The American Association of Retired Persons (AARP) recently released its Long-Term Services and Supports Scorecard. The scorecard lists many recommendations and warns of significant gaps in long-term care for older adults that persist in all 50 states. It notes that the long-term care system failed to rebound more than three years after COVID-19 began.
This is the first LTSS Scorecard that crunches data — using various publicly available sources, such as the Centers for Medicaid and Medicare Services, the Census Bureau’s American Community Survey, and the Bureau of Labor Statistics — from the very height of the pandemic and beyond. The data-rich report factors everything from family care services to the long-term care workforce, equity in nursing homes, and emergency preparedness.
The report concludes that even though the cost of home care has dramatically increased, the availability and quality of direct care workers have suffered.
Minnesota and Washington (along with the District of Columbia) have continued to innovate with unique ways to support family caregivers at the state level. Minnesota (ranked first), Washington (second), and the District of Columbia (third) led the way, primarily due to their strong support for family caregivers. South Carolina (ranked 49th), Alabama (50th), and West Virginia (51st) are at the very bottom of the LTSS Scorecard.
The LTSS Scorecard offers these critical recommendations for states to improve their support for long-term care:
Bolster the workforce.
Nursing homes and in-home care workforces must improve recruitment and training and increase pay to attract and retain skilled workers.
Expand innovative models.
Effective nursing home models with smaller facilities and private rooms can improve the quality of care and the quality of life.
Address inequities.
Make investments that close the gaps in access to quality care facilities.
Support family caregivers.
Prioritize support for family caregivers with paid leave and tax credits to assist with financial needs.
Invest in caregiver infrastructure.
Increase support and training for home health aides and home visits and update key Medicaid regulations.
Build coalitions.
Support age-friendly health systems allowing individuals to live independently with affordable housing and accessible transportation.
Support innovation.
Create comprehensive aging plans that can offer new approaches with things like smaller, more guest-friendly nursing homes.
Mandate emergency plans.
Develop sound emergency preparedness plans in every state to support nursing home residents in times of crisis.
Some specific rankings of Alabama:
Overall Rank – 50
Affordability and Access – 38
Choice of setting and Provider – 51
Safety and Quality – 41
Support for Family Caregivers – 48
Community Integration – 49
Rankings of Alabama related to quality of care in nursing homes:
Hospital Admissions – 17
Residents with Pressure Sores – 33
Inappropriate Antipsychotic Use – 47
Staff Turnover – 15
Top Quality Ratings – 21
Staffing Levels – 35