The SCAN Foundation

There is a high turnover among certified nursing assistants working in nursing homes. This hurts the quality of care for people receiving long-term services and supports that have the people who care for them leave quickly and unexpectedly. The solution may be the appointment of a retention specialist, a person whose job is to stay in close contact with the workers, find out their goals and grievances, and figure ways to keep them on the job, according to an August 2008 study by the Robert Wood Johnson Foundation, “A Facility Specialist Model for Improving Retention of Nursing Home Staff,” published in the Journal Gerontologist.

The Affordable Care Act (ACA) has many provisions relevant to older adults who may someday need long-term services and supports. Most of them are near retirement age or are already enrolled in Medicare, which begins at age 65. The law includes “A temporary reinsurance program [that] will help offset the costs of expensive premiums for employers providing retiree health benefits,” according the Commonwealth Fund, which developed the guide, “What Will Happen Under Health Reform and What’s Next,” and timeline showing when the different parts of the legislation begin operating.

Caregiving is a tricky business. Family members and friends who lend a hand in providing long-term services and supports enter a stress-filled world, where their own health may become at risk because of the burden of being a caregiver. The federal government is providing new resources for those already enrolled as caregivers, and others who may assume the role, according to a May 26, 2010 announcement by the federal government. These new resources include videos for researchers and policymakers that provide insight into the demands on caregivers as they deliver long-term services and supports.

Medicaid in many states will pay for the cost of assisted living facilities, which provide a welcome alternative for people who need long-term services and supports, and want to avoid going into a nursing home. Assisted living residences typically have meals provided, a nurse on duty, help with taking medications, and assistance with activities such as bathing. Medicaid reimbursement for assisted living “can be a tremendous benefit, but the design and implementation of these programs has too often led to discrimination against Medicaid-eligible residents, eviction, and other types of poor care,” according to the January 2010 report “Medicaid Payment for Assisted Living: Current State Practices and Recommendations for Improvement,” by the National Senior Citizens Law Center.