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string(6199) "PPIC.ORG Nursing Homes in California Landon Gibson Nursing home s provide skilled care to disabled and vulnerable populations . Nursing homes provide room and board, on-site nursing care, supervision, and personal assistance to people who are unable to care for themselves . Nursing homes are part of a network of long -term services and support —other services include home- and community -based servic es and home health care . In California, nursing homes are licensed by the California Department of Public Health. At the end of 2014 , there were 1, 220 licensed nursing homes operating statewide. Costs for m ost nursing home patients are covered by Medi -Cal . Nursing home care is the most costly residential care option; in 2014 the average annual cost of each bed was approximately $90,000 for a semi -private room and $104,000 for a private room. California’s nursing facilities had an occupancy rate of 85.4% —119,696 beds with 102,175 patients —at the end of 2014 . M ore than 59 % of these patients were covered by Medi -Cal (California’s Medicaid program), and more than 14 % were covered by Medicare. Medi -Cal payments for nursing home patients are based on facility -specific, cost -based reimb ursement rates determined by the Department of Health Care Services. In 2014, total Medi -Cal costs for nursing home care were $4.5 billion, or 30.4% of all long -term c are services covered by Medi -Cal . Shifting nursing home demographics reflect changes in California’s senior population . While n ursing homes serve patients of all ages , the vast majority are seniors . In 2014, 80.5% of nursing home patients were over the age of 65. As the racial distribution of Californians over the age of 65 changes , so too does the racial composition of nursing home patients. The percentage of patients who are white has declined by 11.1 % since 2004 (to 58 .2%); while the shares of Asian patients and those of o ther or unknown race s have increased by 3. 3% and 6. 6% (to 11. 3% and 18. 8% ). Over the same period, the share of Hispanic patients has increased from 13.3% to 18 .4 %. Most nursing home stays are short term. Many people need nursing home care only for short periods— for example , while they recover from surgery or illness . State data suggests that short -term stays are more common than long -term stays. About one-third ( 34.2% ) of stays are no more than two weeks , half (49.4% ) are between two weeks and three months , and the remaining 16.4% are longer than three months. California has a larger share of highly rated nursing homes than the rest of the nation. According to t he federal Center for Medicare and Medicaid Services—which rates federally certified nursing homes on a five -star scale —California has a large number of high- quality nursing homes . B ased on health inspections, nurse staffing hours, and other quality measures , these ratings provide a way for users to compare quality of care across facilitie s. In 2015 , 56.5% of nursing homes in California received high overall rating s (four or five stars); compared to a national average of 46.4%. Low ratings (one or two stars) were given to 27.4% of nursing homes in California, compared to 34.6% nationally. T he supply of highly rated nursing homes varies across regions —the highest share is in the Sacramento area (72.4 %), and the lowest is in the Northern and Sierra area (24.6%) . Nursing homes could be better coordinated with other long-term support services. R esearch indicates that some senior and disabled Californians can avoid or put off going into nursing homes by participating in programs such as In- Home Support Services (IHSS) , which allows Medi-Cal beneficiaries to hire caregivers who help them with daily tasks and activities . The legislature is working to improve the state’s long -term support network so that it serves seniors more effectively. NOVEMBER 2015 NURSING HOMES IN CALIFORNIA November 2015 PPIC.ORG California nursing home patients are becoming more diverse Source: Office of Statewide Health Planning and Development (OSHPD) facility level files for long -term care facilities (2014) . Note: Based on the share of patients of each racial/ethnic group as of December 31 of the reporting year. Shares for whites , blacks , Asian s, and other /u nknown may include those of Hispanic origin, while those categorized as Hispanic may be of any race. The quality of California nursing homes varies across regions Source: Centers for Medicare and Medicaid Services (CMS) Nursi ng Home Compare files (July 2015) . Note s: High -quality nursing homes are those with an overall CMS rating of four or five; m edium -quality have a CMS rating of three ; and low - quality have a rating of one or two. Central Coast : Monterey, San Benito, San Luis Obispo, Santa Barbara, Santa Cruz, and Ventura. Greater Bay Area : Alameda, Contra Costa, Marin, Napa, San Francisco, San Mateo, Santa Clara, Solano, and Sonoma. Inland Empire : Riverside and San Bernardino. Northern and Sierra : Amador, Butte, Calaveras, Colusa, Del Norte, Glenn, Humboldt, Inyo, Lake, Lassen, Mariposa, Me ndocino, Modoc, Nevada, Plumas, Shasta, Sierra, Siskiyou, Sutter, Tehama, Trinity, Tuolumne, and Yuba. Sacramento area : El Dorado, Placer, Sacramento, and Yolo. San Joaquin Valley : Fresno, Kern, Kings, Madera, Merced, San Joaquin, Stanislaus, and Tulare. Source s: Office of Statewide Health Planning & Development Long -Term Care Facilities , 2014 Final Database , Center for Medicare & Medicaid Services Nursing Home Compare Files (July 2015, and Q4 2014), Kaiser Family Foundation tables on long -term care spending , Newcomer et al., Extended Nursing Facility Stays Among California’s Dual Eligible and Med i- Cal -Only Beneficiaries, 2006 -2008 (2013) , Genworth 2015 Cost of Care Survey . Contact : gibson @ppic.org 0 10 20 30 40 50 60 70 80 White Hispanic BlackAsianOther/Unknown Percent of nursing home patients 2004 2014 0% 40% 800% Central Coast Greater Bay Area Inland Empire Los Angeles County Northern and Sierra Orange County Sacramento Area San Diego Area San Joaquin Valley California High quality Medium quality Low quality"
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string(6199) "PPIC.ORG Nursing Homes in California Landon Gibson Nursing home s provide skilled care to disabled and vulnerable populations . Nursing homes provide room and board, on-site nursing care, supervision, and personal assistance to people who are unable to care for themselves . Nursing homes are part of a network of long -term services and support —other services include home- and community -based servic es and home health care . In California, nursing homes are licensed by the California Department of Public Health. At the end of 2014 , there were 1, 220 licensed nursing homes operating statewide. Costs for m ost nursing home patients are covered by Medi -Cal . Nursing home care is the most costly residential care option; in 2014 the average annual cost of each bed was approximately $90,000 for a semi -private room and $104,000 for a private room. California’s nursing facilities had an occupancy rate of 85.4% —119,696 beds with 102,175 patients —at the end of 2014 . M ore than 59 % of these patients were covered by Medi -Cal (California’s Medicaid program), and more than 14 % were covered by Medicare. Medi -Cal payments for nursing home patients are based on facility -specific, cost -based reimb ursement rates determined by the Department of Health Care Services. In 2014, total Medi -Cal costs for nursing home care were $4.5 billion, or 30.4% of all long -term c are services covered by Medi -Cal . Shifting nursing home demographics reflect changes in California’s senior population . While n ursing homes serve patients of all ages , the vast majority are seniors . In 2014, 80.5% of nursing home patients were over the age of 65. As the racial distribution of Californians over the age of 65 changes , so too does the racial composition of nursing home patients. The percentage of patients who are white has declined by 11.1 % since 2004 (to 58 .2%); while the shares of Asian patients and those of o ther or unknown race s have increased by 3. 3% and 6. 6% (to 11. 3% and 18. 8% ). Over the same period, the share of Hispanic patients has increased from 13.3% to 18 .4 %. Most nursing home stays are short term. Many people need nursing home care only for short periods— for example , while they recover from surgery or illness . State data suggests that short -term stays are more common than long -term stays. About one-third ( 34.2% ) of stays are no more than two weeks , half (49.4% ) are between two weeks and three months , and the remaining 16.4% are longer than three months. California has a larger share of highly rated nursing homes than the rest of the nation. According to t he federal Center for Medicare and Medicaid Services—which rates federally certified nursing homes on a five -star scale —California has a large number of high- quality nursing homes . B ased on health inspections, nurse staffing hours, and other quality measures , these ratings provide a way for users to compare quality of care across facilitie s. In 2015 , 56.5% of nursing homes in California received high overall rating s (four or five stars); compared to a national average of 46.4%. Low ratings (one or two stars) were given to 27.4% of nursing homes in California, compared to 34.6% nationally. T he supply of highly rated nursing homes varies across regions —the highest share is in the Sacramento area (72.4 %), and the lowest is in the Northern and Sierra area (24.6%) . Nursing homes could be better coordinated with other long-term support services. R esearch indicates that some senior and disabled Californians can avoid or put off going into nursing homes by participating in programs such as In- Home Support Services (IHSS) , which allows Medi-Cal beneficiaries to hire caregivers who help them with daily tasks and activities . The legislature is working to improve the state’s long -term support network so that it serves seniors more effectively. NOVEMBER 2015 NURSING HOMES IN CALIFORNIA November 2015 PPIC.ORG California nursing home patients are becoming more diverse Source: Office of Statewide Health Planning and Development (OSHPD) facility level files for long -term care facilities (2014) . Note: Based on the share of patients of each racial/ethnic group as of December 31 of the reporting year. Shares for whites , blacks , Asian s, and other /u nknown may include those of Hispanic origin, while those categorized as Hispanic may be of any race. The quality of California nursing homes varies across regions Source: Centers for Medicare and Medicaid Services (CMS) Nursi ng Home Compare files (July 2015) . Note s: High -quality nursing homes are those with an overall CMS rating of four or five; m edium -quality have a CMS rating of three ; and low - quality have a rating of one or two. Central Coast : Monterey, San Benito, San Luis Obispo, Santa Barbara, Santa Cruz, and Ventura. Greater Bay Area : Alameda, Contra Costa, Marin, Napa, San Francisco, San Mateo, Santa Clara, Solano, and Sonoma. Inland Empire : Riverside and San Bernardino. Northern and Sierra : Amador, Butte, Calaveras, Colusa, Del Norte, Glenn, Humboldt, Inyo, Lake, Lassen, Mariposa, Me ndocino, Modoc, Nevada, Plumas, Shasta, Sierra, Siskiyou, Sutter, Tehama, Trinity, Tuolumne, and Yuba. Sacramento area : El Dorado, Placer, Sacramento, and Yolo. San Joaquin Valley : Fresno, Kern, Kings, Madera, Merced, San Joaquin, Stanislaus, and Tulare. Source s: Office of Statewide Health Planning & Development Long -Term Care Facilities , 2014 Final Database , Center for Medicare & Medicaid Services Nursing Home Compare Files (July 2015, and Q4 2014), Kaiser Family Foundation tables on long -term care spending , Newcomer et al., Extended Nursing Facility Stays Among California’s Dual Eligible and Med i- Cal -Only Beneficiaries, 2006 -2008 (2013) , Genworth 2015 Cost of Care Survey . Contact : gibson @ppic.org 0 10 20 30 40 50 60 70 80 White Hispanic BlackAsianOther/Unknown Percent of nursing home patients 2004 2014 0% 40% 800% Central Coast Greater Bay Area Inland Empire Los Angeles County Northern and Sierra Orange County Sacramento Area San Diego Area San Joaquin Valley California High quality Medium quality Low quality"
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