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Health & Well-Being » Nursing Care

Why It's Important

Nursing care is professional treatment by a skilled nurse during an illness or injury. Nurses participate in the care process from the very beginning, often providing the vast majority of the hands-on care. Their nursing expertise and experience on a health care team equip them to manage ambulatory, acute, home-based and chronic care patients.

How Richmond Is Doing

According to Genworth's Cost of Care Survey, 2009, except for home-based health care, the costs of long-term care also are poised for steady increases.

  • The cost of labor is a key factor driving the price of care at facilities, though that has abated somewhat because of the availability of workers as unemployment has risen and because of higher retention rates.
  • Nationally, the average annual cost for a private room in a nursing home is $74,208 or $208 per day, a 4.7 percent increase over the past year and 4.3 percent more annually over the past five years.
  • In Richmond and Roanoke, the cost for a private room has risen 8 percent a year since 2005 and 5 percent a year in the Norfolk-Virginia Beach region.
  • The median annual cost for a private nursing home room in Richmond is $78,658.
  • In Richmond, costs for a private room in an assisted-living facility rose even faster, increasing 16 percent a year over the past five years to a median annual cost of $37,752.
  • Nationally, the cost for a one-bedroom unit in an assisted-living facility is $33,903 annually or $2,825 monthly, marking an increase of 1.4 percent over 2008 and 4.7 percent annually over the past five years.
  • A bright spot in the company's survey is the relatively flat cost of in-home care. The hourly cost for in-home care for non-Medicare-certified workers rose a half-percent to $18.50 from a year ago and increased 1.7 percent annually over the past five years.
  • In Richmond, however, the median rate is $19, which represents an annual growth rate of 5 percent since 2005. The cost ranges from $15 to $21 in Virginia.

(GENWORTH, COST OF CARE SURVEY, 2009)

 

Rate of nursing home residence among people age 65 and over, by age group, selected years 1985-2004

 

Percent of medicare enrollees age 65 and over residing in selected residential settings, by age group, 2005


How Virginia Is Doing

According to the Virginia Department of Healthcare Professions:

  • By 2020 there will be a projected shortage of 1500 physicians and 22,600 registered nurses in Virginia.
  • Currently in Virginia there is a lack of accurate healthcare data.
  • The area of direct support professionals (DSP) lacks the most data where there is a projected 45 % increase in demand by 2010.

(VA DEPARTMENT OF HEALTHCARE PROFESSIONS, 2009)

How the U.S. Is Doing

According to a report by Marla Salmon on the future roles and services of nursing for older adults: Older adults have greatest need for nursing services

  • Two-thirds have two or more chronic diseases
  • Hospitalized 3X more often & stay 50 percent longer
  • 70 percent have cognitive impairment or at least one ADL limitation
  • 40 percent over 85 suffer cognitive impairment
  • 25 percent over 85 suffer severe depression

The reality: nursing care of older adults

  • Relies heavily on unskilled, unprepared workforce
  • Lacks oversight & appropriate supports
  • Disparities are significant
  • Shortage of all providers is worsening
  • Most promising models not widely adopted

A closer look: assistants, aides and attendants

  • Growing need: 1.3 million more by 2012
  • Poor career options
    • 30 percent live in poverty
    • Frequent turnover
    • Difficult work conditions
    • Few advancement opportunities
  • Lack of training, support & functional teams

A closer look: informal care

  • 57 percent of community care is informal
  • Usually women, average age 46
  • $257 B/yr. "savings"
  • Decreasing availability
  • Significant economic, social & health impact

A closer look: nurses

  • Primary care (particularly advanced practice nurses) & prevention/promotion
  • Chronic disease management (particularly advanced practice nurses)
  • Direct care provision (particularly LPNs in long term care) & coordination
  • Informal care provider training & support
  • Team interface & coordination
  • Family health, education & support

(SALMON, 2004)

Data & Information Sources

Genworth Financial, Cost of Care Survey, 2009

http://www.genworth.com/content/products/long_term_care/long_term_care/cost_of_care.html

Health Workforce Information Center

http://www.healthworkforceinfo.org/

Roadmap for Virginia’s Health, A Report of the Governor’s Health Reform Commission, 2007

http://www.hhr.virginia.gov/Initiatives/HealthReform/MeetingMats/FullCouncil/Health
Reform_Comm_Draft_Report.pdf

Salmon, Marla, Nursing and Care for Older Adults, Future Roles and Services in the Face of Scarcity, 2004

http://www.iom.edu/Object.File/Master/22/917/AM2004Salmon.pdf

U.S. Census Bureau, American Community Survey

http://www.census.gov/acs/www/

Virginia Department of Health Professions, 2009

http://www.dhp.virginia.gov/dhp_programs/hwdc/default.htm

Virginia Employment Commission, Labor Market Data, 2009

http://www.vec.virginia.gov/vecportal/index.cfm

Virginia Nurses Survey, Virginia Department of Health Professions, 2001

www.dhp.virginia.gov/nursing/survey/nursing_surveydoc.htm