: Individuals with low incomes
3. Health status and physical functioning: Those with certain health conditions (such as cognitive impairment, cancer, high blood pressure, diabetes, and a history of strokes and falls) and those who have difficulty performing activities of daily living
4. Prior health care utilization: Individuals who have spent time in the hospital or in a nursing home
5. Living arrangements and family structure: Those who live alone (including widowed and divorced individuals), do not own their home, and have fewer children than their peers not in nursing homes
6. Availability of support: Individuals who lack caregiver support

Overall, nursing home utilization and stays are declining with increased short term stays for medicare services. Growth of home and community based services continues as older persons avoid nursing home care at all costs. How are you transforming your program to prepare for the future?

Demand for Nursing Facilities: Planning for tomorrow

Consider you are planning a remodeling or replacement of a nursing facility for your organization.  A 2010 report by the Standford Center on Longevity titled "New Realities of an Older America" should be required reading. Here are some facts:

In 2004, most nursing home residents were 85+.
There were 1.3 million people 65+  living in nursing homes in 2004.
The oldest old, 85+, are more likely to live in nursing homes; in 2004,
14% of the 85+ population lived in nursing homes, but only 3.6% o the
75-84 year olds did.

In the year 2031, the first boomers will start turning age 85.
The number of people requiring nursing home care will likely increase as the number of 85 year olds increases.
If nursing home residency rates of the population 85+ remain at the 2004 level of 14%, there will be 1.2 million people 85+ in nursing homes by 2030, more than doubling to 2.6 million by 2050.

Major questions for future planning:
In the year 2031, what types of services will the boomers need and desire?
What types of housing, assisted living, memory care, social support services and nursing facilities would meet those desires and needs?
Will the new generation have the resources to pay for those services?
Can you build bricks and mortar so that it can be modified after ten years for another use?

In my view, here are the trends of the future:

1. We will see a decrease in long term care beds, but an increase usage of those beds with emphasis on rehabilitation and outpatient services.
2. Assisted living will become more regulated and future clients needs will mirror the needs of nursing home residents today.
3. Home and community based services will be integrated into more managed care approaches with government providing increased funding.
4. Housing with new technologies will enable persons to remain in their own homes.
5. Providers that survive and flourish will be diversified with a variety of housing, health, wellness and social support programs that reach beyond their own four walls.

Six Important Facts about Tax-Exempt Organization

The IRS has put together the following list of six things you should know about the tax treatment of tax-exempt organizations. Annual returns are made available to the public. Exempt organizations generally must make their annual returns available for public inspection. This also includes the organization’s application for exemption. In addition, an organization exempt under 501(c)(3) must make available any Form 990-T, Exempt Organization Business Income Tax Return. These documents must be made available to any individual who requests them, and must be made available immediately when the request is made in person. If the request is made in writing, an organization has 30 days to provide a copy of the information, unless it makes the information widely available. Donor lists generally are not public information. The list of donors filed with Form 990, Return of Organization Exempt From Income Tax, is specifically excluded from the information required to be made available for public inspection by the exempt organization. There is an exception, private foundations and political organizations must make their donor list available to the public. How to find tax-exempt organizations. The easiest way to find out whether an organization is qualified to receive deductible contributions is to ask them. You can ask to see an organization’s exemption letter, which states the Code section that describes the organization and whether contributions made to the organization are deductible. You can also search for organizations qualified to accept deductible contributions in IRS Publication 78, Cumulative List of Organizations and its Addendum, available at IRS.gov. Taxpayers can also confirm an organization’s status by calling the IRS at 877-829-5500. Which organizations may accept charitable contributions. Not all exempt organizations are eligible to receive tax-deductible charitable contributions. Organizations that are eligible to receive deductible contributions include most charities described in section 501(c)(3) of the Internal Revenue Code and, in some circumstances, fraternal organizations described in section 501(c)(8) or section 501(c)(10), cemetery companies described in section 501(c)(13), volunteer fire departments described in section 501(c)(4), and veterans organizations described in section 501(c)(4) or 501(c)(19).   Requirement for organizations not able to accept deductible contributions. If an exempt organization is ineligible to receive tax-deductible contributions, it must disclose that fact when soliciting contributions. How to report inappropriate activities by an exempt organization. If you believe that the activities or operations of a tax-exempt organization are inconsistent with its tax-exempt status, you may file a complaint with the Exempt Organizations Examination Division by completing Form 13909, Tax-Exempt Organization Complaint (Referral) Form. The complaint should contain all relevant facts concerning the alleged violation of tax law. Form 13909 is available at IRS.gov or by calling 800-TAX-FORM (800-829-3676).   Links: IRS Publication 526, Charitable Contributions (PDF) Search for Charities Using Publication 78 Form 13909, Tax-Exempt Organization Complaint (Referral) Form (PDF)

Pre-retirees Expectations

The MetLife Mature Market Institute and AARP Health Care options sought to examine pre-retirees’ (ages 50-65) expectations regarding their living situation in retirement and the implications for their long-term care needs. In a survey conducted by Mathew Greenwald & Associates, here are the key findings:

1. Almost all pre-retirees want to live in their own home during retirement.
2. Just over 1/3 of pre-retirees anticipate changing homes, with many planning to move to a different city or town.
3. Most pre-retirees expect they will be able to live independently during retirement.
4. A sense of community and independence both factor strongly in pre-retirees’ decisions about where to live in retirement.
5. After a preference for one’s own home, the next most popular living situations are an adult retirement community that has services and amenities or a home/apartment for people 55 and over.

Upscale senior home The Clare averts default after cancellations soar | Crain’s Chicago Business

Upscale senior home The Clare averts default after cancellations soar | Crain’s Chicago Business

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AARP Report Indicates High Demand

A new AARP report indicates that the growth in the frail elderly will continue at a unprecedented rate. The report states "A better barometer for the potential demand for long-term care services
is the growth in the population age 85 or older, which is expected to
increase by 74% between 2007 and 2030. The oldest old not only have
much higher rates of disability, but they also are much more likely to
be widowed and without someone to provide assistance with daily
activities."

Across the States 2009: Profiles of Long-Term Care and Independent Living is the eighth edition of the AARP Public Policy Institute’s state long-term care reference report.  For a complete copy of the report click here: AARP 2009 Profile of long term care needs

Board Development

Program for all inclusive care of elderly (PACE)

Mather’s Trends for 2010

The Mather LifeWays Institute on Aging (MLIA)
released its 2010 predictions. Here are four trends identified by MLIA that I think could have a positive impact on your program this year:

1. The movement to more homelike environments for older adults
   living in long-term care communities will grow. Programs will provide
   care, support individuality, and promote safety in a residential
   environment. Remodel and/or replace your physical environment combined with a "resident centered" approach to services.
2. The use of technology among older adults will grow
   exponentially – whether this means surfing the Internet, joining social
   networks such as Facebook, or using technologic devices in the home to
   monitor their health as well as promote independence and safety. Have you updated your web site lately? Hospital discharge planners are telling me that many people are looking at web sites prior to call the facility.
3. Greater numbers of older adults will use the Internet to learn
   about their health. Health professionals will need to incorporate
   web-based health resources into their patients’ visits to assure that
   accurate websites are being sought out. The proper use of technology can enhance quality of care, reduce costs and increase regulatory compliance.
4.   Senior living residences will also make “healthy living” a priority
   as future prospects will be looking towards a variety of programs and
   amenities that support wellness lifestyles. Wellness programs are becoming standard operating procedures for serving today’s elders.