With nursing homes disappearing and life expectancies rising, gubernatorial candidate Dan Malloy said in a New Haven visit that he sees a “collision course” that could affect cities more than suburbs.
Malloy (at left in photo) made the observation during a Friday afternoon visit to the Mary Wade Home on Clinton Avenue in Fair Haven with his running mate, state Comptroller Nancy Wyman (center).
As a nursing home that is undergoing expansion, Mary Wade is a rarity. Malloy said he chose it because he wanted to visit a home with a strong reputation. As he finished up a tour of the facility, he commented on the state of nursing homes in Connecticut.
Nursing homes are faltering and disappearing, especially in urban areas, where they are more expensive to operate, Malloy said. That’s going to be a problem, since life expectancies continue to increase, he said. The state must ensure that health care reimbursement rates are set high enough to support nursing homes, Malloy argued.
With New Haven’s West Rock Health Care Facility going under after a bankruptcy, the plight of nursing homes has drawn the attention of the Malloy campaign before, as well as that of his opponent Ned Lamont. See here for background.
The state reimbursement system is the subject of an open lawsuit brought against Gov. M. Jodi Rell by a group of nursing homes.
Just after 1 p.m. on Friday, Malloy and Wyman were met at the entrance to Mary Wade by CEO David Hunter (all three are pictured, from left). Hunter led a tour of the building, visiting the three parts of the home: residential living, skilled nursing care, and elderly day programs.
Malloy commented on the name plates on the doors in the residential wing, where the carpeted hallway is lined with flowered wallpaper. “It’s a nice touch,” he said.
In a skilled nursing unit, Malloy and Wyman worked a room of seniors who need more intensive care.
“I’m Nancy Wyman. I’m running for lieutenant governor with Dan Malloy,” said Wyman.
“Running for what?” asked one woman. Wyman raised her voice and tried again.
Later, in the day program section, Malloy and Wyman visited a room-full of seniors who were enjoying a piano concert. The pianist struck up “Hail To The Chief” as Malloy entered.
“This is a wonderful facility,” Malloy told the seniors. He complimented one woman on her word search completion.
In the garden behind the home, Malloy and Wyman paused to speak with 87-year-old Fair Haven native Mary Coiro, who was raking leaves in the shade.
“Nursing home [state reimbursement] rates haven’t changed since 2007,” said Malloy (pictured speaking with Mary Wade board member Al Goldberg), moments later. Meanwhile, the number of nursing homes in the state has been dropping, particularly in urban areas, he said.
When children can’t place their elderly parents in homes nearby or care for them at home, it has “a physiological and emotional impact,” he said. That’s why urban nursing homes like Mary Wade, with day and residential programs are so important.
But it’s more expensive to operate a nursing home in an urban environment, he said. And when reimbursement rates stagnate, it becomes even harder.
“We need reimbursement rates for quality care that allow homes to stay in business,” Malloy said.
The state also needs to help seniors live at home with their families for longer, Malloy said. Elderly day care programs like the ones at Mary Wade help families to keep their parents at home.
Malloy addressed a concern that Hunter brought up during the tour. State funding comes to the home from several sources, each with different regulations and processes, Hunter said. That makes for a cumbersome and convoluted situation, he said.
Malloy said he plans to cut each of the 200 state agencies by a third, without cutting back on services. It will encourage cooperation and reduce duplicate efforts. Nursing homes need a reduction of paperwork and regulation, he said. “That’s what I’m prepared to do.”
“The state needs to have something available for cutting through the bureaucracy,” Hunter said, as the group sat for a moment in an air conditioned conference room.
“I do. It’s called Nancy Wyman,” Malloy said with a laugh.
After Malloy and Wyman departed, Hunter noted that New Haven has lost three nursing homes in the 28 years that he’s run Mary Wade.
What can the state do to help urban nursing homes?
“It could pay us our costs,” he said. “It could also work with us more creatively” to simplify bureaucracy. Hunter said Mary Wade gets state money from three sources: Medicaid, old age assistance, and a home care program fund. Each has its own regulations and standards, which often change, he said. If the state could simplify the system, it would save time and money, he said.
Contacted later, Malloy’s opponent for the Democratic nomination, Ned Lamont, released this statement:
“As more people retire and medical costs go up, Connecticut needs a new type of leadership to ensure that people from every community and walk of life can retire with dignity. Instead of throwing more money at the problem, we need to fundamentally change our system by shifting from costly nursing homes to more affordable, more popular community-based care.
“As governor I will work to give families the choice of community-based alternatives to nursing homes that allow their moms and dads to stay at home, where they want to be anyway. If Connecticut increased the percentage of people receiving home and community-based care from the current 53 percent to 75 percent, we could continue to deliver quality care and save the state as much as $900 million a year by 2025.”
"The state also needs to help seniors live at home with their families for longer, Malloy said."
This is actually what needs to mainly happen, permanent residence in a nursing "home" should be the rare exceptions for elderly people who cannot function on their own, which is actually a small percentage above the age of 65.
There are two major issues coming at us currently and more so in coming decades. One is the aging of the baby boom generation, a massive demographic that will stop working (it is already hasn't) and start requiring lots of government assistance. The other in the maturing of the millennial generation (children on baby boomers) which is another large demographic that is recently and continues to enter the job market and needs affordable, desirable housing and an active social life.
Millions of aging people are about to switch from being self-reliant to assisted-living and many budgets at every level of government are already squeezed to the max. Also, millions of young people are currently looking for jobs that just don't exist and older, more established people from the millennial generation who are employed are bankrupting themselves trying to pay for such a high cost of living-multiple cars, large lot homes, private schools, etc.
The best way to address this coming and existing problems is to provide good urban environments. Prior to 1950, there were no nursing homes or retirement communities. It's not like there weren't elderly people either, they just simply retired in their homes and took care of themselves because they were within walking distance of basic needs like a grocery store, drug store, and transit stop. Elderly people need to be able to remain self-reliant much longer than they currently due and the way to do this is to provide affordable housing in relation to walkable and diverse environments. With over 50 percent of the country now living in suburbs, when people become too old to drive they are immobile because suburbs do not allow the mixing of uses in their zoning so only other residential uses are within walking distance of homes. This forces families to either live with their parents or to send them to very expensive elderly camps, where they are essentially treated like babies.
The same solution is required for the millennial generation. It's not that young people need walkable communities with diverse uses, it's that they enjoy them because they can meet people and have active lives. Unfortunately, cities are losing many young families because they're focusing too much on condos and luxury apartments and not on family-oriented high density housing types. Cities are pushing many families out that would otherwise like to stay because of the conveniences of urban living and because children become chauffeur dependent in suburbs. Most millennials grew up in the suburbs and they know how boring it is, but they are given no choice but to take their families out there when cities cannot provide adequate housing options.
Also on a practical matter, housing should be narrow (not wider than 60 feet on the short dimension) so that cross ventilation can occur-this would reduce the need to air conditioning and make the indoor environment much more appealing. This really is a problem in large housing buildings because enormous amounts of energy are put into cooling and heating them and there are much better building types that do better jobs of housing people than monolithic towers and those should be used more.
The 2-family house is one of the most adaptive building types ever developed. It allows for a wealthier, well-established family to own a large house but also rent out the ground floor (perhaps also the top floor and the basement) to more moderate to low-income people like young singles, young families, or elderly people who need to be on the ground floors where stair use is minimal. This supplements the primary mortgage of the owner and provides affordable housing all in one building. When developed close together with other similar buildings it really has the density that can support small shops and city services.