CareScout conducted the 2008 Cost of Care Survey for Genworth. CareScout, located in Wellesley, Massachusetts, has specialized in developing eldercare provider databases and helping families select appropriate providers nationwide since 1997.
CareScout contacted more than 40,000 providers to complete over 10,000 surveys of providers in all 50 states and the District of Columbia between December 2007 and February 2008. For details, select one of the following:
CareScout researchers conducted telephone interviews with long-term care providers within 90 regions
1 across the U.S. The 90 regions cover every state including the District of Columbia. In some states more than one region was surveyed to account for more heavily populated areas. The heavily populated regions correspond geographically with their Metropolitan Statistical Areas as defined by the U.S. Census Bureau.
To determine historical trends, CareScout used Genworth Financial Cost of Care survey results dating back to 2004 to calculate compound annual growth rates
2.
Long Term Care Providers
Adult Day Health Care topAcross 90 individual regions, researchers polled more than 25% of adult day health care (ADH) facilities, and in no region did less than 10% of providers complete the survey. With limited exception, at least 10 facilities completed the survey in all regions. More than 980 providers completed the survey. The survey evaluated the daily private pay rates for sending an individual to an ADH for services.
There are at least three different models of adult day health care programs: social, medical, and combined. All models are intended to offer socialization, supervision, and structured activities designed for the individual needs of the participants at the center. Some programs may provide personal care, transportation, medication management, health-related services, intergenerational programming, social services, meals, personal assistance, and therapeutic activities.
In interpreting the survey results, where a daily range was provided that included a low-end rate range of less than $25, the high-end rate within the range was used. For example, where the ADH provider charged between zero and $40 “depending upon income level,” CareScout used the $40/day rate. Where the ADH provider charged between $25 and $40, for example, CareScout used the midpoint of the range.
This method proves conservative in that it avoids underestimating the private pay cost of ADH due to the “$0.0” rates for people who cannot afford the care. Where three rates were provided for three levels of care, CareScout used the middle care level rate. Where an hourly range was provided, CareScout used the average of the range. All rates exclude transportation fees.
This is the first Genworth-published ADH survey and therefore a historical trend analysis is not available.
Assisted Living Facilities topAcross 90 individual regions, researchers polled approximately 11% of the licensed facilities and, with limited exception completed surveys with at least 10 facilities per region. In many areas, the sample size was significantly larger. More than 4,500 providers completed the survey.
Unlike nursing homes, there is no national, uniform regulatory protocol for assisted living facilities. As a consequence, states have instituted licensing standards that vary from state to state. CareScout’s researchers interviewed assisted living facilities, which go by a number of different names including “Residential Care Facility” which were licensed according to the licensure requirements of the state in which the assisted living facility was located.
The survey evaluated the monthly base private pay rate for a one-bedroom unit in an assisted living facility. Researchers also determined whether a non-refundable community or entrance fee was typically charged by a facility. While community and entrance fee rates are not included in the average monthly assisted living rate calculations, 33% of the assisted living facilities surveyed charged a one-time, non-refundable fee ranging from $35 to $118,180 with a national average one-time fee of $2,316.
Home Care topAcross 90 individual regions, researchers polled, on average, at least 13% of home care providers across both Medicare-certified and non-Medicare certified provider types to determine the hourly private pay rates charged for the services of a “home health aide.” Researchers also surveyed non-Medicare-certified, licensed home care providers to determine the hourly private pay rates charged for the services of a “homemaker.”
On rare occasions where an area had a small sample size, a minimum of 10 providers completed surveys for each region. In many areas, the sample size was significantly larger. Researchers completed over 3,000 surveys.
Where a rate range was provided by an agency, the midpoint was used. Some agencies charge a higher hourly rate when the patient uses less than four hours of services in a week; where such a practice was employed, surveyors used the hourly rate associated with four or more hours of service in a week (that is, the rate more closely aligned with typical long-term care services utilization). All rates are weekday (Monday – Friday) rates.
Nursing Homes topAcross 90 individual regions, researchers polled at least 13% of all certified and licensed nursing homes and in no region did less than 10% of providers complete the survey. With limited exception, at least 10 facilities completed the survey in all regions. In many areas, the sample size was significantly larger. More than 2,000 providers completed the survey.
The survey evaluated the daily rate for a private room (single occupant) and a semi-private room (double occupancy) in Medicare-certified nursing facilities. Medicare-certified nursing homes represent more than 90% of all nursing homes in the U.S. Rates for transitional care units (typically hospital-based certified nursing homes) were not included. The daily room charge usually includes services beyond rent such as three meals a day, laundry, sundries, basic nurse supervision, and generic-brand, non-prescription pharmaceuticals.
1 The 2007 Genworth Cost of Care survey included 90 regions as well; however, prior to 2007, Genworth Cost of Care surveys included 88 regions. The two newest regions are Richmond, Virginia and Nashville, Tennessee.
2 Compound annual growth/inflation rate = [(Ending Value ÷ Beginning Value)1/n] – 1; where “n” is the number of time periods.
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