Connecticut Partnership for Long-Term Care
Long-term care is a wide range of services provided to people who need continued help with daily activities
(bathing, dressing, eating, toileting, continence, and transferring) due to a chronic condition or limited ability
to function.
The goal of care for persons with chronic conditions is different from acute care. The goal of acute
care is to restore a person to his/her previous level of functioning, if possible. The goal of long-term care
is to maintain independent living, facilitate personal and social adjustment, and minimize further deterioration
of physical and mental health. Hoffman and Rice, Chronic Care in America:
A 21st Century Challenge, The Robert Wood Johnson Foundation, August 1996.
Who's At Risk?
The majority (60%) of individuals living in the community with chronic conditions are working-age adults (age
18 to 64 years). One in seven or 23 million working-age adults were limited in their activities by a chronic condition
in 1994. Hoffman and Rice, Chronic Care in America: A 21st Century Challenge , The Robert Wood Johnson Foundation, August 1996.
For persons who turned 65 in 1990, 43% will enter a nursing home at some point in their life. Women are more
at risk than men, with slightly more than half entering a nursing home at some point in their life. The risk for
nursing home care also increases with age - the older you are, the greater the risk. Murtaugh, Kemper
and Spillman, "The Risk of Nursing Home Use in Later Life," Medical Care, October 1990.
Of those who enter a nursing home, 55% will need care for at least one year. One in five will need care for
five years or more. Kemper and Murtaugh, "Lifetime Use of Nursing Home Care," New England Journal of Medicine, February 28, 1991.
How Much Does It Cost?
The average cost of nursing home care in Connecticut is more than $81,000 per year. With an average length
of stay of 2-1/2 years, the average cost for a nursing home stay could be more than $200,000. State
of Connecticut, Department of Social Services, Survey of Nursing Homes, September 2000.
The average cost for a home health aide associated with a home care agency in Connecticut is $28 per hour.
The cost for a home health aide to provide assistance for eight hours a day would cost as much or more than the
average daily rate for nursing home care. State of Connecticut, Department of Social Services, March
2001.
Who Pays The Bills?
Medicare is not a primary payer of long-term care and pays very little for nursing home costs. Only a small
portion of Medicare benefit payments are for home health care. Health Care Financing Administration,
National Health Expenditures, April 2001, Table 3 - National
Health Expenditures by Source of Funds and Type of Expenditure: Calendar Years 1994-1999; Table 9 - Personal Health
Expenditures by Type of Expenditure and Source of Funds: Calendar Years 1992-1999; and Table 10 - Expenditures
for Health Services and Supplies Under Public Programs by Type of Expenditure and Program: Calendar Year 1999.
Although almost half of all nursing home care is paid for by Medicaid, an individual must "spend down"
his/her assets to the poverty level ($1,600 in Connecticut) to qualify for assistance. Health Care
Financing Administration, National Health Expenditures, April
2001, Table 3 - National Health Expenditures by Source of Funds and Type of Expenditure: Calendar Years 1994-1999;
Table 9 - Personal Health Expenditures by Type of Expenditure and Source of Funds: Calendar Years 1992-1999; and
Table 10 - Expenditures for Health Services and Supplies Under Public Programs by Type of Expenditure and Program:
Calendar Year 1999.
More than 30% of all Connecticut nursing home patients on Medicaid entered the nursing home paying from their
personal income and assets before they spent down nearly all of their resources. Gruman and Curry, Spend-Down Patterns of Individuals Admitted to Nursing Homes in Connecticut,
Connecticut Partnership for Long-Term Care Research Institute, Discussion Paper 11-1999.
About one-third of all nursing home care is paid for by individuals directly out-of-pocket. Health Care Financing Administration, National Health Expenditures,
April 2001, Table 3 - National Health Expenditures by Source of Funds and Type of Expenditure: Calendar Years 1994-1999;
Table 9 - Personal Health Expenditures by Type of Expenditure and Source of Funds: Calendar Years 1992-1999; and
Table 10 - Expenditures for Health Services and Supplies Under Public Programs by Type of Expenditure and Program:
Calendar Year 1999.
Friends and family still provide the majority of care to the elderly disabled residing in the community. About
three out of four caregivers are middle-aged women and 80% of those caring for the elderly disabled provide help
seven days a week and an average of four hours per day. Decreasing birth rates and smaller family networks are
contributing to shrink the pool of future possible caregivers. P. Short and J. Leon, Use of Home and Community Services by Persons Age 65 and Older with Functional Difficulties, DHHS Publication No. 90-3466, September 1990; and Hoffman and Rice, Chronic
Care in America: A 21st Century Challenge, The Robert Wood Johnson Foundation, August
1996.
The Cost of Waiting to Buy Long-Term Care Insurance
For up to date information on Long Term Care Coverage, please click on the provided link. Connecticut Partnership for Long-Term Care
