South Florida Business Journal: Nursing home occupancy falls as home-based services increase

March 10th, 2011 By Jackie Larena-Lacayo

Nursing home occupancy falls as home-based services increase

By Linda Haase

Nursing homes – once considered the place for South Florida’s ailing elderly – are facing many challenges.

“Over the past 10 years, the average nursing home occupancy in Florida has remained below 90 percent and has been declining steadily,” according to an October 2010 Florida Senate Committee on Health Regulation report, which proposes extending the 10-year-old, state-imposed moratorium on additional nursing home beds, set to expire in July.

“The real reason for the decline in nursing home occupancy is the preference of older adults to get care at home,” said Dan Brady, chief of community programs and government affairs officer at 70-year-old Miami Jewish Health Systems, which offers a nursing home, assisted living, rehabilitation, home health care and a hospice. “Most people don’t want somebody else to take care of their parents; they want someone who can help them take care of their parents.”

That’s where companies like West Palm Beach-based Matrix Home Care come in.

“There are not fewer people who need help; there are just more alternatives out there,” said Matrix President Pernille Ostberg said. Many families are combining services, such as home health care, day care centers and help from family members, she said.

State programs designed to divert patients, especially Medicaid recipients, from the state’s more expensive 675 nursing homes, bolster the demand for alternative care.

“Projections show that, in the next two decades, we will have an 800 percent growth in home and community-based services,” noted Alan Sadowsky, senior VP of home- and community-based services at West Palm Beach-based MorseLife, which includes a 280-bed nursing home, assisted and independent living, adult day care and rehabilitation at its seniors campus.

Fewer patients may occupy the 82,682 nursing home beds in Florida, but the state’s 65-and-over population – currently at 3.3 million – is expected to swell to 6.2 million by 2030. Some industry experts worry there won’t be enough nursing home spots to meet future needs.

“It will be more difficult to find a nursing home placement,” said LuMarie Polivka-West, senior director of policy at the Florida Health Care Association. “There is a lot of pressure on the system, and we aren’t really planning for that future, are we?”

And, she added that Florida has one of the nation’s lowest ratios of over-65 population-to-nursing home beds.

Bill Edelstein, administrator at the Memorial Manor nursing home in Pembroke Pines, says his 120-bed facility is 96 percent occupied. The anomaly is due to two factors: the facility, part of the Memorial Healthcare System, gets referrals from its hospitals, and it takes exceptional cases, such as patients with ventilators.

Experts predict nursing homes will continue to cater to older, fragile seniors, including those with Alzheimer’s disease or dementia who need 24/7 care.

“The average age of residents is 90 now,” Sadowsky said. “When we first opened 28 years ago, it wasn’t quite 80. People in nursing homes today are older and frailer, and have more complex medical needs.”

But no one expects nursing homes to become extinct.

“Nursing homes will be around, we will just evolve. We will have to mold to what the call becomes,” Edelstein predicted. “But we could become the place to go when all else fails.”

And that’s just what the state fears.

“The challenge for policymakers is to maintain funding and flexibility so that nursing homes are not the default option for older adults,” according to the Senate report.

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