PROFILES OF LONG-TERM CARE AND INDEPENDENT LIVING NEW JERSEY. by Ari Houser Wendy Fox-Grage Mary Jo Gibson 2006 AARP
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1 ACROSS THE STATES PROFILES OF LONG-TERM RE A INPENNT LIVING W JERSEY by Ari Houser Wendy Fox-Grage Mary Jo Gibson 200 AP 200
2 Introduction This short state-specific report has been created from the full book, Across the States 200: Profiles of Long-Term Care and Independent Living, to facilitate access to and distribution of a single state s information on key long-term care issues. To put this information in a broader context, readers also will want to refer to the Overview section of the full book, which highlights national trends and differences between states, and features key indicators for some of the most important current policy debates. Across the States 200 is a compilation of data on many facets of long-term care and independent living in each state and the District of Columbia. Published biennially since 12 by the AP Public Policy Institute, the Across the States series was developed to help inform policy discussions among public and private sector leaders in long-term care throughout the United States. This 7 th edition of Across the States presents the most up-to-date data available at the time of production. The information is displayed in easy-to-use maps, tables, and graphics. The state-specific reports excerpt the six-page profile of each state from the heart of the full book. This profile provides state- and national-level data and state rankings for 0 indicators in six topic areas. The topic areas are Demographics, Livable Communities & Need for Long-Term Care, Home & Community-Based Services (HCBS), Nursing Facilities, Long-Term Care Financing, and Trends. In addition, the Long-Term Care and Independent Living Maps section, which shows regional patterns for fourteen indicators, is included in this report. Each state s ranking relative to other states for all indicators is included in each state report. In addition, the State Data and Rankings section in this edition of Across the States contains ranking tables for select indicators, and readers may download the complete set of ranking tables from the AP website (the address is at the bottom of this page). For each indicator, the highest data value is given a rank of 1. It is important to recognize that ranking highest does not necessarily imply doing the best (e.g. the highest poverty rate). Some of the indicators in Across the States 200 may be found in prior editions. Please exercise caution when making comparisons with information in earlier editions because of possible changes in the source or definition of a particular indicator. While a list of sources is included in this statespecific report, readers should refer to the Data Documentation section of the full book for complete information specific to each indicator. This section identifies the sources of data, provides a detailed explanation for each indicator, presents any caveats or limitations that apply to the data, and describes how the source or indicator definition may differ from previous years. Questions about the state-specific version of Across the States 200, the full book, or the state data and rankings supplement can be addressed to the AP Public Policy Institute, Independent Living/Long- Term Care Team, at Please visit for electronic versions of these publications.
3 New Jersey Population & Projections Age Groups Year State Rank U.S. Total population (thousands) ,718, ,4 335, Age 50-4 (% of all ages) Age 5+ (% of all ages) Age 5-74 (% of all ages) Age (% of all ages) Age 85+ (% of all ages) Race & Ethnicity State Rank U.S. Minority age 5+ (%), Asian age 5+ (%), Black age 5+ (%), Hispanic age 5+ (%), Population Characteristics Men per 0 women age 85+, 2005 Persons age 75+ living alone (%), 2005 Non-metropolitan population age 5+ (%), 200 Bachelor level education or higher age 5+ (%), 2005 Grandparents age 0+ raising grandchildren (%), 2005 Caregivers (% of all adults age 18+), Note: The highest data value within each ranking is indicated by a rank of 1 The percent change calculations on this page are based on the total population in each age group. For example, the U.S. population age 5+ was 3,70,3 in 2005 (12.4% of the total population) and was projected to be 54,31,81 in 2020 (1.3% of the total population). These numbers represent a 48% increase in the age group population between 2005 and
4 New Jersey 2 Livable Communities & Need for Long-Term Care Housing & Transportation Homeownership rate age 5+ (%), 2005 Homeowners age 5+ paying 30% of income or more for housing (%), 2005 Renters age 5+ paying 30% of income or more for housing (%), 2005 Persons age 5+ in housing built before 10 (%), 2005 Persons age 5+ without a vehicle in household (%), Income & Poverty Median household income age 5+, 2005 At/below poverty level age 5+ (%), 2005 At/below 200% of poverty level age 5+ (%), 2005 At/below 300% of poverty level age 5+ (%), 2005 Women age 75+ at/below poverty level (%), 2005 $32, $28, Disability Rates Persons age 5+ with disabilities (%), 2005 Sensory disability Physical disability Mobility disability Self-care disability Cognitive/mental disability Any disability (one or more of the five listed above) Cognitive/mental disability + any other disability Persons age 50-4 with disabilities (%), 2005 Any disability Cognitive/mental disability + any other disability (one or more of the other four listed above) Projected change in disability rate age 5+ due to economic and demographic factors (%), Persons with Alzheimer s disease, 2 Projected increase in the number of persons with Alzheimer s disease (%), , ,700, +38 4
5 Home & Community-Based Services (HCBS) New Jersey 3 Use of HCBS Medicare beneficiaries receiving home health services (%), 2005 Medicare home health visits per user, 2005 Medicaid HCBS participants, 2002 Medicaid HCBS participants per 1, population, 2002 Home health Personal care* HCBS waiver services Aged/disabled waiver services Medicaid aged/disabled waiver participants per 0 beneficiaries in nursing facilities, 2002 Persons in group residential care settings covered by Medicaid and state-funded public financing, , , ,37, ,421 Medicaid HCBS Participants per 1, Population, 2002 New Jersey United States Home Health Personal Care HCBS Waiver Services HCBS Resources Medicare-certified home health agencies per 0, age 5+, 2005 Adult day facilities per 0, age 5+, Assisted living and residential care facilities, 2004 Assisted living and residential care beds, 2004 Assisted living and residential care beds per 1, age 5+, 2004 Personal and home care aides per 1, age 5+, 2005 Median hourly wage, 2005 Home health aides per 1, age 5+, 2005 Median hourly wage, 2005 HCBS aged/disabled waiver waiting list, ,084 8 $ $ ,451 37,01 2 $ $.04 12,735 Note: The highest data value within each ranking is indicated by a rank of 1 *Only 30 states offered the optional personal care benefit in The lowest rank for this indicator is 30. 5
6 New Jersey 4 Nursing Facilities Medicaid Spending on Long-Term Care Services, by Type of Service, 2005 New Jersey United States HCBS 8% $ Million Nursing Facilities 54% $1.7 Billion HCBS 37% $35 Billion Nursing Facilities 50% $47 Billion ICF-MR 18% $5 Million Nursing Facility Resident Characteristics Total nursing facility residents, 2005 Total nursing facility stays, 2004 Nursing facility residents per 0 age 5+, 2005 Residents with Medicaid as primary payer (%), 2005 Residents with Medicare as primary payer (%), 2005 Residents with other as primary payer (%), 2005 Residents with dementia (%), 2005 Residents with other psychological diagnoses (%), 2005 Nursing Facility Resources Total nursing facilities, 2005 Nursing facility beds per 1, age 5+, 2005 Nursing facility occupancy rate (%), 2005 ICF-MR 13% $1 Billion 45,5 7, ,40,185 3,084, , Quality & Oversight of Nursing Facilities Direct care nursing hours per patient day, 2005 RN hours LPN hours/lvn hours CNA hours Nursing facilities with deficiency for actual harm or jeopardy of residents (%), 2005 Residents with physical restraints (%), 2005 Formal complaints filed with state per nursing facility, 2005 Long-term care facility beds per FTE ombudsman, 2004 Nursing facilities visited by ombudsman at least quarterly (%), , ,388 80
7 New Jersey 5 Long-Term Care Financing Medicaid & State Expenditures Total Medicaid expenditures (millions), 2005 Medicaid long-term care expenditures (% of total Medicaid expenditures), 2005 Medicaid long-term care expenditures per person in the state, 2005 Nursing facilities Intermediate care facilities-mental retardation (ICF-MR) Home and community-based services (HCBS) Home health Personal care* HCBS waiver services Aged/disabled waiver services Medicaid HCBS expenditures (% of Medicaid long-term care), 2005 Medicaid HCBS expenditures for age 5+ (% of Medicaid long-term care for age 5+), 2002 Medicaid nursing facility expenditures per person served, 2003 Medicaid HCBS expenditures per person served, 2002 Home health Personal care* HCBS waiver services Aged/disabled waiver services Federal Medicaid Assistance Percentage (%), 2005 Medicaid personal needs allowance for nursing facility residents (per month), 200** State-funded HCBS for older people (millions), FY2002 $8,40 38 $38 $18 $5 $4 $4 $37 $4 $ $27,72 $1,030 $3,503 $,128 $27,223 $, $35.00 $ $300, $31 $ $41 $ $12 $2 $77 $ $23,882 $,531 $3,5 $7,85 $18,35 $7, $47.53 $1,412 Public & Private Payment Rates Medicaid payment rate per day for nursing facility care, 2002 Medicare payment rate per day for nursing facility care, 2004 Private pay rate per day in nursing facility (urban avg.), 2005 Private pay rate per day in assisted living facility (urban avg.), 2005 Medicare reimbursement per home health visit (avg.), 2005 Private pay hourly rate for home health aide (urban avg.), 2005 $2 $308 $235 $131 $170 $ $8 $270 $17 $ $2 $1 Note: The highest data value within each ranking is indicated by a rank of 1 * Only 3 states offered the optional personal care benefit in 2005, and 30 states in The lowest ranks are 3 and 30. **8 states used only the minimum personal needs allowance of $30 per month. The lowest rank for this indicator is 44. 7
8 New Jersey Trends Livable Communities & Need for Long-Term Care Year Persons age 5+ at/below poverty level (%) 1 Persons age 5+ with any disability (%) Home & Community-Based Services Year Medicaid HCBS participants Medicaid aged/disabled waiver participants Medicare home health visits per user Nursing Facilities Year Nursing facility residents Nursing facility beds Nursing facility occupancy rate (%) Long-Term Care Financing Year Total Medicaid spending (millions) Medicaid long-term care spending (millions) Medicaid nursing facility spending (millions) Medicaid HCBS spending (millions) Medicaid aged/disabled waiver spending (millions) ,1 40,884-5,132 8, ,840 45,5 + 47,02 51,75 + $,0 $8,40 +3 $2,51 $3, $1,4 $1, $42 $ +85 $57 $ ,882,40 2,37, ,744 52, ,43,571 1,40, ,71,25 1,7, $14,347 $300, $8,58 $4, $3,583 $47, $1,030 $35, +85 $2, $5,
9 Percent of Population Age 85+, 2005 Maps 1.5% 1.-1.% 2.0%+ Nursing Facility Occupancy Rate, % 85-8% 0%+
10 Maps 2 Percent of Nursing Facilities that are For-Profit, % 50-% 70%+ Percent of Nursing Facilities with Deficiency for Actual Harm or Jeopardy of Residents, 2005 % -24% 25%+
11 Maps 3 States with Single Entry Point for Long-Term and Supportive Services for Older Adults and Adults with Disabilities, 2003 None Older Adults Only Older Adults and Adults with Disabilities States that Offer Medicaid Personal Care Benefit for Adults, 2004 Not Offered Offered
12 Maps 4 States Adopting Most Recent NAIC Model Long-Term Care Insurance Regulations, 200 Not Adopted Adopted States Requiring Private Rooms in Assisted Living, 2004 NA None Some types of facilities All assisted living and residential care 12
13 Maps 5 Medicaid Home & Community-Based Services Spending (% of Total Medicaid Long-Term Care), % 35-4% 50%+ Medicaid Long-Term Care Spending (% of Total Medicaid), 2005 NA 2% 30-34% 35%+ 13
14 Maps Federal Medicaid Assistance Percentage (FP), % % %+ HCBS Aged/Disabled Waiver Waiting List, 2004 NA None Less than,, or more
15 Maps 7 Family Caregiver Support Programs Include Uniform Assessment Tool, 2003 None Some programs All programs Family Caregiver Support Programs Include Training for Staff Who Work with Caregivers, 2003 None Some programs All programs
16 Data in this report are drawn from AP Public Policy Institute calculations and the following additional sources. Care should be taken when making comparisons to indicators from other publications or earlier editions of Across the States, as data sources, definitions, and methodology may differ. Many of the following sources are available online. Weblinks and detailed documentation for each indicator are included in the Data Documentation section of the full book, available at Administration on Aging, 2004 National Ombudsman Report. Alzheimer s Association, Growth of Alzheimer s disease through 2025, Brian Burwell, Kate Sredl, and Steve Eiken, Medicaid Long Term Care Expenditures FY 2005, Medstat, 200. Bureau of Labor Statistics, Occupational Employment Statistics, May 2005 Estimates. Helen Carrillo and Charlene Harrington, Analysis of On-Line Survey Certification and Reporting System (O) unpublished data from the Centers for Medicare and Medicaid Services, University of California, San Francisco, August 200. Census Bureau, Current Population Survey, 200. Census Bureau, American Community Survey, Census Bureau, 2 Decennial Census. Data Sources Census Bureau, Population Division, Interim State Projections of Population by Single Year of Age and Sex: July 1, 2004 to 2030 Census Bureau, Population Division, State by Age, Sex, Race, and Hispanic Origin Census Bureau, Population Division, State Single Year of Age and Sex Population Estimates: April 1, 2 to July 1, 2005 RESINT Centers for Medicare and Medicaid Services, Medicare Enrollment - All Beneficiaries: as of July 2005 Centers for Medicare and Medicaid Services, Medicare Home Health Utilization by State Calendar Year 2005 Centers for Medicare and Medicaid Services, Office of Information Systems, Health Care Information System, untitled table on skilled nursing facilities in 2004, July 2005 (unpublished data). Centers for Medicare and Medicaid Services, Office of Survey and Certification and Reporting, Report No. Facility Counts, Active Providers, July 2005 (unpublished data). Centers for Medicare and Medicaid Services, Nursing Home Data Compendium: 2005 Edition Centers for Medicare and Medicaid Services, Medicare & Medicaid Statistical Supplement Centers for Medicare and Medicaid Services, Medicare & Medicaid Statistical Supplement Centers for Medicare and Medicaid Services, Medicare & Medicaid Statistical Supplement
17 Nancy J. Cox, National Study of Adult Day Services , Partners in Caregiving: The Adult Day Services Program, Wake Forest University School of Medicine, Winston-Salem,. Federal Register, December 3, 2003, Notices, volume 8, number 232, pp Lynn Friss Feinberg, Sandra L. Newman, Leslie Gray, and Karen N. Kolb, The State of the States in Family Caregiver Support: A 50-State Study, National Center on Caregiving at Family Caregiving Alliance, David C. Grabowski, Zhanlian Feng, Orna Intrator, and Vincent Mor, Project HOPE, Recent Trends in State Nursing Home Policies, Health Affairs, Web Exclusive, Charlene Harrington, Helen Carrillo, and Courtney LaCava, Nursing Facilities, Staffing, Residents and Facility Deficiencies, 1 Through 2005, University of California, San Francisco, 200. The Lewin Group, HCBS Population Tool. Data Sources 2 The Henry J. Kaiser Family Foundation, 2002 State and National Medicaid Enrollment and Spending Data (MSIS), March 200. Martin Kitchener, Terrence Ng, and Charlene Harrington, Medicaid 1(c) Home and Community- Based: Program Data , University of California, San Francisco, 200. Sarah L. McKune, Elena M. Andresen, Jianyi Zhang, and Britta Neugaard, Caregiving: A National Profile and Assessment of Caregiver Services and Needs, Rosalynn Carter Institute. Metlife Mature Market Institute, 2005 MetLife Market Survey of Assisted Living Costs Metlife Mature Market Institute, 2005 MetLife Market Survey of Nursing Homes and Home Care Costs Robert Mollica and Heather Johnson-Lamarche, State Residential Care and Assisted Living Policy: 2004, National Academy for State Health Policy, Robert Mollica and Jennifer Gillespie, Single Entry Point Systems: State Survey Results, National Academy for State Health Policy, National Association of Insurance Commissioners, Long-Term Care Insurance Model Regulation, 200. National Long-Term Care Ombudsman Resource Center, National Citizens Coalition for Nursing Home Reform, update of data from Sandra Hughes, Gail MacInnes, and Tina Geraghty, Personal Needs Allowances For Long Term Care Residents, Laura Summer and Emily S. Ihara, The Medicaid Personal Care Services Benefit: Practices in States that Offer the Optional State Plan Benefit, AP Public Policy Issue Paper, May Laura Summer and Emily S. Ihara, State-Funded Home and Community-Based Service Programs for Older Persons, AP Public Policy Issue Paper, November
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