Regulation of the Long-Term Care


There has been a growing long-term care needs in modern America. This paper addresses the issue of long-term care and gives reasons as to why the average American citizen and family should be interested in this topic. It is particulary laying emphasis on regulation of the Long Term Care. The paper also put forth a recommended policy related to the future of this topic.


Long-term care refers to several services and supports that are provided to meet personal care and health for a long period of time (U.S. department of health and human services 2008). It also points out that this long-term care is mostly provided by non skilled persons and includes assisting in bathing, dressing and in eating.

Who need long-term care?

This service is needed by those in long term illness and those who have been disabled and therefore need to be assisted to continue living. In 2008, the website indicated that close to nine million Americans of above 65 years were in need of the LTC. It also projected that the number of those in need of these services would rise to an all new level of 12 million by the year 2020.

As noted by Massie (1993), the LTC case management is an emerging issue for solving problems in Long-term care industry. Governments all over the world have started plans to partially fund this care. Informal care takers are paid by some governments thus showing the seriousness of the case. In the U.S, the government has put in place several programs that are aimed at assisting those requiring the home care service. Among these programs are ‘Medicaid’ and ‘Medicare’.

Medicare (US.) provides hospital insurance to the public and covers impatient care in hospitals, hospice care services, home health care services and inpatient care in religious non medical institution.This is upon payment of Medicare taxes while you are working. This is in addition to being over 65 years of age or older and if you are a resident of the US. The services provided by Medicare also includes skilled nursing facility care where Medicare caters for rooms, meals and rehabilitation ,doctor’s services, health services at home and care outside the hospital.

Other benefits offered by Medicare are the advantage plans such as emergency cover and urgent care. Also covered by this plan are cases such as poor eyesight, hearing problems, dental and other programs. ‘Medicare Prescription drug Coverage’ is also available to those in this arrangement and has two types of arrangement for its members; the Medicare prescription drug plans and the Medicare Advantage plans.

Medicaid is on the other hand a heath care program available to New Yorkers and is also available in other states for those who cannot afford proper medical care. To enjoy the services of Medicaid, one should not necessarily be from New York or from their home state but should either be pregnant or incase of an emergency which should be proved by a doctor (Medicaid, 2010). The list of long-term care in the US is too long to fit in this paper but it is evident that every state in US has put up some arrangement to take care of its needy citizens.

Nursing Homes

Most of health care organizations are either private, owned by religious groups while others are owned by the government. In most states, these services are available to the aging and war veterans where meals, transportation, home repairs, training and community senior centre activities, shopping for those who can’t drive snow shoveling ad adult day care are some of the help that these people receive. Medicaid in the state of Utah provides nursing care at home for the elderly and to low income earners (Utah eldercare planning council 2010), those who are disabled without considering their ages. Waivers are also given for assisted living and are provided locally by certain agencies those receiving Medicaid in most other states are allowed to stay at home instead of living in the homes for the aged or otherwise.

They are allowed to retain some of their possessions such as cars and homes (Utah eldercare planning council, 2010). Skilled care facilities have been in existence in the US for a very long time. These nursing homes provide a humble and serene environment for those in need and have many home care needs (Care pathways, 2010).these special facilities provide round the clock nursing and other support.They incorporate guardianship concern with their nursing expertise. Their homes are varied depending on institution and the hospital. The houses are either constructed alone or are made part of Assisted Living Facilities.

Rooms are good and may either accommodate one or few people. Other names for these facilities are adult homes, rest homes or even homes for the aged (Care pathways, 2010).One pays for his/her own care in most cases but still others may receive funding from their state Medicaid plans. These homes are inspected by the government on regular basis and are required to be licensed by the home state. They are also required to be certified by making sure that they are in terms with certain standards. The inspections are impromptu and are carried out by government’s officials (Carepathways, 2010).

Why should the common citizen be interested?

The United States has one of the highest health care bill in the world with survey showing almost 30% of the population as being uninsured. There is need for the average American citizen to get interested in long-term care as the benefits far much outweigh the disadvantages. There are regulations in the US especially the ‘Community Living Assistance and Support’ act Which was included in the health care reform (Pender, 2010) that requires participants with certain disabilities notwithstanding the age to receive cash which is used to cater for services such as nursing homes and adult care. Such amendments in law affect the daily life of common American citizen.

A year in a rest home may cost up to $70,000 in US today. Reports indicate that by the year 2050, the cost will be so high that a common American citizen will not manage. since giving long-term care depends on our sympathy, other factors such as time, work and other responsibilities also count and thus this makes it even more difficult for family members to help (Marksbury 2010) Arranging for long-term care makes one not rely on others for both financial and physical help as it takes care of your private care assistance within a hospital or at home. Disabled, young and old are assisted in day to day activities (Marksbury, 2010)

The Kaiser Family Foundation (2010), reports that the implementation timeline for the Medicaid long term care services is October 1, 2011.It reads;

Creates the State Balancing Incentive Program in Medicaid to provide enhanced federal matching payments to increase non-institutionally based long-term care services and establishes the Community First Choice Option in Medicaid to provide community-based attendant support services to certain people with disabilities (Kaiser Family Foundation, 2010).

Every citizen should be made to understand such directives as it concerns them. It is hard to know what support one may need at old age or even in the near future and therefore important for one to get involved. Long-term care insures the common citizen in times of distress like long term illness; this is one issue that anyone of us may be faced with at any time. Just as we have insurance for a car or even house, one should be willing to acquire long-term care insurance which come in handy incase of a long term illness or incase of an accident that may leave one disabled. The needy are always left without care and therefore one should take early steps to insure him/herself in preparation for such a time.

Regulation of the Long Term Care services

Since this care is of importance to each and every American citizen either now or in times to come,there is need to change the way this institution is managed and run.Any american adult who is concerned about how he/she will deal with the need for long-term care when it arise,should show a willingness to push for changes in the institution.Reports show that though people continue buying life insuarances rather that buy a long-time care insuarance thus showing the agency of reforms in the institution. Clients of long term care services continue to complain about the services received despite having bought the care so expensively.

These complaints fall on deaf ears since the politicians never addressthe issues. Other policy makers also show reluctance in addressing the issue thus implying that long-term care is not worth modify this institution, the attitude of the people should change. The change should start from nursing homes where all the problems are brewed, people dread going into nursing homes.The place look like prison or a mental hospital ,is unattractive and filthy.

Unless people believe that putting their money in long-term care is worth,they will forever remain reluctant to do so.More homes should be built to address the problem of overcrowding. Care must be improved and professionals involved in restructuring the institution.The long-term care should be made more responsive.The medical and psycho-socia part should be used to analyse delivery of care.It is generally felt that an over haul of the entire institution is necessary if tangible changes are to be felt.


The US government should put measures in place that ensure that every citizen understand what long-term care mean. The citizens should be encouraged to acquire long-term care policies that are affordable; they should be assisted in finding the best long-term care insurance agents, best companies and the best policies for their needs. The government should also set aside a kitty for those who can’t manage the monthly premiums. People should also be educated on the importance of taking care for their needy and the aged. This will help foot down a lot of money that is usually spent on commercialized long-term care. Affordable premiums should also start to suit those who earn little.In addition,the government should take measures to improve service delivery in nursing homes.

Reference List

Carepathways (2010). Long-term Care. Web.

Kaiser Family Foundation, (2010). Kaiser family foundation, implementation timeline. Web.

Massie, C. (1993). Using total quality management in long term care case management, American Journal of Medical Quality June 1993 vol. 8 no. 2 79-86.

Medicaid (2010). Department of health, information for healthy New Yorker. Web.

Pender, K. (2010). Health care reform Q&A, CLASS act, long term care. San Francisco: Chronicle U.S. Department of Health and Human Services. Understanding LTC. Web.

Utah eldercare planning council (2010). Government long term care programs. Web.

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