Percentage increase 2010 –2014

Limited Access to Idaho’s Residential Care & Assisted Living Facilities

THE PROBLEMLoved ones may be turned away not because a facility can’t meet their needs but because Idaho Medicaid reimbursements don’t adequately cover the cost of care.

OUR FACILITIESThere are 352 residential care/assisted living facilities in Idaho, representing approximately 9,000 beds. Of those beds, 60% are private pay; only 40% are Medicaid:

Population of 60+

(Continued on other side)

2015

100

POPULATION IN THOUSANDS

YEAR

0 200 300 400

2025

2015: 23,000 2025: 33,000

282,000

374,000

Idaho’s 65+ population is also growing faster than the rest of the nation:

NO VACANCYOUR LOVED ONES1

Of Idahoans living in the state’s residential care and assisted living facilities:

OUR GROWING STATE2,3

Idaho’s need for residential care and assisted living facilities is only going to increase:

OUR FUTURE NEEDS4

The number of Idaho residents 65 and older with Alzheimer’s is going to increase more than 43% in the next 10 years:

are elderly

have a physical disability or other need for assisted care

have a developmental disability

have a mental illness

have Alzheimer’s/dementia

49%31%12%

4%

4%

9,000Statewide beds

Medicaid beds

=

3,600=

Facility beds 1 or 2=

Some facilities can only afford to offer 1 or 2 beds to Medicaid patients.

This is nearly enough to fill Boise State University’s Albertsons Stadium.

Idaho

19% National

14.2%

OUR CURRENT SYSTEMA 2015 Idaho Health Care Association survey of 97 Ada County residential care/assisted living facilities showed:

REPRESENTATIVE PATIENT EXPERIENCESample Patient B has severe dementia with violent behaviors. Medicaid patients with similar factors have been known to experience:

27% of surveyed facilities do not accept Medicaid at all.27%

Of surveyed facilities accepting Medicaid, 58% require a spend down—the spending of personal funds—prior to accepting a patient.

58%

Only one surveyed company accepts Medicaid, does not require a spend down, and offers a memory care unit, leaving families one choice if a loved one has dementia.

1%

In the last five years of life, the average total cost of care for patients on Medicare is higher for those with dementia than those with heart disease or cancer.5

Home with spousePhysical injury to spouse

(broken nose)

Hospital emergency department No insurance coverage because under

“observation status”

Long-term facility placementFour-month wait

Out-of-state placementNo contact with spouse

Temporary facility placementSent home after 24 hours because of

behavioral issues

$287,038 DEMENTIA$175,136 HEART DISEASE$173,383 CANCER

Sources: 1: Idaho Facts/Figures/Trends 2014-2015: http://healthandwelfare.idaho.gov/Portals/0/AboutUs/Publications/FFT2014_2015.pdf; 2: U.S. Department of Health and Human Services Administration on Aging: http://www.aoa.gov/AOA_Programs/HPW/Behavioral/docs2/Idaho.pdf; 3: Twin Falls Times-News, “7 Stats on Idaho’s Aging Population,” July 11, 2015; 4: Alzheimer’s Association, “2015 Alzheimer’s Disease Facts and Figures,” http://www.alz.org/facts/downloads/facts_figures_2015.pdf; 5: The New York Times, “Costs of Dementia Care Far Exceeding Other Diseases, Study Finds,” October 26, 2015.

OUR RESPONSIBILITYIdaho needs bold and visionary thinking to come up with real solutions to the growing disconnect between assisted living facility costs and the state’s Medicaid reimbursement rates.

Spend four months living in a hospital emergency department because of lack of open Idaho beds.

END RESULT: