A Flaw in the System


Skilled Nursing News reported that the nation’s top Medicare and Medicaid official called on states to boost their home- and community-based services (HCBS) for the elderly. The impact of COVID-19 on nursing homes has exposed a key flaw in the overall system.

“The COVID-19 crisis has shone a harsh light on the human costs of a long-term care system that relies too heavily on institutional services like nursing homes,” CMS administrator Seema Verma said. “Too often, they are seen as the default option, even for those who may not require round-the-clock care.”

Statehouses show an increasing preference for home health, non-institutional supportive housing, and transportation programs. Consumers prefer staying at home.  And it is cheaper than institutional traditional care.

“States continue to be at the forefront of innovation in designing new models for the delivery and financing of LTSS. CMS supports state efforts to help older adults and people with disabilities to access care and services at home and in other community settings, so they may live their lives with as much dignity and independence as possible.”

The rate of spending on HCBS has grown at a faster rate than overall long-term services and supports (LTSS) funding over the last 30 years.  However, the trend has slowed in recent years despite a rapidly aging population.

Outdated Design

The COVID-19 pandemic shows traditional nursing homes have outdated nursing home designs. Verma said:

“While nursing homes will always be an important part of a complete care continuum, many elderly individuals and their families should have access to a more robust set of home care and community-based care options.” 

Alternative models need to be considered but HCBS should be the new normal. Our loved ones deserve better.