In California, growing wave of seniors on collision course with meager long-term care system

California is facing a gray tide. The largest growth of seniors will occur over the next 30 years as baby boomers continue to age. Most notably, California’s 85 and over population is expected to increase by over 70 percent by 2030, according to the state’s Department of Aging.

Everybody knows this. No one’s doing anything about the fractures already widening in the state’s fragile long-term care infrastructure.

Seniors will be more likely to need care, and yet less likely to get it as California’s long-term care options continue to decline. Skilled nursing facilities are closing. Assisted living is getting more expensive. And Medicare doesn’t cover long-term care.

Is California prepared for its aging boom? Are its seniors?

The goal of my 2018 California Fellowship project is to explore this issue in a nuanced and human-driven series of stories that highlight the changing age demographics of California, which are throwing this problem into sharper relief. 

For one story, I will look at the practice one official report described as “dumping.” Nursing homes in California, and across the country, are unlawfully leaving senior residents stranded at hospitals or homeless shelters, often without any personal effects or the ability to advocate for themselves.

Why are so many nursing homes openly flouting state and federal regulations?

Simple math seems to best explain “dumping.” Facilities receive $800 per day from Medicare, which rarely pays for the maximum 120 days of care allotted.  When Medicare stops reimbursing the patient’s care, patients must get on Medi-Cal (California’s Medicaid program) or pay out-of pocket. Few people have long-term care insurance. So once a patient spends their savings to meet Medi-Cal’s eligibility requirements, it takes over and reimbursements drop to $140 per day for the same patient needing the same care.

Another story will dive into this practice of “spending down,” in which people purge or gift their savings to qualify for Medi-Cal — and the long-term ramifications this has for seniors.

The series will end with a look at long-term care alternatives. What are seniors doing to maintain their financial independence while they age? When seniors lack family to support them, what kind of living arrangements are affordable and successful?

[Photo by Ulrich Joho via Flickr.]