The Long Term Care Market: Nursing Homes, Home Care, Hospice Care, and Assisted Living

Published by: Kalorama Information

Published: Mar. 15, 2012 - 185 Pages


Table of Contents

CHAPTER ONE: Executive Summary

Scope And Methodology

Overall Market Size

Demographics

Activities of Daily Living

Chronic Illness

Income

Quality Of Care

U.S. Health Expenditures

Consumer Preferences And Lifestyle Issues

Fees And Payment

  •   Public Payments

Long Term Care Insurance

  •   Preparing For the Future
  •   Nursing Homes
  •   Number of Facilities
  •   Resident Population
  •   Issues and Trends
  •   Market Size and Forecast
  •   Competitor Analysis
  •   Market Analysis

Home Care

  •   Number of Facilities
  •   Resident Population
  •   Issues and Trends
  •   Market Size and Forecast
  •   Competitor Analysis
  •   Market Analysis

Hospices

  •   Number of Facilities
  •   Resident Population
  •   Issues and Trends
  •   Market Size and Forecast 
  •   Competitor Analysis
  •   Market Analysis

 Assisted Living

  •   Number of Facilities
  •   Resident Population
  •   Issues and Trends
  •   Market Size and Forecast
  •   Competitor Analysis
  •   Market Analysis

CHAPTER TWO: Introduction,  Issues and Trends

The U.S. Health Care Industry

Long Term Care

  • Nursing Homes
  • Home Care
  • Hospices
  • Assisted Living
  • Demographics
  • U.S. Population
  • Aging of the Population
  • Racial Trends
  • Age and Race
  • Obesity
  • Marital and Living Arrangements
  • Geographic Concentrations
  • Activities of Daily Living
  • Chronic Illness
  • Addiction
  • Mental Illness
  • Income

Health Care Reform

Quality Of Care

Certification and Accreditation

U.S. Health Expenditures

Consumer Preferences And Lifestyle Issues

The Elderly

Caregiver Issues

Fees And Payment

  •     Medicare
  •     Medicaid

    Long Term Care Insurance

  •     Numbers of Insured

Cost of Coverage and Affordability

Effect of the Economy

The Managed Care Environment

Preparing For The Future

Staffing and Human Resources

Information and Education Initiatives

Medicaid Reform

Building of New Facilities

CHAPTER THREE: Nursing Homes

Description Of Facilities

Services

Number of Facilities

Resident Population

  •   Demographic Data
  •   Functional Data
  •   Length of Stay
  •   Insurance Coverage
  •   Issues And Trends

    Medicare Reforms

    Health Care Reforms

    Medicaid Cuts

Patient Dumping

Quality of Care

Staffing Issues

State Quality Improvement Initiatives

Legal Action

Safety

Market Size And Forecasts

  Cost of Cares

  Size of the Markets

  Competitor Analsysis

  Market Analysis

CHAPTER FOUR: Home Care

Description Of Facilitiess

Services

Number of Facilitiess

RESIDENT POPULATIONs

Demographic Data

Functional Data

Insurance Coverages

Issues And Trends 

Medicare Reimbursements

Medicaid Reimbursements

Medicare and Medicaid Co-payments

Health Care Reforms

State Service Reductions

Improper Payments

Quality of Cares

Disease Managements

Technology and Telemedicine

Market Size And Forecasts

Cost of Cares

Size of the Markets

Competitor Analysis

Market Analysis

CHAPTER FIVE: HOSPICES

Description Of Facilities

Services 

Number of Facilities 

Resident Population

  •   Demographic Data
  •   Functional Data
  •   Insurance Coverages
  •   Issues And Trends

Fraud and Abuses

Health Care Reforms

Proprietary Technologies 

Profitability

Market Size and Forecasts

  •   Cost of Care
  •   Size of the Market
  •   Competitor Analysis
  •   Market Analysis

CHAPTER SIX: ASSISTED LIVING

Description Of Facilities

Services

Number of Facilities

Resident Populations

  •   Demographic Data 
  •   Functional Data
  •   Length of Stays

Insurance Coverages

Health Care Reforms

Quality of Cares

Mergers and Acquisitions

Consumer Knowledge and Information

Market Size And Forecasts

  •   Cost of Cares
  •   Size of the Markets
  •   Competitor Analysis
  •   Market Analysis

 CHAPTER SEVEN: Market Summaries

Overviews

Issues And Trends

Continuum of Cares

Reimbursement and Regulatory Changes

Specialty Cares

Competitive Bidding

Competitor Analysis     

CHAPTER EIGHT: COMPANY PROFILES

Amedisys 

  History and Lines of Business

  Long-Term Care Business

  Financial Information

  Mergers and Acquisitions

  Corporate Strategies

Apria Healthcare Group Inc./ Blackstone Group

  History and Lines of Business

  Long-Term Care Business

  Financial Information 

  Mergers and Acquisitions

  Corporate Strategies

Atria Senior Living

  History and Lines of Business

  Long-Term Care Business

  Financial Information

  Mergers and Acquisitions

  Corporate Strategies

American Homepatient

  History and Lines of Business

  Long-Term Care Business

  Financial Information

  Mergers and Acquisitions

  Corporate Strategiess

Brookdale Senior Living

  History and Lines of Business

  Long-Term Care Business

  Financial Information

  Mergers and Acquisitions

  Corporate Strategies

Emeritus Corporation

  History and Lines of Business

  Long-Term Care Business

  Financial Information

  Mergers and Acquisitions

  Corporate Strategies

Extendicare, Inc.

  History and Lines of Business

  Long-Term Care Business

  Financial Information

  Mergers and Acquisitions

  Corporate Strategiess

Genesis Healthcare

  History and Lines of Business

  Long-Term Care Business

  Financial Information

  Mergers and Acquisitions

  Corporate Strategies

Gentiva Health Services

  History and Lines of Business

  Long-Term Care Business

  Financial Information

  Mergers and Acquisitions

  Corporate Strategies

Golden Living

  History and Lines of Business

  Long-Term Care Business

  Financial Information

  Mergers and Acquisitions

  Corporate Strategies

Kindred Healthcare, Inc.

  History and Lines of Business

  Long-Term Care Business

  Financial Information

  Mergers and Acquisitions

  Corporate Strategies

HCR MANOR CARE INC.

  History and Lines of Business

  Long-Term Care Business

  Financial Information

  Mergers and Acquisitions

  Corporate Strategies

LIFE CARE CENTERS OF AMERICA

  History and Lines of Business

  Long-Term Care Business

  Financial Information

  Mergers and Acquisitions

  Corporate Strategies

Lincare

  History and Lines of Business

  Long-Term Care Business

  Financial Information

  Mergers and Acquisitions

  Corporate Strategies

SUN HEALTHCARE GROUP

  History and Lines of Business

  Long-Term Care Business

  Financial Information

  Mergers and Acquisitions

  Corporate Strategies

Sunrise Senior Living

  History and Lines of Business

  Long-Term Care Business

  Financial Information

  Mergers and Acquisitions

  Corporate Strategies

T A B L E   O  F   E X H I B I T S


CHAPTER ONE: EXECUTIVE SUMMARY

Figure 1-1: The Overall U.S. Long Term Care Market 

2006–2016 (Nursing Homes, Hospices, Home Care, Assisted Living)

 

CHAPTER TWO: INTRODUCTION, ISSUES AND TRENDS

Table 2-1: Projected U.S. Resident Population, by Age, Selected
 Years
, 2010 - 2030

Table 2-2: U.S. Expectation of Life at Birth, by Sex and Race, 2007

Table 2-3: U.S. Life Expectancy in Years, 2006–2016

Table 2-4: U.S. Resident Population, by Gender and Age, 2011

Table 2-5: U.S. Resident Population, by Age, Hispanic Origin, and Race,
 Selected Years, 2000 - 2025

Table 2-6: U.S. Resident Population, by Age, Hispanic Origin, and Race,
Selected Years, 2000 - 2025

Table 2-7: Proportion of U.S. Resident Population, by Age, Hispanic Origin,
 and Race, Selected Years, 2000 - 2025

Table 2-8: Characteristics of U.S. Household Population of Persons
 65 and Older, 2011

Table 2-9: Marital Status of U.S. Residents Age 65 and Older, 2011.

Table 2-10: Marital Status of U.S. Residents Age 65 and Older, 2011

Figure 2-1: U.S. Senior Population in Top 10 States, 2011

Table 2-11: U.S. Resident Population, by State and Age, 2011

Table 2-12: Estimated Number of Nursing Home Residents by State, 2011

Table 2-13: Disability Prevalence by Age, 2011

Table 2-14: Frequencies of Selected Diseases Among Older U.S. Persons, 2011

Table 2-15: Frequencies of Selected Diseases Among Older U.S. Persons, 2011

Table 2-16: U.S. Median Income by Householder Age, 2009

Table 2-17: National Health Expenditures, 2007 – 2016*.

Table 2-18: Funding Sources for Home Health Care Spending, 2006 – 2016*.

Table 2-19 :Funding Sources for Nursing Home Spending, 2006 – 2016*.

Table 2-20: Selected State Budget Shortfalls in 2012 and 2013.

CHAPTER THREE: NURSING HOME

Table 3-1: Nursing Home Patients and Charges, by State, 2010

Figure 3-2: Medicaid Nursing Home Payment Freezes and Cuts,
by State, 2010 – 2012

Table 3-3: U.S. Nursing Home Deficiencies by State, 2010

Table 3-4: The U.S. Nursing Home Market, 2006–2016

Table 3-5: Leading Competitors in the U.S. Nursing Home Market, by Revenues
 and Market Shares, 2011

CHAPTER FOUR: HOME CARE

Table 4-1: Medicare Home Care Patients and Visits, by State, 2010

Table 4-2: Sources of Payment for Certified Home Health Care Services, 2011 

Table 4-3: Medicare Fee-for-Service Home Health Outlays, Visits, Clients, Payment/Client, and Visits/Client, Calendar Years 1996-2010

CHAPTER FIVE: HOSPICE

Figure 5-1: Services Offered to Hospice Patients’ Family and Friends

Table 5-1: Number of Medicare-certified Hospices and Program
 Payments, by State, 2010
.

Table 5-2: Mean Length of Hospice Stay, According to Disease Category

Figure 5-2: Drugs Prescribed to U.S. Hospice Patients in the Last Week of Life 

Table 5-3: Average Medicare Reimbursements for Hospice Care, FY 2012

Table 5-4: Medicare Hospice Outlays, Clients, and Days per Client,
 FY1996-FY 2011

Table 5-5: The U.S. Market for Hospice Care, 2006-2016

CHAPTER SIX: ASSISTED LIVING

Table 6-1: The U.S. Market for Assisted Living, 2006-2016

Table 6-2: Leading Competitors in the U.S. Assisted Living Market, by

Revenues and Market Shares, 2011

CHAPTER SEVEN: MARKET SUMMARY

Table 7-1: The Overall U.S. Long Term Care Market, 2006–2016

Table 7-2: Long Term Care Industry Revenues by Sector
Selected Years 2006 - 2016

Figure 7-1: Long Term Care Industry Revenues by Sector, Selected
 Years 2006 - 2016

Figure 7-2: Long Term Care Industry Revenues by Year.

Table 7-3: Long Term Care Industry Revenues by Major Player, 2011


 

Abstract

The advancing age of the population makes long-term care an important consideration for health marketers.  This report, The Long-Term Care Market: Nursing Homes, Home Care, Hospice Care, and Assisted Living covers the most important segments of the long term care industry, each of which provide medical care and/or assistance with the activities of daily living (ADLs) on an ongoing basis: 
  • Nursing care;
  • Home care;
  • Hospice care;
  • Assisted living.
 Kalorama Information publishes its fourth edition of this detailed report on the long term care industry at a time of growth but also increasing concern, particularly about payments, for the long term care industry. The elderly must contribute a far greater amount towards care out of pocket than was once the case.  The economy has challenged the business  strategies of key players, while the recent healthcare legislation introduces changes that may affect revenues. These twin challenges are addressed in The Long-Term Care Market: Nursing Homes, Home Care, Hospice Care, and Assisted Living The report provides an in-depth examination of the market for long-term care today.  

Although a small segment of long term care users are younger individuals with various mental and physical disabilities, most persons using long term care services are senior citizens. This population will also drive industry growth over the forecast period. Therefore, this report will focus on the elderly as the primary customers of long term care services.  For each of the segments of long term care the report provides:
  • Market Size and Forecast
  • Number of Facilities/Providers and Growth Trends
  • Patient Statistics
  • Forms of Payment and Reimbursement Levels
  • Trends Affecting the Marketplace
  • Competitors and Competitive Analysis
Sales estimates for each market segment represent U.S. revenues and are expressed in current dollars. Estimates are provided for the historic 2005 to 2009 period and forecasts are provided through 2015.  As part of the report's analysis of the state of the industry, the report covers the following  issues and trends discussed in the report include:
  • Medicare & Health Care Reform
  • Patient Dumping
  • Quality of Care
  • Federal Quality Improvement Initiatives
  • State Quality Improvement Initiatives
  • Legal Actions
  • Safety
  • Aging of the Population
  • Marital and Living Arrangements
  • Geographic Concentrations
  • Certification and Accreditation
  • Fees and Payment
  • Long Term Care Insurance
  • Cost of Coverage and Affordability
  • Staffing and Human Resources
  • Building of New Facilities
Historical information for this report was gathered from a wide variety of published sources including company reports and filings, government documents, legal filings, trade journals, newspapers and business press, analysts’ reports and other sources. Interviews with company representatives were conducted to capture the perspectives from industry participants’ point of view and assess trends, and form the basis of the forecasting and competitive analysis.

As part of its coverage of the industry, the following long term care companies were profiled in this report:

  • Amedisys
  • Apria Healthcare Group Inc./ Blackstone Group
  • Brookdale Senior Living
  • Emeritus Corporation
  • Extendicare, Inc.
  • Genesis Healthcare
  • Gentiva
  • Golden Living
  • Lincare
  • Lifecare Centers of America
  • Kindred Healthcare
  • Manor Care, Inc.
  • Sun Healthcare Group Inc.
  • Sunrise Senior Living Inc.
Excluded are markets that address temporary care needs such as physical or mental rehabilitation as well as residential living programs and facilities that do not generally provide care such as retirement communities and/or continuing care retirement communities (CCRCs). Also excluded are equipment and supplies used in home care such as wheelchairs, beds, diabetic supplies, etc., as well as medications.

Sales estimates for each market segment represent U.S. revenues and are expressed in current dollars. Estimates are provided for the historic 2006 to 2011 period and forecasts are provided through 2016.  Historical information for this report was gathered from a wide variety of published sources including company reports and filings, government documents, legal filings, trade journals, newspapers and business press, analysts’ reports and other sources. Interviews with company representatives were conducted to capture the perspectives from industry participants’ point of view and assess trends, and form the basis of the forecasting and competitive analysis.



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