How States Measure Up in Long-term Care Support
Aging Matters

An upsurge of older adults challenges our nation. With them, comes debilitating chronic conditions and extended lives. The need for specialized long-term support soars and demands significant provisions on health care. As it stands today, Americans lack adequate home and community-based services. They depend on the state governments to satisfy the need. However, insufficient care ranks high throughout the country.

In 2014, a study by AARP, Long-Term Care Services, and Support Scorecard found that local communities hold the key for improved healthcare, but not all states are equal. Some offer better care over others. The report looked at five dimensions of health and rated each state accordingly.

  • Affordability and access
  • Choice of setting and provider
  • Value of care--Family caregivers support
  • Successful transitions

Consumers need to review the results of how one's state measures up. By doing so, it will motivate each of us to take action with state legislatures for the needed change in long-term care policies.

Examining the five dimensions, one can see all the indicators unique to each State and how it measures up when helping people living with disabilities. Follow the links LTSS indicators go to the Executive Summary or go to the Scorecard Chartpack. If your newspaper doesn't hyperlink to the report, go online and search "AARP Long-term Care Services and Support Scorecard."

Because many states have few alternatives; consumers rely on costly nursing homes, putting extra pressure on resources. But the best performing States offer nursing support at home instead of expensive skilled nursing home care.

In the worst performing States, close to 25 percent of Medicaid beneficiaries receive care in their homes and communities. And in the best-performing ones, 75 percent do. The best performing States transitioned close to 15 percent of people from nursing homes back to their community (within three months of hospital visit) while the poorer performers transferred only 5 percent.

Public policies needed:

Consumers need home and community-based choices and the option to hire the people to help.

Better manage the unnecessary transitions between nursing homes and hospitals, which disrupt recovery and add pressures on resources.

Best care states: Minnesota is number 1. New York ranks 25, Texas 30, and Kentucky the lowest. Find out how your state ranks. Nursing home costs: The four affordable states are Texas, Louisiana, Oklahoma, and Missouri; the least are Alaska, Hawaii, Massachusetts, and New York.

Older adults find that home care allows them to stretch their dollars further, but overall, long-term care outpaces affordability for middle-income families. It's imperative that we fight for more home and community-based services to decrease costs, especially for those who cannot afford to pay for support services in a nursing home. Connect with your local and state governing bodies.

Carol Marak is the editor at She's earned a Certificate in the Fundamentals of Gerontology from the University of CA, Davis. Contact Carol at

Part of the Aging Matters Weekly Syndicated Column

Aging Matters is a weekly column tackling everyday challenges that our growing elderly population and their loved ones face. It is also published in a variety of syndication partners including newspapers all over the country.

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