Report says more Californians are seeking home-based healthcare

A new report from the California HealthCare Foundation shows that more Californians are seeking home-based long-term care services instead of nursing home care, while the state's nursing homes face continued quality challenges.

The CHCF report, “Long Term Care Facts and Figures,” showed that use of long-term care services has increased between 2003 and 2007, with more than one million Californians using some type of long-term care service. Most of the growth, the report said, occurred among people using home- and community-based services, while the number of people in nursing homes has remained steady.

According to the report:

• California spends $3.8 billion for Medicaid nursing home services, but the state's nursing homes are facing a large number of federal and state citations and complaints and rank low on several quality measures compared to the nation.
• California Medicare beneficiaries use fewer home health and hospice services and have lower expenditures in this area than the national average.
• California has a higher percentage of Medicaid participants receiving home- and community-based care (80 percent) than the national average (62 percent).
• In spite of recent increases in Medicaid reimbursement to nursing homes, California reimbursement rates continue to lag behind the national average.

The CHCF has unveiled a new Web site rating thousands of the state's long-term care providers on a wide range of quality of care measures – information that the foundation expects will help consumers make better choices and focus providers on improving quality.

The free online service, CalQualityCare.org, rates the care provided by nursing homes, hospice programs and home health agencies where data is available to evaluate performance. The site also provides information on many other kinds of long-term care, such as assisted living, retirement communities and day care.

"There are thousands of long-term care choices in California, but the quality of care provided varies from superior to poor," said Mark D. Smith, MD, the CHCF's president and CEO. "CalQualityCare gives consumers the information to help decide which providers will best meet their needs."

The Web service "will shine a spotlight on each facility's quality of care and opportunities for improvement," said Bonnie Darwin, executive director of the California Culture Change Coalition, a statewide organization representing nursing home providers, resident advocates, state and federal regulators and direct care workers.