Rule Makes It Tough to Meet Rising Demand for Long-Term Services

WASHINGTON — For more than 30 years, states have been finding new ways to care for aged and disabled Medicaid beneficiaries without confining them to nursing homes. The number of people living in skilled nursing facilities has declined significantly over the past decade, despite a marked increase in the number of elderly in the U.S.Starting this year, a new federal rule will require states to ensure that long-term care alternatives to nursing homes — such as assisted living facilities, continuing care retirement communities, group homes and adult day care — work with residents and their families to develop individual care plans specifying the services and setting each resident wants. The overarching goal is to create a “homelike” atmosphere, rather than an institutional one and to give residents choices about their care.