Updated State Scorecard Study on Long Term Care an Eye-opener

The 2014 update to a study originally published in 2011 provides information on the status of Long-Term Care Services and Supports (LTSS) at a state level. Released June 19, and funded by 3 foundations (The AARP Foundation, The Commonwealth Fund, and the SCAN Foundation), the new study says, “Most Americans will eventually rely on the LTSS system, either as consumers or as caregivers providing support to family and friends.”
Both reports are a treasure trove of state-specific information, but perhaps the biggest takeaway I found is no surprise: publicly-funded care options are not keeping pace with need, and offer little or no choice to their recipients. In other words, unless you have the extra cash to pay for care, it’s more important than ever to purchase long term care insurance.
As the new report points out,
“In just 12 years, the leading edge of the Baby Boom Generation will enter its 80s, placing new demands on the LTSS system…
will have far fewer potential family caregivers to provide unpaid help.
Despite this looming care gap, we lack a national solution to providing LTSS…
Where you live really matters because there are very large differences across the states in how well they do this job…
the pace of change is slow.”
The report measures LTSS performance using 5 dimensions: 1) affordability and access, 2) choice of setting and provider, 3) quality of life and quality of care, 4) support for family caregivers, and 5) effective transitions. I’ve compiled some of my favorite points from the report below, along with comments.
“When costs are high for people who pay privately and do not have long-term care insurance, they will more quickly deplete their life savings and turn to the public safety net. If that safety net is inadequate, people may rely so heavily on family caregivers that those caregivers damage their own health and well-being.” In my experience, many people are motivated to purchase long term care insurance (LTCI) in order to take the burden of caregiving off the shoulders of their family members.
“Home care generally is more affordable than nursing home care, allowing consumers to stretch their dollars further. But at an average of 84 percent of median income, the typical older family cannot sustain these costs for long periods.” Depending on the number of hours a day home care is needed, it can be less – or more expensive – than care in a nursing home.
Regarding long term care insurance: “Only 10 percent of Americans aged 50 and older have these policies.” Hard to believe, but true!
Private payers – or those with long term care insurance – know they can interview, choose, hire and fire their own care providers. This is a luxury often not available to those relying on the public systems, as the report states: “hiring the people who will help you bathe, dress, eat, use the toilet, and move from one place to another is fundamental to having more personal control over what happens to you on a daily basis…yet in most states, few consumers have this option.”
Some interesting facts and figures from the report released June 19, 2014:
Nursing home staffing turnover (median figure): 38.1%
Legal and system supports for family caregivers (composite indicator, scale 0-14.5%): 3.00 median
Family caregivers without much worry or stress, with enough time, well-rested: 61.6% median In other words, almost 40% of family caregivers report they do not have enough time, and are not well-rested. No tragedy perhaps if the need for care is weeks-long; more of a problem when we are talking about months and years.
Middle-class to wealthy individuals who health qualify to purchase long term care insurance should consider the purchase of long term care insurance a foundational component of their financial plan.


The study can be found at this link: