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Nursing home and assisted living facility care costs continued to grow while home care costs remained flat in 2011, according to Genworth Financial‘s 2012 edition of its annual Cost of Care Survey (pdf).

The report used data from more than 15,000 long-term care providers throughout the country to determine the median rates for a range of long-term care services:

• Licensed Homemaker Services — $18 median hourly rate; no change from 2011; five-year annual growth rate of 1.15 percent
• Licensed Home Health Aide Services — $19 median hourly rate; no change from 2011; five-year annual growth rate of 1.1 percent
• Adult Day Health Care — $61 median day rate; up 1.67 percent from 2011; five-year growth rate unavailable
• Assisted Living Facility, One Bedroom, Single Occupancy — $3,300 median monthly rate; up 1.2 percent from 2011; five-year annual growth rate of 5.7 percent
• Nursing Home, Semi-Private Room — $200 median daily rate; up 3.63 percent from 2011; five-year annual growth rate of 4.5 percent
• Nursing Home, Private Room — $222 median daily rate; up 4.23 percent from 2011; five-year annual growth rate of 4.3 percent

While nursing home and assisted living facility costs have steadily increased in recent years, home care costs have remained fairly steady.

The report attributes the lack of growth in home care costs to “increased competition among agencies and the availability of unskilled labor,” as well as the fact that home care companies “do not incur the costs associated with maintaining stand-alone health care facilities.”

Declining Direct-Care Worker Wages Left Unmentioned

“What the report fails to mention is that the biggest component of home care costs is direct-care workers’ wages, which over the last 10 years have actually gone down when adjusted for inflation,” said PHI National Policy Director Steve Edelstein.

“One reason their wages remain artificially low is the ‘companionship exemption,’ which excludes home care workers from federal minimum wage and overtime protections,” Edelstein added. “We can’t continue to underwrite the cost of home care by undervaluing and underpaying those who provide the services and still expect that there will be a home care worker available when we need one.”

Genworth’s website includes a section allowing current or prospective consumers of long-term care to compare rates for various services on a state-by-state basis. The website also allows for comparisons between nearly 440 discrete regions throughout the U.S.

– by Matthew Ozga

A new National Emphasis Program (NEP) for Nursing and Residential Care Facilities was released on April 5 by the U.S. Department of Labor‘s (DOL) Occupational Safety and Health Administration (OSHA) in an effort to reduce occupational illnesses and injuries in these long-term care settings.

The NEP (pdf) provides guidance for a three-year effort to use OSHA outreach and inspections to reduce specific occupational hazards in nursing and residential care facilities.

In 2010, workers employed in these settings experienced “one of the highest rates of lost workdays due to injuries and illnesses of all major American industries,” a DOL press release states.

“The incidence rate for cases involving days away from work in the nursing and residential care sector was 2.3 times higher than that of all private industry as a whole, despite the availability of feasible controls to address hazards,” DOL explains.

Nearly two thirds of the cases (62.5 percent) that involved days away from work were attributed to injuries in two categories: 1) overexertion and 2) slips, trips, and falls.

DOL identified the following hazards associated with providing care in nursing and residential facilities:

• exposure to blood and other potentially infectious material;
• exposure to other communicable diseases such as tuberculosis;
• ergonomic stressors related to lifting patients;
• workplace violence;
• slips, trips, and falls; and
• exposure to hazardous chemicals and drugs.

“These are people who have dedicated their lives to caring for our loved ones when they are not well,” said David Michaels, assistant secretary of labor for occupational safety and health. “It is not acceptable that they continue to get hurt at such high rates. Our new emphasis program for inspecting these facilities will strengthen protections for society’s caretakers.”

Nursing Aides Rank among the Highest for Job Injury and Illnesses

According to analysis by PHI of 2010 data on nursing aides from the Bureau of Labor Statistics, Injuries, Illnesses and Fatalities Program:

• Nursing aides ranked second in the list of occupations with the highest numbers of injuries and illness (53,030), after hand laborers and freight, stock, and material movers (65,040), and far ahead of police and sheriff’s patrol officers (29,150).
• Nursing aides also had one of the highest incidence rates of work-related illness and injuries (489.4 per 10,000 workers), placing them third in the list of the top five. In 2010, they experienced injury at a rate four times that of all workers combined.
• Nursing aides had the highest incidence rate for musculoskeletal disorders of all occupations (or ergonomic injuries) at 249.4 per 10,000 full-time, or more than seven times the national average (34.3 per 10,000).

Visit the OSHA website for more information, including guidance on nursing and residential care facility ergonomics and workplace violence.

– by Deane Beebe

Workers in nursing and residential care facilities experienced the highest injury rates of any occupational setting in 2010, according to data (pdf) recently released by the U.S. Bureau of Labor Statistics (BLS).

Overall, the country’s private-industry employees suffered nonfatal injuries and illnesses at a rate of 3.5 cases per 100 full-time workers last year, down from 3.6 in 2009.

But private nursing and residential care facilities reported an injury/illness rate of 8.3 per 100 workers — higher than couriers and messengers (7.2), air-transportation employees (8.1), and people involved in performing arts, spectator sports, and related industries (6.7).

Combined, the health care and social assistance industry reported a higher injury/illness rate than any other private sector.

Public-Sector Injury Rate Even Higher

Nursing and residential care facility workers employed in the public sector suffered even higher injury rates than their private-industry counterparts, the BLS report additionally found.

The injury rate among nursing and residential care workers employed by local governments was 11.4 per 100 full-time employees. Those employed by state governments, meanwhile, recorded an injury rate of 15.1.

BLS reports a total of just 218,200 workers in public-sector nursing and residential care facilities, compared with more than 3.1 million such workers in the private sector.

Labor Secretary Expresses Concern

“We remain concerned that more workers are injured in the health care and social assistance industry sector than in any other, including construction and manufacturing,” said Department of Labor Secretary Hilda Solis in a statement.

“The Department of Labor’s Occupational Safety and Health Administration will continue to work with employers, workers, and unions in this industry to reduce these risks,” Solis added.

Many of the people employed in the nursing and residential care industry are direct-care workers.

“Direct-care workers in nursing and residential care settings face a greater injury rate than nearly any other job type in the country,” said PHI Government Affairs Director Carol Regan.

“Unfortunately, more than one in four lack health insurance (pdf). It is wrong that direct-care workers who get sick or hurt while caring for others cannot get comprehensive care for their own injuries or illnesses,” Regan added.

In 2008, Regan appeared in a short video, “The Most Dangerous Job in America,” to highlight the inordinately high injury risks that nursing assistants face each day.

– by Matthew Ozga

The cost of receiving long-term care services at home is increasing, but not nearly as rapidly as the cost of nursing home or assisted living services, according to an April 2010 report by Genworth Financial, a long-term care insurance company. Read the full story