As the oldest Baby Boomers turn 80, nursing homes across the United States are preparing for a significant increase in demand, according to a July 5 report. The number of people requiring assistance with dementia, disabilities, and daily living activities is rising at a time when available nursing home beds are declining. Nearly 10% of U.S. nursing homes closed between 2011 and 2021, and many direct care providers are leaving the industry.
In a perspective published July 4 in the New England Journal of Medicine, Dr. Mark A. Unruh and Dr. Hye-Young Jung of Weill Cornell Medicine, along with Dr. Vincent Mor of Brown University, warn that this mismatch between need and capacity could strain families, hospitals, and healthcare systems if not addressed. The authors offer several recommendations to address what they describe as a serious healthcare crisis.
Last year there were 14,742 nursing homes serving about 1.24 million Americans with an average occupancy rate of 84%. However, projections indicate that the number of Americans aged 80 or older will increase by more than 45% over the next decade—from less than 15 million currently to about 22 million by 2036—while fewer care providers are entering the field.
The authors outline five recommendations aimed at improving nursing home capacity and attracting more workers to long-term care roles. They emphasize that simply counting licensed beds does not reflect actual availability if there are not enough nurses or certified assistants to provide care for residents.
Dr. Unruh said that payment policy changes from agencies such as the Centers for Medicare & Medicaid Services could help stabilize staffing by encouraging investments in wages and training: "We need to help these nursing homes, especially those that have lower revenue streams due to high Medicaid census, to keep them from closing," he said. "That would be particularly devastating in rural communities where there might only be one nursing home for a large area. If that nursing home closes down, what options will people have? Figuring out where the money is going to come from is difficult, but these are tough questions that need answering. The problem will only be magnified the longer that policy makers wait to do something."
