Nursing Home Rehospitalization Rates Under Medicare: Progress Since 2014, Persistent Risks, and Aging in Place as the Superior Alternative

More than a decade ago, our blog highlighted a sobering federal report on the risks of skilled nursing facility (SNF) care for Medicare beneficiaries recovering from hospitalization. In our March 13, 2014, post, “One-Third of Nursing Home Residents Injured or Killed In Treatment,” we reported on a U.S. Department of Health and Human Services Office of Inspector General (OIG) study that found roughly one-third of Medicare patients in short-term nursing home rehabilitation stays experienced harm,  22%  with adverse events serious enough to prolong their stay, require a hospital transfer, cause permanent damage, or even lead to death, with an additional 11% suffering temporary harm. 

The study looked at only patients who were in a nursing home for 35 days or less.  Medicare covers up to 100 days of nursing home care following a three-day hospitalization. Extrapolated to the total care population, the study suggests that at least 262,324 residents are injured annually as a result of nursing home negligence, and more than 18,456 seniors are killed by the very institutions Medicare pays to care for our nation's seniors.    

Physician reviewers determined that 59% of these events were preventable, often stemming from substandard care, inadequate monitoring, medication errors, infections, or delays in necessary treatment. Over half of those harmed ended up back in the hospital, contributing to an estimated $2.8 billion in annual Medicare costs for treating SNF-related harms (based on 2011 projections). The findings underscored systemic issues in post-acute care, prompting calls for better staffing, quality assurance programs, and oversight.

Fast-forward to 2026: Has the picture improved? Recent Medicare data, tracked by the Centers for Medicare & Medicaid Services (CMS) and the Medicare Payment Advisory Commission (MedPAC), show modest progress but also persistent challenges that should inform how families approach hospital discharge decisions.

Recent Data on Rehospitalization Risks for Medicare SNF Patients

Today, CMS’s Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM), a key quality metric under the SNF Value-Based Purchasing (VBP) Program, tracks unplanned hospital readmissions within 30 days of the original hospital discharge for Medicare fee-for-service beneficiaries sent to an SNF for rehab. The unadjusted national rate has improved to approximately 20.1% in recent performance periods (e.g., FY 2022 data used for later VBP years), down from the higher rates (often cited around 23–25%) prevalent around the time of the 2014 OIG report.

 

MedPAC’s analyses of more recent periods (FY 2022–2024) further highlight the potentially preventable readmission rate after SNF discharge to the community. The median facility-level risk-adjusted rate is approximately 10.4–10.7% and has remained relatively stable. This measure focuses on conditions that might have been avoided with better care, such as infections or falls.

 

In plain terms, roughly 1 in 5 Medicare patients discharged to an SNF for short-term rehab still returns to the hospital within 30 days of leaving the SNF. About half of those readmissions (the preventable subset) are attributable to quality-of-care issues during or immediately after the SNF stay. Rates vary widely by facility, nonprofit and hospital-based SNFs often perform better than for-profit or freestanding ones, and early readmissions (within the first 1–2 weeks of SNF admission) remain common, frequently linked to incomplete or improper hospital-to-SNF handoffs.

Leading causes continue to echo the 2014 findings: respiratory and urinary tract infections, sepsis, falls with injury, exacerbations of heart failure or COPD, medication errors, and functional decline. These are not abstract statistics; they represent disruptions for seniors and their families and reflect substandard quality of care provided by nursing homes. 

What the Numbers Teach Us About Quality of Care

The decline from the 2014-era one-in-three harm rate to today’s roughly one-in-five readmission rate seems to reflect real (if incremental) statistical gains. Federal initiatives such as the SNF VBP Program, Quality Reporting Program, and new staffing rules have driven improvements in monitoring, infection control, and care transitions. CMS is even phasing in a new “within-stay” potentially preventable readmission measure for future VBP years to sharpen focus on harms occurring during the SNF stay itself.

The reliance on improved and specific metrics, however, must be tempered with caution.  Many quality measures feeding into public reporting on CMS Care Compare, including fall rates, pressure ulcers, and functional improvement, rely heavily on self-reported data from nursing homes through Minimum Data Set (MDS) assessments, while hospitals similarly self-report certain harm events. The Office of Inspector General (OIG) has repeatedly warned of significant under- or non-reporting as an ongoing concern; a September 2025 OIG report found that nursing homes failed to report 43 percent of falls with major injury and hospitalization among Medicare-enrolled residents in required MDS assessments, with underreporting most prevalent in for-profit, chain-owned, and larger facilities. This distorts publicly available quality ratings, making some facilities appear safer than they are.   

Furthermore, while readmission measures such as the SNFRM are derived from Medicare claims data, they are not subject to routine independent medical record verification by the OIG or other third parties, and broader quality indicators lack comprehensive external audits. Additional limitations include financial and reputational disincentives for facilities to fully report events that could lower star ratings or Value-Based Purchasing scores, wide variation across facilities that national averages mask, and the absence of robust patient-experience data for SNFs, all issues MedPAC has repeatedly flagged as undermining data reliability. These gaps mean that reported progress, while encouraging, does not guarantee safer conditions for every patient in every facility and underscores why families should weigh institutional options carefully and critically.  

Regardless, improvement does not equal safety. A preventable readmission rate above 10% still signals ongoing systemic vulnerabilities, such as understaffing in many facilities, challenges with high-acuity patients discharged “quicker and sicker” from hospitals, and persistent gaps in fall prevention, medication reconciliation, and early symptom detection. MedPAC notes wide variation across facilities, suggesting that where you go matters enormously.

For families weighing options after a hospital stay, these numbers underscore a critical truth: SNF rehab, while medically necessary for some, carries inherent risks of setback. Even “high-quality” facilities operate in an environment of shared staffing, institutional routines, and exposure to other residents’ illnesses and risks, factors that can amplify infection or injury risks.

Aging in Place: Returning Risk Control to Seniors and Families

This is where aging-in-place planning becomes not just a preference but a strategic risk-management tool. When clinically feasible, recovering at home, supported by family or community caregivers, home health services, physical therapy, and durable medical equipment, shifts control back to the senior and their loved ones or trusted advisors and helpmates. Families, whether biological, chosen, or constructed, play a pivotal role in supporting loved ones to age safely and successfully at home. Compared to institutional nursing home settings, family-centered aging in place offers numerous advantages that promote better health outcomes, dignity, emotional well-being, and cost-effectiveness: 

• Close, Personalized Monitoring in a Familiar, Lower-Risk Environment: Families can observe subtle daily changes and early warning signs of infections, falls, medication errors, dehydration, cognitive shifts, or behavioral changes in real time. The home environment typically has fewer pathogens than communal nursing facilities, thereby reducing the risk of hospital-acquired infections. Familiar surroundings also encourage more accurate symptom reporting, as the cared-for person feels safer and more comfortable expressing needs.

• Fully Customized and Flexible Care Plans: Unlike rigid institutional protocols, families can tailor care to the individual’s unique preferences, cultural values, dietary needs, sleep patterns, and daily routines. Care can be adjusted dynamically as conditions evolve, without needing approvals, bureaucratic delays, or one-size-fits-all facility policies, leading to higher satisfaction and better adherence to treatment plans.

• Prevention of Disorientation, Delirium, and Deconditioning: Moving to a nursing home often causes confusion, anxiety, and accelerated physical decline (deconditioning) due to unfamiliar settings, reduced mobility, and loss of personal control. Aging in place preserves cognitive anchors like personal belongings, beloved pets, favorite views, and established habits, which help maintain orientation, mobility, strength, and overall functional independence longer.

• Enhanced Emotional and Psychological Well-Being: Remaining at home supports dignity, autonomy, identity, and a sense of purpose. Familiar surroundings reduce depression, loneliness, and “relocation stress,” while continued family involvement provides emotional security, social connection, and love, elements often limited by staffing ratios and visiting hours in facilities.

• Caregiver Resilience and Sustainability: Families can proactively build caregiver capacity through targeted resilience training, stress management, peer support networks, and strategic respite care (temporary professional relief). This reduces burnout, improves the long-term sustainability of caregiving, and maintains higher-quality care than that provided by often overworked institutional staff.

• Strategic Deployment of Technology and Assistive Aids:  Families can select and integrate personalized technologies, such as smart home sensors, medication reminders, fall detection wearables, GPS trackers, video monitoring, voice-activated systems, or specialized mobility aids, optimized for the individual’s specific needs and home layout. These tools enhance safety and independence while empowering both the cared-for person and caregivers.

• Stronger Social Connections and Purposeful Daily Life:  Aging at home enables ongoing participation in meaningful and familiar activities, hobbies, faith communities, and relationships with neighbors and extended family. This combats isolation and supports mental sharpness far better than the often regimented, group-oriented routines in nursing homes or other institutions.

• Nutritional and Lifestyle Advantages: Families can prepare preferred, culturally appropriate meals with fresh ingredients, accommodate dietary restrictions more precisely, and encourage gentle physical activity in a safe, familiar space, leading to better nutrition, hydration, and overall health compared to standardized institutional menus.

• Greater Privacy, Dignity, and Autonomy: Individuals retain control over personal space, schedules, and intimate care decisions. This preserves self-esteem and reduces the institutional feelings of helplessness or loss of privacy common in shared facility rooms.

• Potential Cost Savings and Resource Efficiency:  Home-based care, supported by family, often proves more economical than long-term nursing home stays (which can exceed $8,000–$12,000 per month). Families can blend informal care with targeted professional services (home health aides, therapy, telehealth) for optimal value while accessing Medicare/Medicaid home-based benefits.

• Improved Continuity of Care and Better Health Outcomes: Consistent family involvement leads to fewer care transitions, better medication management, and stronger advocacy during medical appointments. Studies and real-world experience frequently show lower rehospitalization rates when robust family support is in place at home.

• Legacy Building and Intergenerational Benefits: Aging in place allows for deeper family bonding, knowledge sharing, and memory-making. Children and grandchildren benefit from witnessing and participating in elder care, strengthening family resilience across generations.

• Easier Integration of Holistic and Palliative Support: Families can more readily incorporate complementary therapies, spiritual care, pet therapy, music, or other personalized comfort measures that align with the individual’s values and customs, options often limited by facility regulations and standardized practices.

By leveraging these advantages, families create a supportive ecosystem that not only reduces the risk of rehospitalization but also genuinely elevates quality of life. Successful aging in place does require planning, resources, and support (legal, financial, and professional), but the outcomes, better health, preserved dignity, and stronger family bonds, make it a superior alternative for many. 

Recent data on discharge-to-community rates (hovering around 50–51% nationally) indicate that many patients do return home, but the nursing home journey can introduce unnecessary detours for others. By planning ahead through advance directives, power of attorney documents, long-term care insurance reviews, and home modification assessments, families can often secure Medicare-covered home health benefits or private-pay supports that achieve similar rehab goals while reducing the risk of readmission.

Importantly, choosing home does not mean going it alone. Elder law attorneys and aging-in-place planners can help coordinate benefits, Medicaid planning (if needed for longer-term support), and caregiver respite resources. The goal is empowerment: reducing reliance on institutional care where possible and building a safety net tailored to the individual.

Looking Ahead: Plan Proactively for Safer Recovery

The contrast between the 2014 OIG findings and today’s Medicare metrics shows that progress is possible through policy pressure and facility accountability. Yet the data also remind us that no facility is risk-free. For many seniors, the safest and most dignified path post-discharge is to prioritize home whenever medically appropriate.

If you or a loved one faces an upcoming hospital discharge, we encourage early conversations with your care team about home-based alternatives. Our team is here to help review options, update legal documents, and help develop a personalized plan that keeps risk control where it belongs, with the senior and their family.

Sources include:

• SNF Value-Based Purchasing (VBP) Program Overview
  https://www.cms.gov/medicare/quality/nursing-home-improvement/value-based-purchasing
  Main hub for the program, including background, incentive payments (withholds 2% of Medicare FFS Part A payments), and performance details.
• SNF VBP Measures
  https://www.cms.gov/medicare/quality/nursing-home-improvement/value-based-purchasing/measures Details on current measures, including the SNF 30-Day All-Cause Readmission Measure (SNFRM) (core readmission metric) and others like healthcare-associated infections (HAI). Includes baseline and performance periods.
• Public Reporting of SNF VBP Data
  https://www.cms.gov/medicare/quality/nursing-home-improvement/value-based-purchasing/public-reporting-snf-vbp-program-data
  Explains how facility-level and national results are reported.
• SNF Quality Reporting Program (QRP) Overview
  https://www.cms.gov/medicare/quality/snf-quality-reporting-program
  Mandated by the IMPACT Act of 2014; covers quality measures including readmissions.
• SNF QRP Measures and Technical Information
  https://www.cms.gov/medicare/quality/snf-quality-reporting-program/measures-and-technical-information
  Includes Potentially Preventable 30-Day Post-Discharge Readmission Measure and other claims-based metrics.
• Care Compare / Provider Data (Public Facility-Level Results)  Search nursing homes here: https://data.cms.gov/provider-data/topics/nursing-homes.  Includes VBP rankings, readmission rates, and quality measures.
• FY 2026 SNF VBP Facility-Level Dataset (CSV downloadable) https://data.cms.gov/provider-data/dataset/284v-j9fz. Contains detailed performance results, including risk-standardized readmission rates, achievement/improvement scores, and more.

• FY 2026 SNF VBP Aggregate Performance
  National-level summaries: https://data.cms.gov/provider-data/dataset/ujcx-uaut
• SNFRM Technical Report (example for FY 2022 data): https://www.cms.gov/files/document/2023-snfrm-measure-updates-report.pdf

Nursing Homes Create Phony Diagnoses to Sedate Patients with Dangerous Drugs, Doubling Risk of Death

The New York Times (NYT), in a recent front-page Sunday article, "Phony Diagnoses Hide High Rates of Drugging at Nursing Homes," explores and exposes the use of chemical restraints, including antipsychotic medications, to control behavior of  long-term care residents. This blog has previously discussed the use of pointless  and dangerous drugs dispensed to terminally ill dementia patients in nursing homes.  See, "Most Terminal Dementia Patients in Nursing Homes Given Pointless and Potentially Dangerous Drugs."

Antipsychotic drugs have faced criticism for decades as “chemical straitjackets. They are medically unnecessary and dangerous for older people with dementia, nearly doubling their chance of death from heart problems, infections, falls and other ailments. Understaffed nursing homes have, nonetheless, often used the sedatives so they don’t have to hire more staff to handle residents.  

The battle against this pernicious practice is not new.  In 1987, President Ronald Reagan signed a law banning the use of drugs that serve the interest of the nursing home or its staff, not the patient.

But the practice persisted. In the early 2000s, studies found that antipsychotic drugs like Seroquel, Zyprexa and Abilify made older people drowsy and more likely to fall. The drugs were also linked to heart problems in people with dementia. More than a dozen clinical trials concluded that the drugs nearly doubled the risk of death for older dementia patients.

In 2005, the Food and Drug Administration (FDA) required manufacturers to put a label on the drugs warning that they increased the risk of death for patients with dementia.  While FDA advisories generated public awareness, it is well known that prescribers’ compliance with black-box warnings is low. Seven years later, in 2012, with antipsychotics still widely used, nursing homes were required to report to Medicare how many residents were getting the drugs. That data is posted online and becomes part of a facility’s “quality of resident care” score, one of three major categories that contribute to a home’s star rating.

The only catch: antipsychotic prescriptions for residents with any of three uncommon conditions, schizophrenia, Tourette’s syndrome and Huntington’s disease, are not included in a facility’s public tally. The theory was that since the drugs were approved to treat patients with those conditions, nursing homes shouldn’t be penalized.

The loophole was opened. The NYT has discovered that residents are simply  given "new" diagnoses of, for example, schizophrenia, attempting to justify the sedation associated with major antipsychotic medications, such as Haldol, despite the fact that such medications are contraindicated for dementia patients. According to the NYT, since 2012, the share of residents classified as having schizophrenia has risen to 11 percent from less than 7 percent.  The diagnoses rose even as nursing homes reported a decline in behaviors associated with the disorder. The number of residents experiencing delusions, for example, fell to 4 percent from 6 percent.

Today, one in nine residents has received a schizophrenia diagnosis. In the general population, the disorder, which has strong genetic roots, afflicts roughly one in 150 people.  Moreover, Schizophrenia, which often causes delusions, hallucinations and dampened emotions, is almost always diagnosed before the age of 40.

“People don’t just wake up with schizophrenia when they are elderly,”  Dr. Michael Wasserman, a geriatrician and former nursing home executive who has become a critic of the industry told the NYT. “It’s used to skirt the rules.”

Some portion of the rise in schizophrenia diagnoses probably stems from the fact that nursing homes, like prisons, have become a refuge of last resort for people with the disorder, after large psychiatric hospitals closed decades ago.

But unfounded diagnoses are also undoubtedly driving the increase. In May, a report by a federal oversight agency said nearly one-third of long-term nursing home residents with schizophrenia diagnoses in 2018 had no Medicare record of being treated for the condition.  Even for those for which there was some record of treatment, the treatment records, do not provide important details about the drug use (e.g., which antipsychotic drugs were prescribed; at what quantities and strengths; and for what durations).  The lack of treatment records suggest the drugs are not being prescribed to treat a legitimate condition, but are being used for other purpose.

The revelation should come as no surprise: many facilities have found ways to hide serious problems, like inadequate staffing and haphazard care, from government audits and inspectors.  The problem with misreporting staffing was so outrageous that, in 2019, CMS actually demanded payroll reports to verify nursing home reporting of staff numbers, immediately after which implementing such verification, more than one-third of nursing homes saw their ratings decline. See, this blog's article: "Medicare Ratings Fall for Short-Staffed Nursing Homes- One-Third of Nursing Homes See Ratings Drop."  There were a minority of nursing homes that didn't even have a staff nurse, resulting in home closures. 

The NYT, demonstrating the power of investigative journalism, reports:

According to Medicare’s web page that tracks the effort to reduce the use of antipsychotics, fewer than 15 percent of nursing home residents are on such medications. But that figure excludes patients with schizophrenia diagnoses.

To determine the full number of residents being drugged nationally and at specific homes, The Times obtained unfiltered data that was posted on another, little-known Medicare web page, as well as facility-by-facility data that a patient advocacy group got from Medicare via an open records request and shared with The Times.

The figures showed that at least 21 percent of nursing home residents...are on antipsychotics [link included in original].

That means a full one in five nursing home residents are receiving potentially unnecessary and dangerous medications!  The reasons why this practice continues are obvious: caring for dementia patients is time- and labor-intensive. Workers need to be trained to handle challenging behaviors like wandering and aggression. But many nursing homes are chronically understaffed and do not pay enough to retain a sufficient number of employees, especially the nursing assistants who provide the bulk of residents’ daily care. 

Studies have found that the worse a home’s staffing situation, the greater its use of antipsychotic drugs. That suggests that some homes are using the powerful drugs to subdue and sedate patients to avoid having to hire extra staff, or alternately to relieve already over-worked staff from the burden of caregiving.  According to the NYT analysis of Medicare data, homes with staffing shortages are also the most likely to misrepresent the number of residents on antipsychotics.

Staffing shortages are extreme, and threatening, made worse by a pandemic that has battered the industry. Nursing home employment is down more than 200,000 since early last year and is at its lowest level since 1994.

As staffing dropped, the use of antipsychotics rose.

Recent vaccine mandates further threaten industry staffing. In fact, following an announcement from President Biden that all nursing home staff will be required to be fully vaccinated against COVID-19 in a forthcoming regulation, the nursing home industry warned about the potential impact on the profession’s already challenging workforce situation. Industry leaders are deeply concerned that it may cause a "mass exodus" from the nursing home profession, leaving frail seniors without the caregivers and access to care they need.

In Ohio, only 54.3% of nursing home staff have been vaccinated, according to federal data.  Pete Van Runkle, head of the Ohio Health Care Association, which represents the state's for-profit long-term care facilities, fears additional staffing shortages. A facility in Ohio on average has 19 open positions it can't fill, according to a recent Ohio Health Care Association survey. The mandate could make things worse, Van Runkle has said.

"I'm scared to death of what that's going to look like," he said.

Van Runkle noted there was one large long-term care company that voluntarily mandated vaccines, only to walk it back later after workers threatened to leave.

Staff exodus will only increase the already strong incentives to misuse and abuse drugs as chemical restraints.  According to the NYT, the country’s leading experts on elder care are already "taken aback" by the frequency of false diagnoses and the overuse of antipsychotics.  Barbara Coulter Edwards, a senior Medicaid official in the Obama administration, told the NYT she discovered that her own father was given an incorrect diagnosis of psychosis in the nursing home where he lived even though he had dementia.

“I just was shocked,” Ms. Edwards said. “And the first thing that flashed through my head was this covers a lot of ills for this nursing home if they want to give him drugs.”

In 2019 and again in 2021, Medicare said it planned to conduct targeted inspections to examine the issue of false schizophrenia diagnoses, but those plans were repeatedly put on hold because of the pandemic.

In an analysis of government inspection reports, The NYT found about 5,600 instances of inspectors citing nursing homes for misusing antipsychotic medications. Nursing home officials told inspectors that they were dispensing the powerful drugs to frail patients for reasons that ranged from “health maintenance” to efforts to deal with residents who were “whining” or “asking for help.”  

"Asking for help."  Let that sink in.

Medicare Advantage Plans and Staffing Shortages Slowing Hospitals Discharges to Nursing Homes

Skilled nursing admissions are being slowed by both staffing shortages and Medicare Advantage restrictions.  According to a recent article in Mcknight's Long-term Care News, the delays  are threatening log jams in "hospitals desperate to discharge patients to post-acute care and free up needed beds."  The problem is especially pronounced in states with high COVID-19 case rates. 

Hospital executives and healthcare leaders have complained that the prior authorizations needed to send no-longer acute patients on to post-acute care have always come slowly in states like Florida, Louisiana and Oregon. But the problem is limiting access to care for would-be hospital admits during the ongoing delta surge.

Many Medicare Advantage plans have suspended their restrictions during this stage of the pandemic, but their replacement requirements and expiration dates vary. Humana’s waiver for Louisiana lasts until Sept. 17, while Florida Blue’s is open-ended. 

Some want uniformity directed by state or federal regulation.  “The challenge when it is not being directed by a state or federal agency is you have significant variation from one plan to the next as to how they are providing the flexibility, which creates more confusion at a time when we need to minimize as much confusion as possible,” Mary Mayhew, CEO of the Florida Hospital Association, told Modern Healthcare.

In places where waivers exist, they can be highly effective. AdventHealth in Altamonte Springs, FL, estimated waivers issued by some Medicare Advantage plans cut transitions into post-acute care down to about 24 hours.

“If the waiver goes away, we are concerned hospitals could return to seeing delayed transfers contribute to challenging capacity constraints,” said Lisa Musgrave, vice president of home care administration and post-acute services.

The American Hospital Association has been working with the Centers for Medicare & Medicaid Services (CMS) and Medicare Advantage organizations to “encourage adoption of these waivers.”  For its part, CMS issued a memo that “strongly encouraged” plans to relax prior authorizations “to facilitate the movement of patients from general acute-care hospitals to post-acute care and other clinically-appropriate settings, including skilled nursing facilities.”

Whether skilled nursing facilities could accept patients more quickly if prior authorizations are lifted remains to be seen. Kristen Knapp, spokeswoman for the Florida Health Care Association, said the larger issue “is all about staffing.”

A survey of FHCA members in early August found half had had to reduce admissions in the previous month due to worker shortages.

“The workforce crisis is real, and while we want to be good community partners during the surge, nursing centers right now are doing everything they can to maintain and recruit more staff to support the patients they are currently caring for,” Knapp told McKnight’s Long-Term Care News.

Home Health Care Staff Shortages Threaten Health- Frustrates Aging in Place

This Blog has reported the threat staffing shortages pose to the long-term institutional care industry, its residents, and its patients.  Staffing shortages in the home health care industry present similar threats, both to the industry and to actual and prospective customers.  

There is a legal maxim that "Justice Delayed is Justice Denied."  In the long-term care and the health care industry there is no simple maxim that  warns that "freedom delayed is freedom denied," but there should be.  A shortage of home health care workers means that some seniors may be unable to safely return to their homes, and may, instead, be forced into institutional care alternatives otherwise avoidable.  This may seem an anomalous result, but it is real.  Seniors are transferred to institutions that are woefully understaffed every day.  

There is no compromise possible, however, for a family seeking return of their mother or father to a home when they cannot demonstrate adequate and sufficient support services.  The systemic choice is clear; it is unacceptable for a senior to be at risk in their own home, but acceptable if that risk is institutional.  The Trump Administration learned, for example, that there were nursing homes opened and operating, without a nurse.  Medicare did not, and to this day, does not prohibit the transfer of a patient from a hospital to a poorly staffed nursing home or assisted living facility!     

Aging in Place Planning is specifically designed to reduce the risk of unnecessary and avoidable institutional care.  Unfortunately, many seniors may need home health care workers for short periods of time following acute needs or hospitalizations in order to rehabilitate safely at home.  "Freedom," may be denied these seniors if there is no choice but institutional care.   

Kaiser Health News, published a story about the on-going shortage, entitled, "Desperate for Home Care, Seniors Often Wait Months With Workers in Short Supply."  Using Maine as an example, the article explains:

"The Maine home-based care program, which helps....more than 800 in the state, has a waitlist 925 people long; those applicants sometimes lack help for months or years, according to officials in Maine, which has the country’s oldest population. This leaves many people at an increased risk of falls or not getting medical care and other dangers.  The problem is simple: Here and in much of the rest of the country there are too few workers. Yet, the solution is anything but easy."

Katie Smith Sloan , CEO of Leading Age, which represents nonprofit aging services providers, told Kaiser that the workforce shortage is a nationwide dilemma:

 “Millions of older adults are unable to access the affordable care and services that they so desperately need,” she said at a recent press event. State and federal reimbursement rates to elder care agencies are inadequate to cover the cost of quality care and services or to pay a living wage to caregivers."

This shortage was not unexpected.  Kaiser reported that "[f]or at least 20 years, national experts have warned about the dire consequences of a shortage of nursing assistants and home aides as tens of millions of baby boomers hit their senior years." President Biden even included funding for home and community-based care in the infrastructure bill ("human infrastructure").

And here we are. 

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