across the states 2002 - aarp · states with regulations mandating cna training above 75 hours ......

New Hampshire

Across the States 2002Profiles of Long-Term Care

by Steven R. Gregoryand Mary Jo Gibson

PUBLIC POLICY INSTITUTE

AARP

© 2002

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Table of Contents

Acknowledgements

INTRODUCTION .......................................................................................................................iv

HOW TO USE ACROSS THE STATES 2002 ..................................................................................vi

HIGHLIGHTS ..........................................................................................................................vii

STATE LONG-TERM CARE PROFILES.........................................................................................1

DemographicsNeed for Long-Term CareHome and Community-Based ServicesHome and Community-Based ResourcesNursing Facility ServicesNursing Facility ResourcesLong-Term Care Expenditures and Financing

LONG-TERM CARE MAPS ........................................................................................................7

States with Regulations that Include Assisted Living PhilosophyStates Requiring Private Rooms in Assisted LivingStates Requiring Disclosure on Special Care UnitsProportion of For-Profit Nursing FacilitiesStates with Legislation Addressing Nursing Facility Staffing ShortagesStates with Regulations Mandating CNA Training Above 75 HoursProportion of Deaths Occurring at HomeStates Offering Tax Incentives for Long-Term Care Insurance

STATE DATA & RANKINGS .....................................................................................................13

DATA DOCUMENTATION .........................................................................................................49

STATE OFFICES ......................................................................................................................63

We extend our appreciation to the many individuals who contributed to this project by sharing state-level data available through their organizations. In particular, we thank Brian Burwell at TheMEDSTAT Group; C. McKeen Cowles at Cowles Research Group; Charlene Harrington at theUniversity of California, San Francisco; Robert Mollica at the National Academy for State HealthPolicy; and Joan Teno at Brown University.

We also thank all our colleagues on the AARP Public Policy Institute’s Independent Living/Long-Term Care Team, each of whom contributed to this publication. We also appreciate the contributionsof staff members in State Affairs. Special thanks go to Arnell Carr and Kari Stone for their assis-tance with the data and to Barbara Coleman for reviewing the draft.

The information compiled in this document is presented for purposes of information, discussion,and debate and does not necessarily represent formal policies of AARP.

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IntroductionAcross the States: Profiles of Long-Term Care is a compilation of data on many dimensions of long-term care in each state and the District of Columbia. Published biennially since 1992 by the AARPPublic Policy Institute, the Across the States series was developed to help inform policy discussionsamong public and private sector leaders in long-term care throughout the United States. It presentsa snapshot of each state’s long-term care landscape by providing comparable state-level and nationaldata for over 70 indicators which are otherwise difficult to obtain from a single source. This 5th

edition of Across the States presents the most up-to-date data available at the time of production.

This year’s edition of Across the States has been revised in three important ways:

(1) The most significant change is that readers can now find each state’s ranking relative toother states for all indicators in one place—in the profile for each state. This change will permitreaders to quickly assess each state’s rankings relative to those in other states across a wide range ofindicators. However, readers are cautioned that the highest ranking is not necessarily an indicatorof “doing the best”; for example, having the highest percent of persons age 65 and older withincomes at or below the poverty level indicates that the state scores worse on this measure than allthe other states. In addition, some indicators are not well suited to ranking. Readers should referregularly to the Data Documentation section for reference sources, explanations of indicators, andthe limitations of specific data.

(2) In addition, many new measures have been added to this year’s edition.

• The Demographics section includes new measures of education and income status, and the shares of the population age 65 and older of minority/ethnic background or living in rural areas.

• The section on Need for Long-Term Care includes changes in the proportion of persons age85 and older; the number of men per 100 women age 85 and older; and the share of womenage 85 and older living in poverty. It also presents detailed data on disabilities among persons65 and older from the Census Bureau, including data on limitations in self-care and mobility,and on sensory and cognitive/mental limitations.

• A new subsection on Community Characteristics includes measures of homeownership ratesamong persons 65 and older, aged housing stock (over 40 years old), and the shares of olderpersons with driver’s licenses and without vehicles.

• The former section on Providers under Home and Community-Based Services has beenrenamed Home and Community-Based Resources Available and new measures have beenadded on the number of personal and home care aides per 1,000 persons age 65 and older, aswell as their median hourly wages.

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Introduction• In the Nursing Facility Services section, new measures have been added on the share of resi-

dents with physical restraints and with pressure (bed) sores.

• The former section on Public Expenditures for Long-Term Care Services has been renamedLong-Term Care Expenditures and Financing. New measures include per capita Medicaidspending (per person in the state) on long-term care, broken out by spending on: (1) nursingfacilities; (2) ICF/MR facilities; (3) home health; (4) 1915(c) HCBS waivers; and (5)personal care. We also include measures of private pay rates in nursing facilities, and of ratespaid by clients to home care agencies for care by licensed practical nurses and home healthaides.

(3) A new section entitled Long-Term Care Maps illustrates the regional variation in long-term care policies and the diversity in state approaches. Maps include those addressing statepolicies on assisted living, on nursing facility staffing, and on tax incentives for private long-termcare insurance.

Although the Across the States series has a longstanding history, caution must be used when makingcomparisons with information in previous editions because of changes that may have been made inthe source or definition of a particular indicator.

For additional copies of Across the States 2002, please call the AARP Public Policy Institute’sIndependent Living/Long-Term Care Team at 202-434-3860.

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How to Use Across the States 2002Across the States consists of four sections—State Long-Term Care Profiles, Long-Term Care Maps,State Data and Rankings, and Data Documentation. Listed below are tips on using this year’s edition.

To find data on a particular state, consult the State Long-Term Care Profiles, organized alpha-betically by state. This section provides state- and national-level data on seventy-two indicators inseven topic areas. The topic areas are Demographics, Need for Long-Term Care, Home &Community-Based Services, Home & Community-Based Resources, Nursing Facility Services,Nursing Facility Resources, and Long-Term Care Financing.

To find data on a particular long-term care indicator, go to the State Data and Rankings section.It organizes the state data from the State Long-Term Care Profiles section by indicator. For eachindicator, readers can quickly see the variation among states.

To compare how states are performing on particular measures, go to the State Data andRankings section, which also ranks the state data from highest to lowest. Readers can see where astate falls relative to others, and they can compare how states rank across several measures. It isimportant to recognize that ranking highest does not necessarily imply “doing the best” (e.g., thehighest poverty rate). In addition, some indicators are not well-suited to being ranked.

For information on state long-term care policies, visit the new section entitled Long-Term CareMaps. It showcases regional perspectives on long-term care policies and practices.

To determine the original data source, refer to the Data Documentation section in the back of thebook. Readers should use this section regularly. It identifies the sources of data, provides a detailedexplanation for each indicator, and describes any caveats or limitations that apply to the data.

The location of each AARP State Office, including address, telephone number and fax number, isprovided at the back of the book.

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DEMOGRAPHICS

Distribution of Population by Age

• Growth in the older population will accelerate over the next several decades due to theaging of “boomers” born between 1946 and 1964. Between 2000 and 2020, the share ofpersons age 50 and older in the U.S. population is projected to rise from 27.3 percent to 35percent, and the share of persons age 65 and older from 12.4 percent to 16.3 percent.

• By 2020, in six states, Iowa, West Virginia, Wisconsin, Oregon, Maine, and Wyoming,persons age 50 and older are projected to be about 40 percent of the state population. Iowa,Oregon, and West Virginia will also have the highest proportions of persons age 65 andolder, about 20 percent of their populations.

• Different subgroups of the older population are projected to grow at different rates:

° The share of persons age 50-64 in the U.S. will rise from 14.9 percent in 2000 to 18.7percent in 2020. The states with the highest proportions of persons 50-64 in 2020 will beConnecticut, Massachusetts, Iowa, Wisconsin, and West Virginia, all with shares of 21percent.

° The share of persons age 65-74 will rise from 6.5 percent in 2000 to 9.7 percent in 2020.The states with highest shares of persons in this age group by 2020 will be Wyoming,Oregon, Iowa, West Virginia, and Hawaii, all with shares of 11.5 percent or higher.

° The share of persons age 75-84 will rise from 4.4 percent in 2000 to 4.7 percent in 2020.By 2020, states with the highest shares of persons in this age group will be Florida, Iowa,Oregon, Hawaii, and Wyoming.

° The share of persons age 85 and older, the age group most likely to need long-term care,will rise from 1.5 percent to 1.9 percent. The states with the highest shares of persons85 and older by 2020 will be Iowa, North Dakota, South Dakota, Hawaii, Nebraska, andFlorida.

Select Population Characteristics

• The states with the highest proportion of persons age 65 and older who were minority inrace or ethnicity in 2000 were Hawaii (78.1%) and the District of Columbia (74%),followed by New Mexico (35%) and California (30%). Nevada experienced the greatestrate of increase (182%) in its minority/ethnic population age 65 and older between 1990and 2000.

• The proportion of persons age 65 and older living in rural areas in 2000 varied from over50 percent in five states (Vermont, Maine, North and South Dakota, and Mississippi) tounder 10 percent in seven states and the District of Columbia.

• In the District of Columbia, New Hampshire, and Washington, over 20 percent of those age65 and older had a bachelor degree or higher in 2000, while three states, Kentucky, WestVirginia, and North Dakota, ranked last, with under ten percent.

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HighlightsMedian family income of persons age 65 and older was highest, above $50,000 annually in 2000, inthe District of Columbia and Hawaii, and lowest, under $30,000, in Kentucky and West Virginia.Over 15 percent of persons age 65 and older had incomes at or below the poverty level in 1999 inten states, led by Arkansas (18.5%) and Mississippi (17.4%). Those states with the lowest rates ofpoverty among persons age 65 and older were Alaska, Connecticut, Colorado, and Hawaii (all under8%). Across all states, an additional 23.7 percent of persons age 65 and older had incomes between101 percent and 200 percent of poverty.

NEED FOR LONG-TERM CARE

Need for Long-Term Care Services

• Indicators of the need for long-term care services can include the share of: (1) persons age65 and older with limitations in self-care or mobility; (2) persons age 65 and older livingalone; and (3) women age 85 and older with incomes below the poverty level. Five states—South Dakota, Rhode Island, Tennessee, West Virginia, and Missouri—ranked among theten highest in two of these three indicators. Four states—Massachusetts, Delaware, Idaho,and New Hampshire—scored among the ten lowest.

HOME AND COMMUNITY-BASED SERVICES

Selected Community Characteristics

• Homeownership was high among older persons in 2000, with nearly four-fifths (79.4%) ofthose age 65 and older owning their homes. However, whether they own or rent, olderpersons often live in older homes; 45.3 percent of persons age 65 and older lived in homesthat were at least 40 years old, and these homes often have high costs for maintenance,repair, and utilities. In thirty states, homeownership was 80 percent or higher, with Utah,Idaho, Wyoming, and West Virginia having the highest rates. Only three states, RhodeIsland, New York, and the District of Columbia, had homeownership rates below 70 percent.Those same three states with the lowest ownership rates had the highest percent of personsage 65 and older living in housing over 40 years old. In 20 states, at least half of the olderpopulation lived in housing over 40 years old, while less than 20 percent did so in fourstates, Florida, Arizona, Alaska, and Nevada.

• Over two-thirds (68.3%) of persons age 75 and older had a driver’s license in 2000 in theU.S. as a whole; in five states, West Virginia, Colorado, Wyoming, Florida, and Tennessee,at least 80 percent of residents age 75 and older did so. (Two additional states, Vermont andAlabama, appear to be outliers, reporting 99.4 % and 91.9%, respectively; see data docu-mentation for caveats.) In the District of Columbia and Hawaii, less than 50 percent of resi-dents age 75 and older had licenses. Across the U.S., 14.6 percent of persons age 70 andolder lived in households without a vehicle in 2000. The District of Columbia and NewYork had the highest percent of persons age 70 and older living in households with novehicle, and Alaska had the lowest.

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Use of Home and Community-Based Services

• Among Medicaid beneficiaries age 65 and older, 5.6 percent received home health servicesin 1999, with the proportions varying widely among the states. Minnesota and New Yorkhad the highest percent (30.5% and 21.9%, respectively), while in ten states one percent orless received these services, with Texas and Oregon reporting the lowest rate (0.1%).

• About 6.5 percent of Medicare beneficiaries received home health services in 2000, withVermont reporting the highest share (11.3%), followed by Mississippi and Maine (9-10%).In twelve states, less than five percent of Medicare beneficiaries received home healthservices, with Hawaii, Arizona, and Minnesota having the lowest shares. States with highshares of Medicare beneficiaries receiving home health services also often had an above-average number of home health visits per user, including Mississippi, Louisiana,Massachusetts, Tennessee, and Connecticut. Similarly, some states with low shares ofbeneficiaries receiving home health services also had a low average number of visits peruser, including Washington, Hawaii, Arizona, Minnesota, and Oregon.

• Between 1992 and 1999, the percent of Medicaid beneficiaries enrolled in aged/disabledwaiver programs in the U.S. nearly doubled, from 0.6 percent to 1.1 percent. Oregon hadthe highest share in both 1992 and 1999. Enrollment increased in every state with a waiverprogram. (Arizona does not have a waiver, although it does have a similar program.) In tenstates, enrollment increases in the waiver programs did not keep up with the increases inMedicaid beneficiaries.

HOME AND COMMUNITY-BASED RESOURCES

Home and Community-Based Resources Available

• Wyoming led other states in 2000 in the number of Medicare-certified home healthagencies per 1,000 persons age 65 and older, followed by Louisiana, Texas, Arkansas, andAlaska. New York, Maryland, and New Jersey had the fewest Medicare-certified homehealth agencies per 1,000 persons age 65 and older.

• Nearly half the states did not license their adult day facilities in 1998. Among those thatdid, states with high numbers or high proportions of older persons had the most licensedfacilities, including Pennsylvania with 627 facilities, California with 619, and New Yorkwith 484.

• The generic term residential care beds is used for all of the beds in homes that states licenseto provide housing with services to older persons; these include assisted living, board andcare, and homes with other names, such as homes for the aged. Across the U.S., there wasan average of 25.5 beds per 1,000 persons age 65 and older in 1998. Several western stateshad the highest number of such beds, with Oregon having over 50 beds per 1,000 personsage 65 and older, followed by Washington, California, and Montana. Three states, Illinois,Indiana, and Louisiana, had five or fewer residential care beds per 1,000 persons age 65 andolder.

• The availability of personal and home care aides and of home health aides (HHAs) variedwidely across the states in 2000. The number of personal and home care aides ranged from31 per 1,000 persons age 65 and older in Texas to five or fewer in 14 states, with Hawaii

Highlights

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and Nevada having the fewest. Across the U.S., the average was 11 per 1,000 persons age65 and older. The availability of HHAs was higher, with 16 per 1,000 persons age 65 andolder across the U.S., but their availability also varied widely across the states. New Yorkhad 44 home health aides per 1,000 persons age 65 and older, followed by Minnesota andTexas with 30 each. Fourteen states had fewer than 10 home health aides per 1,000 personsage 65 and older, with Mississippi and Nevada having the fewest.

• On average in the U.S., personal and home care aides were paid $7.81 an hour, and HHAswere paid $8.13 in 2000. Median personal and home care aide wages ranged from a highof $10.93 in Alaska to below $7 in twelve states, with Louisiana and Texas reporting thelowest wages. For HHAs, median wages ranged from $11.45 in Connecticut to below $7.00in Arkansas, Texas, and West Virginia.

NURSING FACILITY SERVICES

Use of Nursing Facility Services

• The number of persons of any age residing in a nursing facility in 2001 was nearly 1.5million (1,469,001). Nationally, the total number of nursing facility residents of any agedeclined, and was 0.7 percent lower in 2001 than in 1996. There was an increase in nineteenstates, with the District of Columbia seeing an 18 percent increase and four other statesseeing increases of over ten percent (Nevada, New York, Florida, and Hawaii). There wasa decline in thirty-two states, with seven states, Arkansas, Wisconsin, Oklahoma,Washington, Maine, Kansas, and Oregon, showing a decline of ten percent or greater.

• The percent of persons age 65 and older who resided in nursing facilities averaged 4.2percent in the U.S. as a whole in 2001. In five states, Iowa, North Dakota, Minnesota,Nebraska, and South Dakota, nursing facility residents represented 6.5 percent of the age65 and older population in 2001. In 17 states, nursing home residents were less than fourpercent of the population age 65 and older, with six states, Florida, Oregon, Hawaii,Arizona, Nevada, and Alaska below three percent.

• Across the U.S., nursing facilities reported an average of 8 percent of residents in physicalrestraints in July 2002, and an average of 8 percent of residents with one or more pressure(bed) sores. The three states reporting the lowest percent of residents in physical restraints,Nebraska, Iowa, and Montana, also reported the lowest percent with pressure sores. Threeother states, North Dakota, Wisconsin, and New Hampshire, scored within the ten loweststates on both indicators. States with the highest percent of nursing facility residents inrestraints were Arkansas (23%), and Texas, California, and Louisiana (each at 18%). TheDistrict of Columbia and New Jersey had the highest percent of nursing facility residentswith pressure sores (13%), with Pennsylvania next (12%).

Nursing Facility Residents by Primary Payer Source

• Medicaid was the primary source of payment for nursing facility care for 67 percent ofnursing facility residents in the U.S. in 2001. Medicare, the other source of public funding,was the primary source for 9.6 percent. Other sources, including out-of-pocket paymentsand private insurance, were the primary payment sources for the remaining 23.5 percent ofnursing facility residents. In Alaska, the District of Columbia, and Mississippi, over 80percent of nursing facility residents relied mainly on Medicaid. In contrast, in nine states,

Highlights

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HighlightsMedicaid was the primary payer for less than 60 percent of residents; that proportion waslowest (49.6%) in Iowa. Reliance on Medicare was highest in Florida and Utah, and lowestin Kansas, North Dakota, and Iowa. In states where Medicaid and Medicare covered alower share of residents, other sources paid higher shares. In Iowa, Nebraska, and Kansas,these other sources were the primary payers for over 40 percent of residents of nursingfacilities; other sources were the primary payers for the lowest proportion of residents inthe District of Columbia, Mississippi, and Alaska.

NURSING FACILITY RESOURCES

Nursing Facility Resources Available

• Across the U.S., 54 nursing facility beds were available per 1,000 persons age 65 and olderin 2001. In Iowa, Missouri, Minnesota, Illinois, Nebraska, and North Dakota, over 80 bedswere available per 1,000 persons age 65 and older, while in nine states, fewer than 40 bedswere available, with Hawaii, Alaska, and Nevada having the fewest. The number of nursingfacility beds available in the U.S. has decreased slightly (0.1%) between 1996 and 2001.Arkansas led the decrease with 21.1 percent fewer beds; beds in Kansas, Ohio, Maine, andIowa each declined over 10 percent. In over half the states, there was an increase in thenumber of nursing facility beds available; Nevada had the greatest increase, 26.6 percent,and there were increases of over 10 percent in New York, Florida, the District of Columbia,and New Jersey.

• Across the U.S., the occupancy rate for nursing facilities was 82.5 percent in 2001, rangingfrom 93.9 percent in New York to 69.1 percent in Oklahoma. The occupancy rate declinedslightly, 0.7 percent, from 1996 to 2001. It decreased in thirty-seven states, with the largestdecrease in Oregon, Montana, and Utah. During the same time, fourteen states experiencedincreases in occupancy rates; Iowa had the largest increase, followed by Arkansas and Ohio.

LONG-TERM CARE FINANCING

Medicaid Expenditures and Financing

• In 2001, total U.S. spending on Medicaid was over $214 billion. This spending ranged fromover $31 billion in 2001 in New York and $20 billion in California to under $500 million inSouth Dakota, North Dakota, and Wyoming.

• The Medicaid program is the largest single payer for long-term care services. The share oftotal Medicaid spending devoted to long-term care averaged 35 percent across the states in2001. This share varied from over 50 percent in North Dakota, Connecticut, Kansas,Wisconsin, and South Dakota to under 25 percent in California, Nevada, Tennessee, andGeorgia.

• Another way to look at Medicaid long-term care spending is per capita, that is, the amountspent per person in the entire state or the whole nation. This figure permits general compar-isons of states’ relative “level of effort” with respect to financing Medicaid services. (It isnot to be confused with average Medicaid spending per beneficiary, which indicates howmuch is spent per person served.) Per capita Medicaid long-term care spending in 2001 was$264 per person in the U.S. This amount ranged from over $400 per person in four eastern

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states, New York, Connecticut, the District of Columbia, and Pennsylvania, to less than $200in 12 states, mostly located in the South or West (Maryland, Idaho, South Carolina, Colorado,Hawaii, Florida, Texas, California, Virginia, Georgia, Utah, and Nevada).

• How Medicaid long-term care spending is allocated among different types of services, bothinstitutional and home and community-based, is another important indicator.

° Per capita spending on nursing facilities averaged $150 in the U.S. as a whole in 2001.The highest spending (over $250 per person) was in the four states with the highest totalMedicaid long-term care spending per capita, New York, Pennsylvania, Connecticut, andthe District of Columbia. Similarly, the states with the lowest spending (under $100 perperson) included many of those with the lowest total Medicaid long-term care spending,such as South Carolina, Georgia, Idaho, Colorado, Wyoming, California, Texas,Virginia, and Utah.

° Per capita spending on ICF/MR facilities averaged $36 in the U.S. as a whole, rangingfrom highs of over $100 per person in the District of Columbia and New York to under$5 per person in Colorado, Oregon, Michigan, Vermont, and New Hampshire.

° Per capita spending on home health averaged $9 in the U.S. as a whole, ranging fromhighs of $25 or more in New York, Connecticut, Kentucky, and the District of Columbia,to lows of less than $1 per person in nine states. (Note: Some of the states that spendvery little on home health services spend much more on HCBS waivers or personal care.)

° Per capita spending on HCBS waivers averaged $51 in the U.S. as a whole, ranging frommore than $100 in 11 states to less than $30 in seven states. Among the states with thehighest spending were Rhode Island, Vermont, Oregon, Connecticut, and Minnesota.Those with the lowest included the District of Columbia, Nevada, California,Mississippi, and Georgia.

° Per capita spending on personal care averaged $18 in the U.S. as a whole, but variedwidely among the thirty-two states that provide this optional Medicaid service. NewYork spent the most ($98), followed by California, Massachusetts, and New Mexico (at$36-$40). Fifteen states spent under $10.

• One indicator of spending on home and community-based care versus institutional care forolder persons is the amount of HCBS aged/disabled waiver spending per $100 of nursingfacility spending. These waivers permit states to waive certain Medicaid program andeligibility rules and offer non-medical services to persons with disabilities that otherwisewould not be covered. Washington and Oregon had the highest spending ratios on thesewaivers ($47 and $41, respectively), followed by Texas and Idaho ($25 each). Fifteen statesspent from $10-$25, while thirty spent $10 or less.

• In addition to the aged/disabled population, states may provide HCBS waivers to othergroups, such as persons with AIDS and AIDS-related conditions, mental retardation/devel-opmental disabilities, and mental illness. Aged/disabled waiver spending as a percent oftotal HCBS waiver spending averaged 21.5 percent in the U.S as a whole. This percent was50 percent or more in six states, including the District of Columbia, Mississippi, Ohio,Texas, Washington, and Idaho. It was less than 10 percent in 13 states.

• The percent of Medicaid federal matching funds is set by a formula designed to provide higher matching rates to poorer states and lower matching rates to more affluent

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Highlightsstates, based on average per capita income. It varies from highs of 70-77 percent in 11states to a low of 50 percent in 12 states in FY 2003. (The federal share cannot be less than 50%.)

• On average, states allocated 29.5 percent of their total spending on Medicaid long-term carein 2001 to home and community-based services, including home health, persona1 care, andwaiver spending, up from 21.4 percent in 1996. Five states, New Mexico, Vermont, Alaska,Wyoming, and Colorado, allocated 50 percent or more of their Medicaid long-term careexpenditures to home and community-based services in 2001; with the exception of Alaska,these same states were also among those with the highest shares of HCBS spending in1996. The states with the lowest shares in 2001 (under 10%) were Louisiana, Mississippi,and the District of Columbia; these same states allocated less than 10 percent to HCBS in1996 as well.

• The share of states’Medicaid LTC spending allocated to nursing facility care dropped from60 percent to 57 percent between 1996 and 2001, on average, while spending devoted toICF/MR facility care fell from 19 percent to 14 percent. States with the highest share ofspending devoted to nursing facility care in 2001 were Arizona, Michigan, Alabama,Pennsylvania, Hawaii, and Georgia; with the exception of Michigan, these same states werealso among those with the highest shares in 1996. Those states with the highest shares ofICF/MR facility spending in 2001 were the District of Columbia, Iowa, Illinois,Mississippi, and Idaho, all of which were also among those with high shares in 1996.

Public and Private Payment Rates

• Medicaid nursing facility reimbursement rates per day averaged $96 in 1998 in the U.S. asa whole. Nineteen states had rates over $100 per day, with the highest rates in Alaska, $253per day, followed by the District of Columbia at $180, and New York at $159. States withthe lowest rates ($62-$66) were Arkansas, Oklahoma, and Louisiana.

• Private pay nursing facility rates per day averaged $150 per day in 2001 in the U.S. as awhole. The highest rates were in Alaska ($448), followed by Connecticut, New York,District of Columbia, Hawaii, New Jersey, and Massachusetts, all at $200 or more per day.The lowest rates ($99-$110) were in Louisiana, Arkansas, and Oklahoma.

• Medicare nursing facility reimbursement rates per day averaged $229 in 2000 in the U.S.as a whole. The highest rates were in California ($311), followed by Oregon, Washington,Colorado, and Nevada ($270-$276). States with the lowest rates ($174-$198) were SouthDakota, North Dakota, Arkansas, North Carolina, Mississippi, Alabama, Vermont, andSouth Carolina.

• Medicare reimbursement per home health visit averaged $81 in 2000 in the U.S. as a whole.The highest rates were in Alaska ($138), followed by Oregon, Hawaii, Washington, andCalifornia ($108-116). The lowest rates ranged from $60-$68, in Vermont, Arkansas,Oklahoma, Mississippi, Louisiana, Iowa, Alabama, and Wyoming.

• The hourly rates charged to clients by home care agencies for licensed practical nurses(LPNs) averaged $37 in 2002 in the U.S. as a whole, while those for home health aides(HHAs) averaged $18. Wisconsin and Alaska were among the five states with the highestrates for both LPNs ($54-$75 per hour) and for HHAs ($21-$27). Alabama, Louisiana, andArkansas were among the states with the lowest rates for both LPNs ($23-$27 per hour) andfor HHAs ($13-$14.)

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Highlights

LONG-TERM CARE MAPS

As of 2002, twenty-nine states reported having regulations on assisted living that included aconsumer-focused philosophy of assisted living, emphasizing such values as independence, dignity,privacy, and autonomy. In addition, sixteen states required private rooms in assisted living facilities,and twenty-two states had disclosure requirements for special care units or units that care for personswith Alzheimer’s disease.

The proportion of for-profit nursing homes in the U.S. as a share of all nursing homes, includingnon-profit and government, averaged 65 percent in 2002. The proportions ranged from highs inOklahoma and Texas (over 80%) to lows of 10 percent or less in North Dakota and Alaska.

As of 2000, twenty states had enacted legislation addressing shortages of nursing home staff, suchas wage pass-throughs, wage supplements, fringe benefits, or related measures.

As of 2000, fifteen states had mandated additional hours of training for certified nursing assistants(CNAs) in nursing homes above the federal requirement of 75 hours.

The proportion of deaths occurring at home rather than in hospitals or nursing homes averaged 24percent in the U.S. as a whole in 1997. The states with the highest shares of deaths at home (30%or more) were all in the western U.S.

Twenty-five states, as of 2002, offer tax incentives, including deductions, credits, or both, for thepurchase of private long-term care insurance.

1

State Long-Term CareProfile

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DEMOGRAPHICS

Distribution of Population by Age, 2000 & 2020 (Projected)


Need for Long-Term Care Services

Select Population Characteristics

State

US

State

US

State

US

2000 (%)

2020 (%)

% Change inPopulation # *

50-64 65-74 75-84 85+Total

Population

USState Rank

Minority/Ethnic Population Age 65+ (%), 2000

Minority/Ethnic Population Age 65+ (% change),1990-2000

Rural Population Age 65+ (%), 2000

Bachelor Level Education or Higher Age 65+ (%),2000

Family Income Age 65+ (median), 2000

Poverty Status Age 65+ (%), 1999

At/Below Poverty Level

101-200% of Poverty Level

Population Age 85+ (% change), 1990-2000

Men per 100 Women Age 85+ (#), 2000

Women Age 85+ At/Below Poverty Level (%), 1999

Persons Age 65+ Living Alone (%), 2000

Persons Age 65+ with Activity Limitations, 2000

Self-Care Limitations (%)

Mobility Limitations (%)

Self-Care or Mobility Limitations (%)

Sensory Limitations (%)

Cognitive/Mental Limitations (%)

1.7 47 16.4

39.2

21.7

14.9

$38,155

10.9

23.7

148.4 3

39.9 13

20.4 2

$39,350 15

12.0 16

18.1 41

USState Rank

37.2 24 37.6

38.3 28 40.7

22.4 19 17.830.1

8.9

18.1

19.8

16.0

10.2

27.3 33

6.7 31

17.7 20

18.9 26

20.8 4

11.6 13

14.9 6.5 4.4 1.5 281,421,906

18.7 9.7 4.7 1.9 327,909,900

46.6 72.3 25.5 48.9 16.5

15.8 6.3 4.2 1.5 1,235,786

19.9 10.6 4.7 1.9 1,504,239

53.3 103.1 38.1 58.7 21.7

Note: The highest data value within each ranking is indicated by a “1.”

*The percent change calculation is based on the total number in each age group. For example, the U.S. population age 50-64 was41,860,232 in 2000 (14.9% of 281,421,906), and was projected to be 61,377,849 in 2020 (18.7% of 327,909,900). Among personsage 50-64, these population numbers represent a 46.6% increase from 2000 to 2020. See data documentation for an explanation ofhow rounding affects the calculations.

New Hampshire

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HOME & COMMUNITY-BASED SERVICES

Select Community Characteristics

Homeownership Rate Age 65+ (%), 2000

Housing Over 40 Years Old (%), 2000

Persons Age 75+ with Driver’s License (%), 2000

Persons Age 70+ without a Vehicle (%), 2000

Grandchildren Living with Grandparents Age 65+ (%),2000

USState Rank

79.0 27 79.4

44.5 26 45.3

69.7 26 68.3

9.2 37 14.6

2.1 27 4.4

Use of Home and Community-Based Services

Medicaid Beneficiaries Age 65+ Receiving HomeHealth Services (%), 1999

Medicare Beneficiaries Receiving Home HealthServices (%), 2000

Medicare Home Health Visits per User (average), 2000

USState Rank

2.7 24 5.6

8.0 8 6.5

35 15 36

0

1

2

3

4

5

6

1992 1999New HampshireUnited States

1.3%0.6%

1.5%1.1%

Medicaid Beneficiaries Enrolled in Aged/Disabled Waivers, 1992 & 1999

HOME & COMMUNITY-BASED RESOURCES

Home and Community-Based Resources AvailableMedicare-Certified Home Health Agencies (per 1,000Age 65+), 2000

Licensed Adult Day Facilities (#), 1998

Residential Care Beds (per 1,000 Age 65+), 1998

Personal & Home Care Aides (per 1,000 Age 65+),2000

Hourly Wage (median)

Home Health Aides (per 1,000 Age 65+), 2000

Hourly Wage (median)

USState Rank

0.28 14 0.22

18 23 3,590

21 18 26

13 10 11$7.96 18 $7.81

10 14 16

$10.21 4 $8.13


Perc

ent

New Hampshire 2

4


Use of Nursing Facility ServicesTotal Nursing Facility Residents (#), 2001

Nursing Facility Residents (% of Age 65+)

Nursing Facility Residents (% change), 1996-2001

Select Nursing Facility Resident Measures, 2002

Residents with Physical Restraints (%)

Residents with Pressure (Bed) Sores (%)

USState Rank7,126 38 1,469,001

4.8 13 4.2

-2.6 28 -0.7

4.0 14 8.0

7.0 7 8.0

Medicare8.9%

Medicaid69.4%

Medicaid67.0%

Medicare9.6%Other*

21.7%

Other*23.5%

Nursing Facility Residents by Primary Payer Source, 2001


Nursing Facility Resources AvailableNursing Facility Beds (per 1,000 Age 65+), 2001

Nursing Facility Beds (% change), 1996-2001

Nursing Facility Occupancy Rate (%), 2001

Nursing Facility Occupancy Rate (% change),1996-2001

USState Rank52 19 54

-1.1 32 -0.1

90.4 9 82.5

-1.5 17 -0.7

*Out-of-pocket spending, private insurance, other spending

New Hampshire United States


New Hampshire 3

5


Medicaid Expenditures & FinancingTotal Medicaid Spending (in millions), 2001

Medicaid Long-Term Care Spending (% of TotalMedicaid), 2001

Per Capita LTC Spending

Per Capita Nursing Facility Spending

Per Capita ICF/MR Facility Spending

Per Capita Home Health Spending

Per Capita 1915(c) HCBS Waiver Spending

Per Capita Personal Care Spending

Medicaid Aged/Disabled HCBS Waiver Spending per$100 of Nursing Facility Spending, 2001

Medicaid Aged/Disabled HCBS Waiver Expenditures(% of Total 1915(c) HCBS Waivers), 2001

Medicaid Federal Matching Funds (%), FY 2003

USState Rank$878 40 $214,586

50.0 35 NA

8.8 38 21.5

$6 17 $7

$3 18 $18

$109 8 $51

$4 14 $9

$2 38 $36

$167 16 $150

$285 19 $264

40.8 15 35.1

Public and Private Payment RatesMedicaid Reimbursement per day for Nursing FacilityCare (average), 1998

Medicare Reimbursement per day for Nursing FacilityCare (average), 2000

Private Pay Rate per day in Nursing Facility (average),2001

Medicare Reimbursement per Home Health Visit(average), 2000

Home Care Agency Hourly Rates (average), 2002

Licensed Practical Nurse (LPN)

Home Health Aide (HHA)

USState Rank

$115 9 $96

$240 13 $229

$190 7 $150

$73 20 $81

$33 27 $37

$21 7 $18

0 20 40 60 80 100% % % % % %

Nursing Facilities ICF/MR Facilities Home and Community-Based Services

58.5%

65.8%

2001

1996

1.1% 33.2%

0.6% 40.9%

Allocation of Medicaid LTC Expenditures for Nursing Facilities, ICF/MR Facilities, andHome and Community-Based Services, 1996 & 2001


New Hampshire 4

7

Long-Term Care Maps

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States with Regulations that Include Assisted Living Philosophy, 2002

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States Requiring Private Rooms in Assisted Living, 2002

Long-Term Care

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Long-Term Care

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States Requiring Disclosure on Special Care Units, 2002

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Proportion of For-Profit Nursing Facilities, 2001

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States with Legislation Addressing Nursing Facility Staffing Shortages, 2000

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Yes No Not Available

States with Regulations Mandating CNA Training Above 75 Hours, 2000

Long-Term Care

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<20% 20%-25% >25%

Proportion of Deaths Occurring at Home, 1997

ME

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CTRIPA

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Tax Credit or Deduction More Generous than Federal Tax Deduction Same as FederalNo Broad-Based State Income TaxNo Tax Incentives

States Offering Tax Incentives for Long-Term Care Insurance, 2002

Long-Term Care

13

State Data andRankings

14

DEMOGRAPHICS


*See data documentation for an explanation of how rounding affects the calculations and for a complete explanation of columnheadings and data.

Rankings

50-64, 2000Data Rank





Rankings

Alabama 15.8 7 7.1 7 4.4 13Alaska 13.7 22 3.6 25 1.7 24Arizona 14.4 18 7.1 7 4.6 11Arkansas 15.9 6 7.4 5 4.8 9California 13.6 23 5.6 21 3.8 19Colorado 14.4 18 5.3 23 3.3 21Connecticut 15.8 7 6.8 10 5.1 7Delaware 15.4 11 7.2 6 4.4 13Dist. of Columbia 15.0 14 6.3 15 4.4 13Florida 15.9 6 9.1 1 6.4 1Georgia 14.3 19 5.3 23 3.2 22Hawaii 15.5 10 7.0 8 4.8 9Idaho 14.3 19 5.9 19 4.0 17Illinois 14.4 18 6.2 16 4.3 14Indiana 15.0 14 6.5 13 4.4 13Iowa 15.0 14 7.2 6 5.4 4Kansas 14.2 20 6.5 13 4.8 9Kentucky 15.7 8 6.8 10 4.3 14Louisiana 14.5 17 6.3 15 3.9 18Maine 16.8 2 7.5 4 5.0 8Maryland 15.6 9 6.1 17 4.0 17Massachusetts 15.1 13 6.7 11 5.0 8Michigan 15.1 13 6.5 13 4.4 13Minnesota 14.4 18 6.0 18 4.3 14Mississippi 14.6 16 6.5 13 4.0 17Missouri 15.3 12 7.0 8 4.7 10Montana 16.3 4 6.9 9 4.8 9Nebraska 14.3 19 6.8 10 4.8 9Nevada 16.0 5 6.6 12 3.5 20New Hampshire 15.8 7 6.3 15 4.2 15New Jersey 15.5 10 6.8 10 4.8 9New Mexico 15.0 14 6.5 13 3.9 18New York 15.3 12 6.7 11 4.5 12North Carolina 15.4 11 6.6 12 4.1 16North Dakota 14.2 20 7.1 7 5.3 5Ohio 15.3 12 7.0 8 4.8 9Oklahoma 15.3 12 7.0 8 4.5 12Oregon 15.8 7 6.4 14 4.7 10Pennsylvania 15.7 8 7.9 3 5.8 2Rhode Island 14.8 15 7.0 8 5.5 3South Carolina 15.8 7 6.7 11 4.1 16South Dakota 14.1 21 7.0 8 5.2 6Tennessee 16.0 5 6.7 11 4.2 15Texas 13.4 24 5.5 22 3.3 21Utah 11.1 25 4.5 24 3.0 23Vermont 16.5 3 6.7 11 4.4 13Virginia 15.6 9 6.1 17 3.9 18Washington 15.1 13 5.7 20 4.1 16West Virginia 17.4 1 8.2 2 5.3 5Wisconsin 14.8 15 6.6 12 4.7 10Wyoming 15.8 7 6.3 15 4.0 17

15

DEMOGRAPHICS



Rankings 2

85+, 2000Data Rank

Total, 2000Data Rank


Alabama 1.5 9 4,447,100 23 19.4 10Alaska 0.4 16 626,932 48 13.7 33Arizona 1.3 11 5,130,632 20 15.4 30Arkansas 1.7 7 2,673,400 33 18.4 18California 1.3 11 33,871,648 1 17.3 23Colorado 1.1 13 4,301,261 24 17.5 22Connecticut 1.9 5 3,405,565 29 21.2 1Delaware 1.3 11 783,600 45 20.6 4Dist. of Columbia 1.6 8 572,059 50 14.0 32Florida 2.1 3 15,982,378 4 17.1 25Georgia 1.1 13 8,186,453 10 18.2 19Hawaii 1.4 10 1,211,537 42 16.1 29Idaho 1.4 10 1,293,953 39 17.1 25Illinois 1.5 9 12,419,293 5 19.2 12Indiana 1.5 9 6,080,485 14 20.8 3Iowa 2.2 2 2,926,324 30 21.1 1Kansas 1.9 5 2,688,418 32 19.1 13Kentucky 1.4 10 4,041,769 25 20.0 6Louisiana 1.3 11 4,468,976 22 18.0 21Maine 1.8 6 1,274,923 40 20.5 5Maryland 1.3 11 5,296,486 19 19.3 11Massachusetts 1.8 6 6,349,097 13 21.1 1Michigan 1.4 10 9,938,444 8 20.8 3Minnesota 1.7 7 4,919,479 21 20.0 6Mississippi 1.5 9 2,844,658 31 18.0 21Missouri 1.8 6 5,595,211 17 19.8 8Montana 1.7 7 902,195 44 17.5 22Nebraska 2.0 4 1,711,263 38 19.1 13Nevada 0.9 15 1,998,257 35 16.6 27New Hampshire 1.5 9 1,235,786 41 19.9 7New Jersey 1.6 8 8,414,350 9 20.0 6New Mexico 1.3 11 1,819,046 36 16.4 28New York 1.6 8 18,976,457 3 19.7 9North Carolina 1.3 11 8,049,313 11 18.5 17North Dakota 2.3 1 642,200 47 19.0 14Ohio 1.6 8 11,353,140 7 20.5 5Oklahoma 1.7 7 3,450,654 27 18.1 20Oregon 1.7 7 3,421,399 28 18.8 16Pennsylvania 1.9 5 12,281,054 6 20.8 3Rhode Island 2.0 4 1,048,319 43 20.0 6South Carolina 1.3 11 4,012,012 26 18.5 17South Dakota 2.1 3 754,844 46 18.0 21Tennessee 1.4 10 5,689,283 16 18.9 15Texas 1.1 13 20,851,820 2 16.9 26Utah 1.0 14 2,233,169 34 15.3 31Vermont 1.6 8 608,827 49 20.0 6Virginia 1.2 12 7,078,515 12 19.0 14Washington 1.4 10 5,894,121 15 19.3 11West Virginia 1.8 6 1,808,344 37 21.0 2Wisconsin 1.8 6 5,363,675 18 21.0 2Wyoming 1.4 10 493,782 51 17.2 24

16

DEMOGRAPHICS



Rankings 3



85+, 2020Data Rank


17

DEMOGRAPHICS



Rankings 4

Total, 2020Data Rank

50-64 % change, 2000-2020Data Rank


Alabama 4,843,420 23 33.9 33 48.1 45Alaska 779,565 47 23.9 40 286.1 1Arizona 6,738,146 15 40.6 24 53.9 41Arkansas 2,858,006 32 23.7 41 39.0 49California 44,944,240 1 68.6 1 108.8 4Colorado 4,828,587 24 36.7 29 135.1 2Connecticut 3,956,186 27 56.2 5 77.4 19Delaware 883,763 45 50.6 12 53.3 42Dist. of Columbia 722,923 49 18.4 45 65.7 29Florida 21,171,370 4 42.5 21 40.1 48Georgia 9,934,454 9 54.6 7 97.3 9Hawaii 1,406,871 41 20.8 43 89.6 12Idaho 1,317,037 42 21.0 42 82.2 16Illinois 13,447,890 6 44.2 20 70.9 23Indiana 6,337,126 18 45.0 18 69.7 27Iowa 2,766,097 33 33.2 35 55.6 39Kansas 2,759,718 34 37.9 27 68.9 28Kentucky 4,181,257 26 31.7 37 56.8 37Louisiana 4,902,141 22 35.6 30 56.6 38Maine 1,482,118 40 42.1 22 70.1 26Maryland 7,082,046 14 65.5 2 100.5 7Massachusetts 7,147,711 13 57.8 3 71.0 22Michigan 10,628,990 8 47.6 16 70.7 24Minnesota 5,509,199 21 56.1 6 94.8 10Mississippi 3,123,811 30 35.0 32 46.7 46Missouri 5,849,761 19 35.3 31 51.1 44Montana 982,581 44 17.0 47 78.8 18Nebraska 1,712,206 38 33.8 34 64.1 31Nevada 2,960,945 31 54.2 8 83.2 15New Hampshire 1,504,239 39 53.3 10 103.1 5New Jersey 9,928,637 10 52.9 11 70.1 25New Mexico 2,335,323 35 40.2 25 75.8 20New York 21,572,320 3 46.6 16 60.6 34North Carolina 9,376,400 11 40.2 25 61.9 33North Dakota 665,929 50 38.6 26 58.1 36Ohio 12,298,630 7 45.1 17 61.9 32Oklahoma 3,503,593 29 19.6 44 44.9 47Oregon 3,689,619 28 28.1 39 102.0 6Pennsylvania 13,735,840 5 48.2 15 46.7 46Rhode Island 1,225,211 43 57.6 4 60.3 35South Carolina 4,448,171 25 29.6 38 55.5 40South Dakota 831,102 46 41.3 23 52.0 43Tennessee 6,598,894 17 37.6 28 64.5 30Texas 24,648,050 2 49.1 13 89.4 13Utah 2,148,135 36 32.0 36 89.2 14Vermont 742,820 48 47.6 16 98.4 8Virginia 8,925,715 12 53.5 9 93.0 11Washington 6,639,702 16 44.3 19 120.2 3West Virginia 1,767,978 37 17.9 46 38.1 50Wisconsin 5,613,940 20 48.9 14 72.6 21Wyoming 428,501 51 -5.6 48 80.1 17

18

DEMOGRAPHICS



Rankings 5


85+ % change, 2000-2020Data Rank

Total % change, 2000-2020Data Rank

Alabama 22.2 27 43.9 24 8.9 31Alaska 230.8 1 319.1 1 24.3 9Arizona 39.7 12 96.3 5 31.3 5Arkansas 16.0 34 28.2 43 6.9 34California 42.7 10 65.2 18 32.7 3Colorado 70.1 3 96.9 4 12.3 24Connecticut 13.4 39 25.6 44 16.2 18Delaware 24.8 24 70.1 13 12.8 22Dist. of Columbia 2.8 46 12.1 51 26.4 7Florida 27.1 23 71.7 11 32.5 4Georgia 54.3 4 67.8 14 21.4 12Hawaii 42.5 11 116.5 3 16.1 19Idaho 35.7 16 66.0 17 1.8 41Illinois 13.0 40 23.3 49 8.3 32Indiana 21.9 28 40.4 31 4.2 37Iowa 6.8 45 28.3 42 -5.5 46Kansas 13.0 40 30.3 40 2.7 40Kentucky 22.6 26 43.1 27 3.5 39Louisiana 15.2 35 38.8 32 9.7 30Maine 20.2 29 41.9 29 16.3 17Maryland 38.2 14 58.4 22 33.7 2Massachusetts 7.2 44 24.3 47 12.6 23Michigan 16.7 32 41.5 30 6.9 34Minnesota 29.8 20 37.4 33 12.0 25Mississippi 17.9 30 24.5 46 9.8 29Missouri 14.3 36 28.9 41 4.5 36Montana 27.4 22 63.2 19 8.9 31Nebraska 13.6 38 36.0 35 0.1 43Nevada 90.2 2 161.5 2 48.2 1New Hampshire 38.1 15 58.7 21 21.7 11New Jersey 14.0 37 32.1 38 18.0 14New Mexico 44.7 8 82.5 7 28.4 6New York 8.2 42 17.2 50 13.7 21North Carolina 39.0 13 77.6 8 16.5 16North Dakota 7.2 44 30.9 39 3.7 38Ohio 11.2 41 43.7 25 8.3 32Oklahoma 16.1 33 36.5 34 1.5 42Oregon 34.8 17 59.7 20 7.8 33Pennsylvania -4.9 49 23.8 48 11.8 26Rhode Island -2.7 48 24.8 45 16.9 15South Carolina 29.2 21 71.6 12 10.9 27South Dakota 7.4 43 43.5 26 10.1 28Tennessee 32.0 19 45.0 23 16.0 20Texas 48.1 6 72.1 10 18.2 13Utah 44.3 9 92.0 6 -3.8 45Vermont 34.0 18 42.8 28 22.0 10Virginia 48.3 5 76.0 9 26.1 8Washington 45.8 7 67.7 15 12.6 23West Virginia 0.9 47 32.3 37 -2.2 44Wisconsin 17.7 31 35.6 36 4.7 35Wyoming 24.7 25 66.8 16 -13.2 47

19

DEMOGRAPHICS



Rankings 6Minority/ Ethnic Population Age 65+

(%), 2000Data Rank

Minority/ Ethnic Population Age 65+(% Change), 1990-2000

Data RankRural Population Age 65+ (%), 2000

Data Rank

Alabama 20.3 13 6.4 46 43.0 9Alaska 26.9 6 71.2 12 34.9 19Arizona 13.3 21 66.5 14 12.1 41Arkansas 11.7 25 -0.4 48 47.8 6California 30.0 4 61.5 16 7.1 47Colorado 13.2 22 56.2 19 15.9 36Connecticut 8.7 29 52.2 20 10.1 42Delaware 13.6 20 42.8 27 20.1 34Dist. of Columbia 74.0 2 -4.0 50 0.0 50Florida 17.2 16 57.1 18 9.5 43Georgia 22.1 11 24.7 37 32.5 23Hawaii 78.1 1 38.1 30 7.6 45Idaho 3.7 42 83.7 9 35.5 18Illinois 16.2 18 36.3 32 14.0 38Indiana 7.6 31 28.8 34 27.7 26Iowa 2.0 46 51.9 21 41.4 11Kansas 6.7 33 37.2 31 33.7 20Kentucky 6.5 34 14.6 43 41.9 10Louisiana 25.7 8 10.5 45 26.8 27Maine 1.2 49 140.1 4 55.8 2Maryland 22.7 10 50.3 22 15.0 37Massachusetts 6.9 32 73.2 11 7.2 46Michigan 12.5 23 19.6 40 25.4 28Minnesota 3.1 44 89.9 7 33.1 22Mississippi 26.3 7 -1.8 49 50.8 5Missouri 9.0 27 21.9 39 31.7 25Montana 4.0 40 59.5 17 43.5 8Nebraska 4.0 40 46.8 25 37.6 15Nevada 15.3 19 182.8 1 9.4 44New Hampshire 1.7 47 148.4 3 39.9 13New Jersey 16.7 17 49.3 23 4.8 49New Mexico 35.9 3 48.9 24 23.1 30New York 21.3 12 40.6 28 12.2 40North Carolina 17.9 15 19.0 41 41.1 12North Dakota 2.2 45 63.7 15 52.9 3Ohio 9.9 26 25.6 36 20.4 33Oklahoma 12.5 23 27.4 35 36.0 17Oregon 5.3 38 88.1 8 24.1 29Pennsylvania 8.2 30 22.2 38 20.6 32Rhode Island 6.1 35 90.5 6 7.0 48South Carolina 22.8 9 17.2 42 37.7 14South Dakota 3.6 43 38.5 29 51.6 4Tennessee 12.1 24 11.6 44 36.4 16Texas 27.4 5 43.4 26 22.6 31Utah 5.9 36 80.7 10 13.7 39Vermont 1.6 48 158.0 2 58.7 1Virginia 19.2 14 29.3 33 32.5 23Washington 8.8 28 92.5 5 18.9 35West Virginia 3.8 41 4.8 47 47.6 7Wisconsin 4.1 39 67.6 13 32.3 24Wyoming 5.5 37 51.9 21 33.4 21

20

DEMOGRAPHICS



Rankings 7Bachelor Level Education or Higher

Age 65+ (%), 2000Data Rank

Family Income Age 65+ (median),2000

Data Rank

Poverty Status Age 65+ (%), 1999Below Poverty Level

Data Rank

Alabama 13.9 25 $31,712 44 13.3 11Alaska 19.6 5 $48,912 3 3.6 39Arizona 17.6 12 $36,936 19 9.9 23Arkansas 11.8 33 $31,045 47 18.5 1California 18.9 8 $42,391 6 8.6 32Colorado 19.7 4 $39,154 16 6.9 37Connecticut 16.4 17 $43,269 5 5.6 38Delaware 16.9 14 $40,391 12 9.9 23Dist. of Columbia 26.3 1 $53,244 1 11.1 17Florida 18.0 11 $35,660 24 10.7 21Georgia 13.6 26 $32,459 43 15.7 6Hawaii 16.9 14 $51,663 2 7.6 36Idaho 14.3 24 $36,771 20 11.1 17Illinois 13.0 28 $39,552 14 9.7 25Indiana 11.2 35 $34,383 34 9.6 26Iowa 10.6 39 $34,515 33 9.8 24Kansas 13.2 27 $35,693 23 9.0 30Kentucky 9.8 40 $29,052 50 15.6 7Louisiana 12.6 30 $31,329 45 16.4 4Maine 16.6 15 $30,628 48 10.8 20Maryland 18.7 9 $44,406 4 9.9 23Massachusetts 16.3 18 $38,741 17 8.9 31Michigan 11.9 32 $35,497 26 9.3 28Minnesota 12.9 29 $34,842 29 10.9 19Mississippi 10.9 38 $30,127 49 17.4 2Missouri 10.9 38 $33,031 39 10.6 22Montana 16.3 18 $32,828 41 15.2 8Nebraska 11.0 37 $34,231 35 11.0 18Nevada 15.9 20 $41,494 9 11.1 17New Hampshire 20.4 2 $39,350 15 12.0 16New Jersey 15.2 22 $42,390 7 8.3 34New Mexico 18.4 10 $35,505 25 13.2 12New York 16.1 19 $40,863 11 11.1 17North Carolina 12.4 31 $32,917 40 16.9 3North Dakota 9.2 42 $31,098 46 14.5 9Ohio 11.2 35 $34,033 36 9.1 29Oklahoma 11.8 33 $32,492 42 12.9 14Oregon 17.3 13 $35,485 27 8.3 34Pennsylvania 11.2 35 $34,629 31 9.8 24Rhode Island 13.6 26 $36,152 22 8.4 33South Carolina 16.5 16 $35,160 28 15.7 6South Dakota 10.9 38 $33,436 37 13.6 10Tennessee 11.7 34 $33,217 38 15.2 8Texas 15.5 21 $34,788 30 13.1 13Utah 19.0 7 $41,892 8 8.9 31Vermont 19.4 6 $36,517 21 12.6 15Virginia 16.9 14 $40,368 13 9.3 28Washington 20.1 3 $40,881 10 8.0 35West Virginia 9.4 41 $27,318 51 16.2 5Wisconsin 11.1 36 $34,549 32 9.5 27Wyoming 14.6 23 $37,757 18 12.9 14

21

DEMOGRAPHICS



Rankings 8

101-200% of Poverty Level, 1999Data Rank

Alabama 28.7 4Alaska 19.7 37Arizona 21.6 31Arkansas 23.0 26California 23.2 25Colorado 17.6 42Connecticut 20.9 35Delaware 17.6 42Dist. of Columbia 23.0 26Florida 22.8 27Georgia 25.4 13Hawaii 14.3 43Idaho 25.2 14Illinois 21.2 34Indiana 25.7 12Iowa 26.0 10Kansas 22.2 29Kentucky 26.7 8Louisiana 28.8 3Maine 28.7 4Maryland 19.0 38Massachusetts 26.0 10Michigan 25.4 13Minnesota 24.0 22Mississippi 28.5 5Missouri 23.9 23Montana 27.3 7Nebraska 23.7 24Nevada 24.3 20New Hampshire 18.1 41New Jersey 20.7 36New Mexico 22.2 29New York 21.3 33North Carolina 29.8 2North Dakota 27.9 6Ohio 24.4 19Oklahoma 26.2 9Oregon 24.5 18Pennsylvania 24.9 16Rhode Island 24.2 21South Carolina 25.9 11South Dakota 21.5 32Tennessee 24.8 17Texas 25.0 15Utah 18.5 39Vermont 24.3 20Virginia 22.4 28Washington 18.4 40West Virginia 32.4 1Wisconsin 21.8 30Wyoming 23.7 24

22

NEED FOR LONG-TERM CARERankings 9Population Age 85+ (% change),

1990-2000Data Rank

Men per 100 Women Age 85+ (#),2000

Data Rank

Women 85+ Below Poverty Level (%),1999

Data Rank

Alabama 38.7 21 36.5 37 22.5 18Alaska 110.6 2 52.2 2 26.2** 12Arizona 81.7 3 50.6 4 16.5 31Arkansas 32 30 41.2 17 41.0 2California 42.3 20 46.0 11 9.3 47Colorado 46.3 15 41.5 16 15.1 34Connecticut 36.8 25 38.7 26 9.2 48Delaware 47.7 14 38.8 25 10.3** 44Dist. of Columbia 14.4 49 37.0 34 6.3** 50Florida 57.7 9 51.2 3 16.7 30Georgia 53.5 10 34.2 43 27.6 11Hawaii 68.9 4 70.6 1 31.2** 6Idaho 58.4 8 49.5 6 13.6** 40Illinois 30.1 33 38.1 30 14.8 35Indiana 27.6 37 38.2 29 14.1 38Iowa 17.8 47 38.1 30 20.7 22Kansas 22.6 44 39.3 23 22.1 20Kentucky 25.7 39 36.9 35 24.5 16Louisiana 34.5 26 38.5 27 25.5 13Maine 27.9 36 38.1 30 8.9** 49Maryland 43.9 17 38.8 25 13.5 41Massachusetts 26.6 38 36.1 39 11.3 43Michigan 33.3 27 40.1 19 17.1 29Minnesota 24.4 43 39.7 22 17.5 27Mississippi 32.6 29 37.9 31 19.3 25Missouri 21.4 45 37.6 32 30.6 8Montana 43.7 18 46.7 9 18.8** 26Nebraska 16.3 48 39.2 24 21.5 21Nevada 127.6 1 49.7 5 28.6** 10New Hampshire 37.2 24 38.3 28 22.4** 19New Jersey 42.3 20 39.8 21 9.4 46New Mexico 63.8 5 48.5 8 25.1** 15New York 25.5 40 38.8 25 15.7 33North Carolina 50.7 11 35.0 41 34.2 3North Dakota 31 31 45.0 13 32.7** 5Ohio 28.1 35 37.5 33 10.2 45Oklahoma 24.7 42 38.5 27 25.2 14Oregon 48 13 46.6 10 16.3 32Pennsylvania 38.3 23 38.2 29 13.9 39Rhode Island 30.5 32 35.0 42 33.1 4South Carolina 63.5 6 35.4 40 22.4** 19South Dakota 20.6 46 41.7 15 41.3 1Tennessee 38.6 22 36.6 36 30.7 7Texas 42.8 19 40.2 18 24.1 17Utah 59.8 7 49.2 7 20.0** 24Vermont 32.9 28 38.3 28 29.5** 9Virginia 46.2 16 36.2 38 14.2 37Washington 49.3 12 45.3 12 20.2 23West Virginia 24.9 41 38.7 26 14.4** 36Wisconsin 28.7 34 39.9 20 17.4 28Wyoming 48 13 42.8 14 12.6** 42

Note: The highest data value within each ranking is indicated by a “1.”*See data documentation for an explanation of how rounding affects the calculations and for a complete explanation of columnheadings and data.**Estimates are based on fewer than 30 observations; therefore, percentages and resulting rankings are less reliable than those forother states.

23




Rankings 10Persons Age 65+ living alone (%),

2000Data Rank

Persons Age 65+ with Activity Limitations, 2000Self-Care Limitations (%)

Data RankMobility Limitations (%), 2000

Data Rank


24




Self-Care or Mobility Limitations(%), 2000

Data RankSensory Limitations (%), 2000

Data Rank

Cognitive/ Mental Limitations (%),2000

Data Rank


Rankings 11

25




Homeownership Rate Age 65+ (%),2000

Data RankHousing Over 40 Years Old (%), 2000

Data Rank

Persons Age 75+ with Driver'sLicense (%), 2000

Data Rank


Rankings 12

26




Persons Age 70+ w/out a Vehicle (%),2000

Data Rank

Grandchildren Living withGrandparents Age 65+ (%), 2000

Data Rank

Medicaid Benes Age 65+ receivingHome Heath Services (%), 1999

Data Rank

Alabama 11.4 25 4.5 11 7.1 13Alaska 5.2 43 8.8 2 1.2 40Arizona 10.6 29 3.2 20 0.3 45Arkansas 12.0 22 3.7 16 6.2 16California 14.9 12 7.6 3 0.6 43Colorado 8.7 39 4.0 14 9.2 10Connecticut 11.7 24 5.1 8 19.2 4Delaware 8.9 38 4.4 12 6.4 14Dist. of Columbia 43.0 1 6.0 5 10.7 6Florida 10.6 29 4.2 13 2.3 29Georgia 13.5 16 6.0 5 9.2 11Hawaii 16.6 7 13.4 1 NA NAIdaho 7.9 41 3.9 15 1.6 33Illinois 16.0 10 4.5 11 1.2 39Indiana 10.2 32 3.0 22 2.9 23Iowa 9.5 35 3.1 21 17.8 5Kansas 8.1 40 1.5 30 5.3 19Kentucky 18.3 5 3.5 17 10.4 7Louisiana 13.8 15 5.9 6 1.6 34Maine 10.9 27 1.4 31 5.9 18Maryland 16.3 9 5.3 7 4.4 20Massachusetts 19.0 4 3.4 18 9.5 8Michigan 11.7 24 3.1 21 0.3 48Minnesota 13.1 18 2.1 27 30.5 1Mississippi 11.3 26 4.8 10 2.5 26Missouri 13.4 17 3.9 15 0.5 44Montana 9.9 34 2.1 27 2.3 28Nebraska 11.9 23 3.2 20 3.6 21Nevada 10.5 30 4.2 13 2.4 27New Hampshire 9.2 37 2.1 27 2.7 24New Jersey 16.4 8 4.2 13 6.1 17New Mexico 7.6 42 5.1 8 1.2 38New York 30.4 2 4.9 9 21.9 2North Carolina 14.7 13 4.0 14 9.3 9North Dakota 9.3 36 1.9 28 2.2 30Ohio 12.6 20 2.5 25 3.2 22Oklahoma 10.8 28 3.1 21 1.4 36Oregon 15.2 11 3.2 20 0.1 50Pennsylvania 17.9 6 2.8 23 1.4 35Rhode Island 14.7 13 3.3 19 8.0 12South Carolina 12.6 20 4.5 11 2.6 25South Dakota 12.2 21 0.8 32 0.3 46Tennessee 14.6 14 2.3 26 0.3 47Texas 10.0 33 6.7 4 0.1 49Utah 10.9 27 4.5 11 1.8 32Vermont 14.6 14 3.2 20 6.4 15Virginia 14.7 13 4.9 9 1.0 41Washington 12.7 19 2.7 24 1.4 37West Virginia 19.8 3 3.2 20 19.6 3Wisconsin 12.2 21 1.7 29 2.1 31Wyoming 10.4 31 4.5 11 0.6 42

Rankings 13

27




Medicare Benes Receiving HomeHealth Services (%), 2000Data Rank

Medicare Home Health Visits peruser (average), 2000

Data Rank

Medicaid Benes Enrolled inAged/Disabled Waivers, 1992Data Rank

Alabama 7.1 13 52 6 1.5% 3Alaska 4.4 29 20 28 0.0% 17Arizona 3.4 32 23 26 NA NAArkansas 6.4 18 39 12 0.3% 14California 4.7 27 28 22 0.2% 15Colorado 4.9 26 33 17 1.2% 6Connecticut 8.1 7 43 9 0.9% 9Delaware 7.6 10 29 21 0.7% 10Dist. of Columbia 6.7 16 28 22 0.0% 17Florida 7.0 14 38 13 0.5% 12Georgia 6.9 15 44 8 1.2% 6Hawaii 2.5 33 21 27 0.4% 13Idaho 6.0 19 27 23 1.3% 5Illinois 6.7 16 29 21 1.7% 2Indiana 5.5 22 32 18 0.2% 15Iowa 5.0 25 25 25 0.0% 17Kansas 4.5 28 28 22 1.0% 8Kentucky 7.7 9 42 10 0.6% 11Louisiana 8.6 4 81 1 0.1% 16Maine 9.0 3 36 14 0.5% 12Maryland 6.6 17 25 25 0.0% 17Massachusetts 8.4 5 42 10 0.4% 13Michigan 8.1 7 32 18 0.1% 16Minnesota 3.7 31 23 26 1.2% 6Mississippi 9.6 2 63 2 0.1% 16Missouri 6.9 15 29 21 1.2% 6Montana 5.8 20 28 22 1.1% 7Nebraska 5.4 23 25 25 0.5% 12Nevada 4.3 30 33 17 0.7% 10New Hampshire 8.0 8 35 15 1.3% 5New Jersey 7.0 14 29 21 0.5% 12New Mexico 5.4 23 31 19 0.6% 11New York 6.6 17 35 15 0.6% 11North Carolina 7.7 9 31 19 0.5% 12North Dakota 6.4 18 23 26 0.7% 10Ohio 5.7 21 29 21 0.5% 12Oklahoma 7.6 10 62 3 0.0% 17Oregon 4.5 28 19 29 5.2% 1Pennsylvania 7.1 13 29 21 0.0% 17Rhode Island 7.1 13 34 16 0.4% 13South Carolina 7.4 11 34 16 1.2% 6South Dakota 4.9 26 23 26 0.3% 14Tennessee 8.2 6 55 4 0.0% 17Texas 6.7 16 53 5 0.0% 17Utah 7.2 12 48 7 1.1% 7Vermont 11.3 1 40 11 0.5% 12Virginia 7.2 12 33 17 1.5% 3Washington 4.5 28 21 27 1.2% 6West Virginia 5.5 22 30 20 0.9% 9Wisconsin 4.5 28 26 24 1.4% 4Wyoming 5.3 24 34 16 0.0% 17

Rankings 14

28




Medicaid Benes Enrolled inAged/Disabled Waivers, 1999Data Rank

Alabama 1.1% 16Alaska 1.3% 14Arizona NA NAArkansas 1.8% 11California 0.3% 23Colorado 3.2% 3Connecticut 2.2% 6Delaware 0.7% 19Dist. of Columbia 0.0% 25Florida 1.1% 16Georgia 1.1% 16Hawaii NA NAIdaho 0.8% 18Illinois 2.0% 9Indiana 0.4% 22Iowa 1.3% 14Kansas 3.9% 2Kentucky 1.9% 10Louisiana 0.1% 24Maine 1.2% 15Maryland 0.0% 25Massachusetts 0.5% 21Michigan 0.5% 21Minnesota 2.0% 8Mississippi 0.5% 21Missouri 2.6% 5Montana 1.6% 12Nebraska 1.1% 16Nevada 1.0% 17New Hampshire 1.5% 13New Jersey 0.6% 20New Mexico 0.4% 22New York 0.6% 20North Carolina 1.0% 17North Dakota 0.6% 20Ohio 2.0% 8Oklahoma 1.9% 10Oregon 5.0% 1Pennsylvania 0.3% 23Rhode Island 1.5% 13South Carolina 2.2% 6South Dakota 1.0% 17Tennessee 0.0% 25Texas 1.1% 16Utah 1.6% 12Vermont 0.8% 18Virginia 2.0% 9Washington 3.0% 4West Virginia 1.5% 13Wisconsin 2.6% 5Wyoming 2.1% 7

Rankings 15

29




Medicare-Certified Home HealthAgencies/1,000 Age 65+, 2000Data Rank

Licensed Adult Day Facililties (#),1998

Data Rank

Residential Care Beds per 1000 65+,1998

Data Rank

Alabama 0.24 18 NL NL 12.4 43Alaska 0.50 5 NL NL 33.8 12Arizona 0.12 29 28 21 32.6 14Arkansas 0.51 4 44 19 13.7 41California 0.17 25 619 2 46.8 3Colorado 0.35 12 NL NL 27.1 19Connecticut 0.20 22 NL NL 6.5 48Delaware 0.17 25 NL NL 7.8 47Dist. of Columbia 0.23 19 NL NL 23.6 24Florida 0.12 29 155 6 24.8 21Georgia 0.13 28 NL NL 24.2 23Hawaii 0.13 28 30 20 18.2 30Idaho 0.41 10 NL NL 33.4 13Illinois 0.21 21 NL NL 5 49Indiana 0.26 16 NL NL 4.2 50Iowa 0.44 8 NL NL 14.1 39Kansas 0.46 7 9 27 17 34Kentucky 0.23 19 82 12 15.6 35Louisiana 0.57 2 282 5 3.7 51Maine 0.20 22 49 18 35.8 10Maryland 0.09 31 125 7 36.9 7Massachusetts 0.18 24 NL NL 11.8 44Michigan 0.16 26 NL NL 37.8 6Minnesota 0.43 9 103 8 29.9 15Mississippi 0.19 23 NL NL 10.2 46Missouri 0.25 17 61 15 29.2 18Montana 0.49 6 51 17 45.5 4Nebraska 0.33 13 NL NL 29.5 17Nevada 0.19 23 12 26 17.6 31New Hampshire 0.28 14 18 23 21.3 27New Jersey 0.05 32 87 10 17.4 32New Mexico 0.35 12 14 25 23.3 25New York 0.09 31 484 3 17.1 33North Carolina 0.17 25 100 9 36.5 8North Dakota 0.37 11 NL NL 18.6 29Ohio 0.26 16 NL NL 24.6 22Oklahoma 0.46 7 21 22 14.7 38Oregon 0.14 27 NL NL 51.8 1Pennsylvania 0.18 24 627 1 36.1 9Rhode Island 0.16 26 17 24 15.3 36South Carolina 0.16 26 73 13 27 20South Dakota 0.46 7 NL NL 20.9 28Tennessee 0.24 18 NL NL 14 40Texas 0.52 3 292 4 14.9 37Utah 0.27 15 67 14 13 42Vermont 0.17 25 NL NL 29.8 16Virginia 0.23 19 55 16 40.4 5Washington 0.10 30 NL NL 49.2 2West Virginia 0.27 15 85 11 11.4 45Wisconsin 0.22 20 NL NL 34.5 11Wyoming 0.76 1 NL NL 23.2 26

Rankings 16

30




Personal & Home Care Aids/100065+, 2000

Data Rank

Personal & Home Care Aids HourlyWage (median), 2000

Data RankHome Health Aids/1000 65+, 2000

Data Rank

Rankings 17

Alabama 6 17 $6.64 43 8 16Alaska 25 3 $10.93 1 18 6 Arizona 4 19 $8.39 7 15 9Arkansas 4 19 $6.41 48 9 15California 9 14 $7.64 31 9 15Colorado 13 10 $7.56 34 15 9Connecticut 10 13 $9.80 2 24 3Delaware NA NA $6.63 44 10 14Dist. of Columbia 7 16 $7.93 19 14 10Florida 4 19 $8.07 16 8 16Georgia 5 18 $7.62 32 8 16Hawaii 2 21 $7.60 33 13 11Idaho 5 18 $7.30 36 18 6Illinois 6 17 $6.60 45 8 16Indiana 9 14 $8.25 10 12 12Iowa 5 18 $7.73 30 13 11Kansas 14 9 $7.81 26 13 11Kentucky 5 18 $7.22 38 10 14Louisiana 11 12 $6.17 50 9 15Maine 28 2 $8.05 17 20 5Maryland 5 18 $8.09 15 10 14Massachusetts 7 16 $9.11 5 18 6Michigan 12 11 $7.85 23 20 5Minnesota 21 5 $8.91 6 30 2Mississippi 3 20 $6.54 46 5 18Missouri 14 9 $7.25 37 11 13Montana 19 6 $6.95 40 10 14Nebraska 3 20 $8.24 12 8 16Nevada 1 22 $8.36 8 7 17New Hampshire 13 10 $7.96 18 10 14New Jersey 5 18 $9.23 4 20 5New Mexico 18 7 $6.97 39 15 9New York 22 4 $7.90 20 44 1North Carolina 14 9 $7.47 35 23 4North Dakota 18 7 $7.77 29 15 9Ohio 6 17 $8.10 14 18 6Oklahoma 11 12 $6.46 47 13 11Oregon 11 12 $8.29 9 15 9Pennsylvania 8 15 $7.80 27 11 13Rhode Island 9 14 $9.49 3 17 7South Carolina 7 16 $7.82 25 8 16South Dakota 12 11 $8.11 13 8 16Tennessee 5 18 $7.90 21 8 16Texas 31 1 $6.11 51 30 2Utah 5 18 $7.80 28 16 8Vermont 7 16 $7.84 24 18 6Virginia 9 14 $6.66 42 11 13Washington 11 12 $7.88 22 16 8West Virginia 12 11 $6.33 49 17 7Wisconsin 15 8 $8.25 11 16 8Wyoming 10 13 $6.70 41 9 15

31




Home Health Aids Hourly Wage(median), 2000

Data Rank

Alabama $7.67 42Alaska $11.05 2Arizona $7.90 33Arkansas $6.79 49California $8.82 11Colorado $10.02 5Connecticut $11.45 1Delaware $9.03 10Dist. of Columbia $8.13 26Florida $8.17 24Georgia $7.68 40Hawaii $7.64 44Idaho $7.64 45Illinois $7.96 31Indiana $8.54 16Iowa $8.13 27Kansas $8.21 23Kentucky $7.91 32Louisiana $7.82 38Maine $8.24 22Maryland $8.04 29Massachusetts $9.92 6Michigan $8.64 15Minnesota $9.36 7Mississippi $8.68 14Missouri $7.67 43Montana $7.58 48Nebraska $9.17 8Nevada $8.05 28New Hampshire $10.21 4New Jersey $9.13 9New Mexico $7.97 30New York $8.17 25North Carolina $7.76 39North Dakota $7.61 47Ohio $8.30 20Oklahoma $7.64 46Oregon $8.44 18Pennsylvania $8.71 13Rhode Island $10.30 3South Carolina $7.87 36South Dakota $7.89 34Tennessee $7.87 37Texas $6.60 50Utah $8.78 12Vermont $8.27 21Virginia $7.68 41Washington $8.43 19West Virginia $6.44 51Wisconsin $8.48 17Wyoming $7.88 35

Rankings 18

32




Total Nursing Facility Residents (#),2001

Data Rank

Nursing Facility Residents (% age65+), 2001

Data RankNF Residents (% change), 1996-2001

Data Rank

Alabama 23,538 23 4.0 20 6.2 7Alaska 638 51 1.7 32 1.9 15Arizona 13,455 33 2.0 31 -0.4 20Arkansas 18,677 28 5.2 10 -10.0 40California 105,923 2 3.0 27 -1.7 23Colorado 16,855 29 4.1 19 -2.0 26Connecticut 29,166 19 6.3 3 -3.4 29Delaware 3,950 46 3.8 21 -2.0 26Dist. of Columbia 2,863 49 4.1 19 18.0 1Florida 70,029 7 2.5 28 14.1 4Georgia 36,356 16 4.7 14 2.4 13Hawaii 3,694 47 2.2 30 13.5 5Idaho 4,619 44 3.2 25 -3.6 31Illinois 81,749 5 5.6 7 -3.5 30Indiana 41,946 10 5.6 7 -6.5 34Iowa 28,825 20 6.7 1 -4.2 32Kansas 21,498 26 6.2 4 -13.0 44Kentucky 22,776 24 4.5 16 4.9 10Louisiana 30,127 18 5.9 5 -5.9 33Maine 7,189 37 4.0 20 -12.3 43Maryland 25,361 22 4.3 18 5.0 9Massachusetts 48,876 8 5.8 6 2.2 14Michigan 41,508 11 3.5 23 -3.6 31Minnesota 38,052 14 6.5 2 -8.8 38Mississippi 15,696 31 4.6 15 3.3 12Missouri 38,706 12 5.1 11 0.0 19Montana 5,928 42 4.9 12 -8.0 36Nebraska 14,492 32 6.5 2 -8.9 39Nevada 4,036 45 1.7 32 14.8 2New Hampshire 7,126 38 4.8 13 -2.6 28New Jersey 45,672 9 4.1 19 5.1 8New Mexico 6,364 40 3.1 26 3.7 11New York 114,141 1 4.6 15 14.2 3North Carolina 37,106 15 3.8 21 1.6 16North Dakota 6,279 41 6.7 1 -7.7 35Ohio 80,930 6 5.4 9 -1.2 22Oklahoma 22,640 25 5.2 10 -11.5 42Oregon 9,444 35 2.3 29 -17.2 45Pennsylvania 82,971 4 4.4 17 -4.2 32Rhode Island 8,923 36 5.9 5 -0.8 21South Carolina 16,117 30 3.2 25 9.4 6South Dakota 6,952 39 6.5 2 -8.6 37Tennessee 34,588 17 4.9 12 0.7 17Texas 85,517 3 4.1 19 -0.4 20Utah 5,592 43 3.0 27 -4.2 32Vermont 3,293 48 4.3 18 -1.9 25Virginia 26,875 21 3.4 24 -1.8 24Washington 20,663 27 3.2 25 -11.5 42West Virginia 10,304 34 3.7 22 0.4 18Wisconsin 38,430 13 5.5 8 -11.3 41Wyoming 2,546 50 4.5 16 -2.5 27

Rankings 19

33




Nursing Facility Residents w/Physical Restraints (%), 2002Data Rank

Nursing Facility Residents w/Pressure (bed) Sores (%), 2002

Data Rank

Medicare Nursing Facility Residents,2001

Data Rank

Alabama 5.0 13 8.0 6 10.0% 18Alaska 7.0 11 9.0 5 7.8% 32Arizona 11.0 7 9.0 5 8.5% 27Arkansas 23.0 1 8.0 6 6.5% 37California 18.0 2 10.0 4 8.8% 24Colorado 7.0 11 6.0 8 6.9% 35Connecticut 12.0 6 8.0 6 12.8% 4Delaware 8.0 10 8.0 6 10.6% 13Dist. of Columbia 5.0 13 13.0 1 7.7% 33Florida 6.0 12 9.0 5 14.2% 1Georgia 13.0 5 10.0 4 8.4% 28Hawaii 7.0 11 6.0 8 8.5% 27Idaho 7.0 11 5.0 9 13.9% 3Illinois 5.0 13 9.0 5 7.9% 31Indiana 7.0 11 10.0 4 10.5% 14Iowa 3.0 15 5.0 9 4.1% 42Kansas 6.0 12 7.0 7 5.7% 40Kentucky 9.0 9 11.0 3 10.3% 15Louisiana 18.0 2 10.0 4 6.0% 39Maine 6.0 12 9.0 5 11.6% 8Maryland 8.0 10 9.0 5 10.5% 14Massachusetts 7.0 11 9.0 5 9.8% 19Michigan 7.0 11 8.0 6 12.5% 5Minnesota 5.0 13 6.0 8 8.3% 29Mississippi 15.0 3 9.0 5 8.1% 30Missouri 9.0 9 7.0 7 7.3% 34Montana 4.0 14 5.0 9 9.1% 22Nebraska 3.0 15 5.0 9 6.1% 38Nevada 12.0 6 10.0 4 9.4% 20New Hampshire 4.0 14 7.0 7 8.9% 23New Jersey 5.0 13 13.0 1 11.3% 10New Mexico 9.0 9 9.0 5 8.5% 27New York 7.0 11 10.0 4 11.5% 9North Carolina 10.0 8 11.0 3 12.4% 6North Dakota 5.0 13 5.0 9 5.5% 41Ohio 8.0 10 9.0 5 9.1% 22Oklahoma 10.0 8 9.0 5 6.0% 39Oregon 14.0 4 8.0 6 7.3% 34Pennsylvania 7.0 11 12.0 2 9.3% 21Rhode Island 8.0 10 8.0 6 9.3% 21South Carolina 10.0 8 10.0 4 12.0% 7South Dakota 8.0 10 7.0 7 6.6% 36Tennessee 14.0 4 9.0 5 10.1% 17Texas 18.0 2 8.0 6 8.7% 25Utah 10.0 8 7.0 7 14.0% 2Vermont 5.0 13 9.0 5 10.5% 14Virginia 8.0 10 11.0 3 11.0% 11Washington 8.0 10 9.0 5 10.8% 12West Virginia 7.0 11 11.0 3 11.0% 11Wisconsin 5.0 13 7.0 7 8.6% 26Wyoming 8.0 10 6.0 8 10.2% 16

Rankings 20

34




Medicaid Nursing Facility Residents,2001

Data Rank

Other Payer Nursing FacilityResidents, 2001

Data Rank

Alabama 72.9% 12 17.1% 36Alaska 83.9% 1 8.3% 45Arizona 63.7% 34 27.8% 12Arkansas 74.0% 7 19.5% 32California 64.6% 30 26.6% 16Colorado 60.2% 39 32.9% 7Connecticut 66.1% 25 21.1% 29Delaware 56.0% 45 33.3% 6Dist. of Columbia 81.6% 2 10.7% 43Florida 61.5% 38 24.3% 22Georgia 77.3% 5 14.4% 42Hawaii 74.4% 6 17.1% 36Idaho 59.6% 41 26.5% 17Illinois 63.6% 35 28.5% 11Indiana 65.4% 28 24.0% 23Iowa 49.6% 49 46.2% 1Kansas 53.1% 47 41.2% 3Kentucky 73.4% 9 16.3% 38Louisiana 78.2% 4 15.8% 39Maine 69.5% 18 18.9% 34Maryland 61.8% 37 27.7% 13Massachusetts 70.1% 17 20.0% 31Michigan 67.2% 21 20.3% 30Minnesota 60.0% 40 31.6% 8Mississippi 81.5% 3 10.4% 44Missouri 66.2% 24 26.5% 17Montana 58.0% 43 32.9% 7Nebraska 52.5% 48 41.3% 2Nevada 64.8% 29 25.8% 18New Hampshire 69.4% 19 21.7% 28New Jersey 66.8% 22 21.9% 27New Mexico 69.4% 19 22.1% 25New York 73.6% 8 14.9% 41North Carolina 71.8% 15 15.8% 39North Dakota 55.8% 46 38.7% 4Ohio 65.8% 26 25.1% 20Oklahoma 63.9% 33 30.1% 10Oregon 62.0% 36 30.7% 9Pennsylvania 64.0% 32 26.7% 15Rhode Island 71.4% 16 19.3% 33South Carolina 72.7% 13 15.3% 40South Dakota 57.0% 44 36.3% 5Tennessee 73.2% 10 16.7% 37Texas 73.0% 11 18.3% 35Utah 58.7% 42 27.2% 14Vermont 67.6% 20 22.0% 26Virginia 66.4% 23 22.6% 24Washington 64.3% 31 24.9% 21West Virginia 72.3% 14 16.7% 37Wisconsin 65.6% 27 25.7% 19Wyoming 62.0% 36 27.8% 12

Rankings 21

35




Nursing Facility Beds/1000 65+, 2001Data Rank

Nursing Facility Beds (% change)1996-2001

Data RankNF Occupancy Rate (%), 2001

Data Rank

Alabama 48 23 7.1 10 91.2 7Alaska 25 35 6.4 12 72.3 41Arizona 30 33 -0.9 30 79.9 30Arkansas 69 10 -21.1 48 74.5 37California 37 30 -6.4 39 81.5 28Colorado 44 26 2.1 25 83.8 22Connecticut 61 15 -1.9 33 91.9 4Delaware 51 20 -3.0 35 83.4 23Dist. of Columbia 48 23 13.5 4 91.3 6Florida 33 31 15.1 3 83.3 24Georgia 50 21 5.1 16 91.3 6Hawaii 27 34 5.6 15 91.4 5Idaho 45 25 6.3 13 72.5 40Illinois 84 4 0.7 26 75.5 36Indiana 67 12 -6.6 40 73.8 38Iowa 91 1 -19.2 47 78.0 33Kansas 68 11 -11.0 44 80.4 29Kentucky 57 17 3.9 20 89.4 13Louisiana 73 7 0.03 27 77.5 35Maine 52 19 -12.7 46 89.8 11Maryland 44 26 9.2 6 83.1 25Massachusetts 72 8 2.6 23 89.7 12Michigan 45 25 -0.8 29 83.8 22Minnesota 89 3 -9.5 43 93.2 2Mississippi 49 22 6.9 11 89.9 10Missouri 90 2 5.0 17 70.5 42Montana 63 13 2.8 21 78.1 32Nebraska 84 4 -4.6 36 83.4 23Nevada 22 36 26.6 1 79.6 31New Hampshire 52 19 -1.1 32 90.4 9New Jersey 48 23 11.7 5 87.1 19New Mexico 33 31 0.0 28 87.6 17New York 52 19 16.2 2 93.9 1North Carolina 47 24 7.6 9 87.9 16North Dakota 81 5 -5.2 37 92.9 3Ohio 78 6 -12.0 45 77.8 34Oklahoma 69 10 -2.4 34 69.1 44Oregon 32 32 -8.0 41 72.8 39Pennsylvania 62 14 -1.0 31 87.5 18Rhode Island 68 11 6.1 14 87.6 17South Carolina 37 30 7.7 8 88.6 15South Dakota 68 11 -5.9 38 91.9 4Tennessee 62 14 2.7 22 88.9 14Texas 59 16 2.7 22 69.3 43Utah 43 27 8.7 7 72.8 39Vermont 53 18 2.5 24 90.6 8Virginia 40 29 4.9 18 86.4 20Washington 42 28 -8.9 42 82.7 26West Virginia 43 27 4.1 19 90.6 8Wisconsin 70 9 -4.6 36 84.2 21Wyoming 53 18 -0.9 30 82.2 27

Rankings 22

36




NF Occupancy Rate (% change),1996-2001

Data Rank

Alabama -0.9 16Alaska -4.2 31Arizona 0.5 12Arkansas 14.1 2California 5.0 5Colorado -3.9 30Connecticut -1.6 18Delaware 1.1 9Dist. of Columbia 4.0 6Florida -0.8 15Georgia -2.5 22Hawaii 7.5 4Idaho -9.3 40Illinois -4.2 31Indiana 0.1 13Iowa 18.5 1Kansas -2.2 21Kentucky 1.0 10Louisiana -6.0 36Maine 0.5 12Maryland -3.9 30Massachusetts -0.4 14Michigan -2.9 25Minnesota 0.8 11Mississippi -3.4 28Missouri -4.7 34Montana -10.4 43Nebraska -4.5 33Nevada -9.3 40New Hampshire -1.5 17New Jersey -6.0 36New Mexico 3.7 7New York -1.7 19North Carolina -5.6 35North Dakota -2.6 23Ohio 12.4 3Oklahoma -9.4 41Oregon -10.0 42Pennsylvania -3.2 27Rhode Island -6.5 38South Carolina 1.5 8South Dakota -2.8 24Tennessee -2.0 20Texas -3.1 26Utah -11.9 44Vermont -4.3 32Virginia -6.3 37Washington -2.8 24West Virginia -3.5 29Wisconsin -7.1 39Wyoming -1.6 18

Rankings 23

37




Total Medicaid Spending (inmillions), 2001

Data Rank

Medicaid Long Term Care spending(% of Medicaid), 2001

Data Rank

Per Capita Long Term CareSpending, 2001

Data Rank

Alabama $2,887,514,793 25 32.1 33 $207.76 37Alaska $580,767,655 47 26.9 42 $246.64 24Arizona $2,641,018,769 27 0.6 50 $2.84 51Arkansas $1,837,854,871 31 35.2 22 $240.42 26California $20,513,230,494 2 24.7 46 $146.83 46Colorado $2,153,318,576 29 35.7 21 $173.93 42Connecticut $3,386,611,586 21 54.4 2 $537.70 2Delaware $593,522,480 46 32.8 28 $244.86 25Dist. of Columbia $974,306,686 39 26.0 43 $442.98 3Florida $8,683,537,438 5 30.5 37 $161.52 44Georgia $5,183,956,791 13 21.2 49 $131.13 48Hawaii $634,119,511 44 33.1 27 $171.72 43Idaho $706,213,899 42 36.5 19 $195.25 40Illinois $8,102,969,450 7 31.3 36 $202.96 38Indiana $4,061,790,272 17 32.2 32 $213.73 35Iowa $1,727,640,228 32 43.7 11 $258.57 22Kansas $1,679,105,534 33 52.8 3 $329.25 13Kentucky $3,387,870,502 20 27.6 41 $230.06 31Louisiana $4,380,632,815 16 38.3 18 $375.60 10Maine $1,349,675,068 36 30.5 37 $319.62 15Maryland $3,311,047,378 22 32.0 34 $197.42 39Massachusetts $7,248,610,148 8 33.8 25 $384.14 8Michigan $7,182,065,339 10 33.2 26 $238.72 27Minnesota $3,908,644,831 18 49.0 6 $385.35 7Mississippi $2,504,510,226 28 25.8 44 $225.96 33Missouri $4,687,678,522 14 35.8 20 $297.99 19Montana $509,348,850 48 42.3 14 $238.27 29Nebraska $1,212,500,510 38 47.7 7 $337.78 11Nevada $689,510,747 43 23.5 47 $77.02 50New Hampshire $878,037,464 40 40.8 15 $284.65 21New Jersey $7,197,164,314 9 44.4 10 $376.26 9New Mexico $1,424,513,281 35 28.8 38 $224.33 34New York $31,605,930,404 1 42.6 13 $708.49 1North Carolina $6,239,709,423 11 32.6 30 $248.87 23North Dakota $415,967,653 50 60.4 1 $396.17 6Ohio $8,480,062,022 6 43.0 12 $320.32 14Oklahoma $2,053,773,185 30 39.5 17 $234.41 30Oregon $2,668,512,151 26 39.7 16 $304.81 18Pennsylvania $10,886,949,361 4 47.0 8 $416.18 4Rhode Island $1,221,804,282 37 34.3 23 $396.52 5South Carolina $3,094,578,743 23 25.5 45 $194.13 41South Dakota $472,298,828 49 50.1 5 $312.93 16Tennessee $5,458,639,159 12 22.0 48 $209.55 36Texas $11,520,544,748 3 28.5 39 $154.20 45Utah $845,837,581 41 28.4 40 $106.05 49Vermont $604,562,212 45 31.5 35 $310.93 17Virginia $3,091,047,377 24 32.7 29 $140.48 47Washington $4,389,519,750 15 32.5 31 $238.41 28West Virginia $1,563,077,593 34 34.0 24 $294.92 20Wisconsin $3,507,045,092 19 51.7 4 $335.59 12Wyoming $246,735,811 51 45.7 9 $228.34 32

Rankings 24

38




Per Capita Medicaid Nursing FacilitySpending, 2001

Data RankPer Capita ICF/MR Spending, 2001

Data Rank

Per Capita Home Health Spending,2001

Data Rank

Alabama $150.89 22 $13.82 37 $8.67 16Alaska $112.95 36 $0.00 50 $1.06 41Arizona $2.31 51 $0.00 50 $0.10 48Arkansas $137.29 26 $35.76 20 $8.57 17California $75.31 46 $12.17 40 $4.24 29Colorado $81.42 44 $3.63 45 $16.53 5Connecticut $299.06 3 $67.30 7 $45.12 2Delaware $138.84 25 $38.78 18 $7.84 19Dist. of Columbia $278.02 4 $136.45 1 $24.40 4Florida $103.86 38 $17.72 36 $5.25 24Georgia $90.70 41 $13.36 39 $5.76 21Hawaii $121.12 34 $6.54 44 $1.85 37Idaho $90.06 43 $46.19 13 $5.21 26Illinois $120.16 35 $53.60 9 $1.27 40Indiana $133.71 29 $48.55 12 $8.49 18Iowa $127.78 31 $69.40 5 $16.36 6Kansas $177.84 15 $25.59 30 $8.92 15Kentucky $139.05 24 $23.20 34 $28.87 3Louisiana $259.43 5 $79.57 3 $5.24 25Maine $156.60 20 $34.87 21 $5.15 27Maryland $129.63 30 $10.87 41 $11.34 8Massachusetts $223.11 9 $33.21 23 $10.28 12Michigan $174.57 17 $3.12 47 $1.43 39Minnesota $181.28 14 $43.78 14 $11.77 7Mississippi $145.45 23 $59.56 8 $3.94 32Missouri $184.92 13 $32.79 25 $0.86 42Montana $123.05 33 $23.63 33 $0.68 44Nebraska $215.93 10 $27.88 27 $10.44 10Nevada $43.79 49 $13.73 38 $3.36 34New Hampshire $166.64 18 $1.71 49 $4.16 31New Jersey $258.51 6 $49.68 10 $6.29 20New Mexico $90.65 42 $10.07 42 $0.44 45New York $336.24 1 $113.59 2 $54.53 1North Carolina $107.04 37 $48.88 11 $10.36 11North Dakota $238.58 7 $75.92 4 $4.24 30Ohio $203.42 12 $69.20 6 $5.44 22Oklahoma $123.19 32 $32.98 24 $0.20 47Oregon $156.32 21 $3.23 46 $0.21 46Pennsylvania $299.83 2 $39.57 17 $5.27 23Rhode Island $230.90 8 $6.71 43 $3.18 35South Carolina $91.96 40 $41.62 15 $4.99 28South Dakota $205.40 11 $24.48 31 $3.65 33Tennessee $136.70 28 $40.56 16 $0.01 49Texas $75.22 47 $33.98 22 $0.00 50Utah $40.67 50 $23.90 32 $1.48 38Vermont $137.23 27 $2.66 48 $10.54 9Virginia $73.51 48 $26.08 29 $0.70 43Washington $102.57 39 $21.82 35 $2.19 36West Virginia $162.77 19 $26.52 28 $10.54 9Wisconsin $177.77 16 $38.08 19 $10.12 13Wyoming $79.61 45 $30.07 26 $9.72 14

Rankings 25

39




Per Capita 1915 (c) HCBS WaiverSpending, 2001

Data Rank

Per Capita Personal Care Spending,2001

Data Rank

Medicaid Aged/Disabled per $100Nursing Home Spending, 2001

Data Rank

Alabama $34.37 39 NA NA $6 17Alaska $119.23 6 $13.40 14 $22 5Arizona NA NA $0.42 31 NA NAArkansas $35.81 38 $22.99 11 $8 15California $15.24 48 $39.88 2 $2 21Colorado $72.35 20 NA NA $21 6Connecticut $126.22 4 NA NA $6 17Delaware $59.40 24 NA NA $9 14Dist. of Columbia $2.58 50 $1.54 27 $1 22Florida $33.63 40 $1.07 29 $6 17Georgia $21.32 46 NA NA $10 13Hawaii $42.21 31 NA NA $15 9Idaho $44.30 29 $9.50 18 $25 3Illinois $27.93 44 NA NA $5 18Indiana $22.97 45 NA NA $2 21Iowa $45.02 28 NA NA $4 19Kansas $112.38 8 $4.53 22 $11 12Kentucky $38.94 36 NA NA $13 10Louisiana $31.36 43 NA NA $1 22Maine $118.86 7 $4.14 24 $7 16Maryland $39.90 34 $5.69 21 $1 22Massachusetts $79.67 16 $37.87 3 $1 22Michigan $41.24 32 $18.35 13 NA NAMinnesota $122.63 5 $25.89 8 $6 17Mississippi $17.01 47 NA NA $7 16Missouri $52.69 27 $26.73 6 $7 16Montana $64.83 23 $26.08 7 $19 7Nebraska $79.33 17 $4.19 23 $8 15Nevada $13.04 49 $3.10 25 $8 15New Hampshire $109.41 9 $2.73 26 $6 17New Jersey $38.42 37 $23.36 10 $3 20New Mexico $87.31 13 $35.85 4 $13 10New York $105.79 11 $98.35 1 $0 23North Carolina $55.57 25 $27.02 5 $23 4North Dakota $77.42 19 NA NA $3 20Ohio $42.26 30 NA NA $12 11Oklahoma $66.94 22 $11.10 17 $9 14Oregon $135.77 3 $9.28 19 $41 2Pennsylvania $71.51 21 NA NA $1 22Rhode Island $155.73 1 NA NA $8 15South Carolina $55.12 26 $0.43 30 $22 5South Dakota $78.21 18 $1.20 28 $1 22Tennessee $32.28 42 NA NA $1 22Texas $32.46 41 $12.54 16 $25 3Utah $39.64 35 $0.36 32 $3 20Vermont $153.13 2 $7.37 20 $19 7Virginia $40.20 33 NA NA $16 8Washington $86.29 14 $25.54 9 $47 1West Virginia $81.68 15 $13.40 15 $15 9Wisconsin $90.32 12 $19.30 12 $19 7Wyoming $108.93 10 NA NA NA NA

Rankings 26

40




Medicaid Aged/Disabled Waiver Expenditures (% of Total 1915(c) HCBS Waivers), 2001

Data Rank

Medicaid Federal Matching Funds(%), FY 2003

Data Rank

Home and Community-Based ServicesExpenditures (% of LTC), 2001Data Rank

Alabama 28.5 18 70.6 9 20.7% 38Alaska 20.8 23 58.3 30 54.2% 3Arizona NA NA 67.3 14 18.4% 40Arkansas 30.2 15 74.3 4 28.0% 28California 9.8 36 50.0 35 40.4% 10Colorado 23.4 21 50.0 35 51.1% 5Connecticut 14.5 31 50.0 35 31.9% 21Delaware 19.9 25 50.0 35 27.5% 30Dist. of Columbia 72.6 1 70.0 10 6.4% 48Florida 19.0 26 58.8 28 24.7% 36Georgia 41.9 11 59.6 26 20.6% 39Hawaii 43.3 10 58.8 28 25.7% 33Idaho 50.8 6 71.0 8 30.2% 23Illinois 20.5 24 50.0 35 14.4% 45Indiana 12.6 33 62.0 21 14.7% 44Iowa 12.4 34 63.5 18 23.7% 37Kansas 16.9 29 60.2 24 38.2% 14Kentucky 45.4 8 69.9 11 29.5% 24Louisiana 6.8 40 71.3 6 9.7% 46Maine 9.2 37 66.2 15 40.1% 11Maryland 2.4 44 50.0 35 28.8% 27Massachusetts 1.5 46 50.0 35 33.3% 20Michigan NA NA 55.4 31 25.6% 34Minnesota 8.2 39 50.0 35 41.6% 8Mississippi 60.7 2 76.6 1 9.3% 47Missouri 24.8 20 61.2 23 26.9% 31Montana 35.7 14 73.0 5 38.4% 13Nebraska 22.4 22 59.5 27 27.8% 29Nevada 26.4 19 52.4 33 25.3% 35New Hampshire 8.8 38 50.0 35 40.9% 9New Jersey 17.8 27 50.0 35 18.1% 41New Mexico 13.5 32 74.6 3 55.1% 1New York 1.3 47 50.0 35 36.5% 16North Carolina 44.3 9 62.6 19 37.3% 15North Dakota 9.2 37 68.4 13 20.6% 39Ohio 58.7 3 58.8 28 14.9% 43Oklahoma 15.8 30 70.6 9 33.4% 19Oregon 47.2 7 60.2 24 47.7% 7Pennsylvania 6.2 41 54.7 32 18.4% 40Rhode Island 11.1 35 55.4 31 40.1% 11South Carolina 37.2 12 69.8 12 31.2% 22South Dakota 3.9 42 65.3 16 26.5% 32Tennessee 2.1 45 64.6 17 15.4% 42Texas 57.6 4 60.0 25 29.2% 25Utah 3.2 43 71.2 7 39.1% 12Vermont 17.0 28 62.4 20 55.0% 2Virginia 30.0 16 50.5 34 29.1% 26Washington 55.7 5 50.0 35 47.8% 6West Virginia 29.5 17 75.0 2 35.8% 17Wisconsin 36.7 13 58.4 29 35.7% 18Wyoming NA NA 61.3 22 52.0% 4

Rankings 27

41




Home and Community-Based ServicesExpenditures (% of LTC), 1996Data Rank

Nursing Facility Care Expenditures(% total LTC), 2001

Data Rank

Nursing Facility Care Expenditures(% total LTC), 1996

Data Rank

Alabama 19.2% 28 72.6% 3 70.1% 8Alaska 20.7% 26 45.8% 44 69.4% 10Arizona 5.2% 44 81.6% 1 94.8% 1Arkansas 21.0% 25 57.1% 25 58.3% 32California 17.3% 31 51.3% 35 67.3% 13Colorado 36.2% 5 46.8% 42 59.1% 29Connecticut 22.8% 18 55.6% 28 63.5% 21Delaware 23.1% 17 56.7% 27 54.1% 39Dist. of Columbia 7.7% 42 62.8% 16 62.8% 22Florida 19.3% 27 64.3% 13 67.4% 12Georgia 15.8% 34 69.2% 6 70.5% 7Hawaii 12.8% 37 70.5% 5 80.3% 3Idaho 22.7% 19 46.1% 43 53.2% 40Illinois 9.0% 40 59.2% 21 60.9% 25Indiana 6.8% 43 62.6% 17 65.2% 18Iowa 13.5% 36 49.4% 36 52.1% 41Kansas 28.2% 10 54.0% 30 50.0% 43Kentucky 24.0% 14 60.4% 19 66.4% 14Louisiana 8.5% 41 69.1% 7 57.0% 34Maine 23.2% 16 49.0% 37 62.4% 23Maryland 32.5% 7 65.7% 9 58.0% 33Massachusetts 21.9% 23 58.1% 24 63.9% 19Michigan 22.2% 21 73.1% 2 65.7% 16Minnesota 17.5% 30 47.0% 41 69.8% 9Mississippi 4.4% 46 64.4% 12 70.8% 5Missouri 25.7% 12 62.1% 18 58.0% 33Montana -6.7% 47 51.6% 34 93.1% 2Nebraska 23.2% 16 63.9% 14 65.4% 17Nevada 15.0% 35 56.9% 26 61.7% 24New Hampshire 33.2% 6 58.5% 22 65.8% 15New Jersey 22.3% 20 68.7% 8 58.6% 31New Mexico 40.0% 3 40.4% 47 47.4% 47New York 30.8% 8 47.5% 39 49.4% 45North Carolina 24.2% 13 43.0% 46 51.6% 42North Dakota 17.0% 32 60.2% 20 59.9% 27Ohio 10.7% 39 63.5% 15 68.8% 11Oklahoma 21.7% 24 52.6% 32 58.8% 30Oregon 50.2% 1 51.3% 35 33.9% 48Pennsylvania 12.0% 38 72.0% 4 70.7% 6Rhode Island 26.5% 11 58.2% 23 63.7% 20South Carolina 16.1% 33 47.4% 40 50.0% 43South Dakota 23.7% 15 65.6% 10 59.2% 28Tennessee 4.8% 45 65.2% 11 72.0% 4Texas 19.1% 29 48.8% 38 55.6% 37Utah 25.7% 12 38.4% 48 48.2% 46Vermont 42.5% 2 44.1% 45 55.4% 38Virginia 22.0% 22 52.3% 33 56.0% 36Washington 29.7% 9 43.0% 46 57.0% 34West Virginia 30.8% 8 55.2% 29 56.2% 35Wisconsin 22.7% 19 53.0% 31 60.7% 26Wyoming 39.4% 4 34.9% 49 49.5% 44

Rankings 28

42




ICF/MR Facility Expenditures (%total LTC), 2001

Data Rank

ICF/MR Facility Expenditures (%total LTC), 1996

Data Rank

Medicaid NF reimbursement per day (average), 1998

Data Rank

Alabama 6.7% 35 10.7% 39 $99 15Alaska 0.0% 45 9.9% 40 $253 1Arizona 0.0% 45 0.0% 47 $94 18Arkansas 14.9% 18 20.8% 15 $62 34California 8.3% 33 15.4% 25 $83 24Colorado 2.1% 39 4.7% 44 $102 14Connecticut 12.5% 21 13.7% 29 $134 4Delaware 15.8% 17 22.8% 13 $109 11Dist. of Columbia 30.8% 1 29.5% 5 $180 2Florida 11.0% 24 13.4% 31 $98 16Georgia 10.2% 26 13.8% 28 $81 26Hawaii 3.8% 38 6.9% 43 $130 5Idaho 23.7% 4 24.1% 10 $94 18Illinois 26.4% 3 30.0% 4 $70 31Indiana 22.7% 5 28.1% 6 $80 27Iowa 26.8% 2 34.3% 2 $72 30Kansas 7.8% 34 21.9% 14 $72 30Kentucky 10.1% 27 9.5% 42 $89 21Louisiana 21.2% 10 34.5% 1 $66 32Maine 10.9% 25 14.4% 26 $116 8Maryland 5.5% 36 9.5% 42 $99 15Massachusetts 8.6% 32 14.2% 27 $117 7Michigan 1.3% 41 12.0% 36 $91 20Minnesota 11.4% 22 12.7% 34 $106 12Mississippi 26.4% 3 24.8% 9 $81 26Missouri 11.0% 24 16.4% 23 $88 22Montana 9.9% 28 13.6% 30 $88 22Nebraska 8.3% 33 11.3% 37 $82 25Nevada 17.8% 15 23.3% 11 $86 23New Hampshire 0.6% 44 1.1% 46 $115 9New Jersey 13.2% 20 19.1% 19 $116 8New Mexico 4.5% 37 12.6% 35 $129 6New York 16.0% 16 19.8% 17 $159 3North Carolina 19.6% 11 24.1% 10 $95 17North Dakota 19.2% 13 23.1% 12 $94 18Ohio 21.6% 8 20.5% 16 $109 11Oklahoma 14.1% 19 19.5% 18 $64 33Oregon 1.1% 42 15.9% 24 $89 21Pennsylvania 9.5% 29 17.3% 20 $114 10Rhode Island 1.7% 40 9.7% 41 $104 13South Carolina 21.4% 9 33.9% 3 $83 24South Dakota 7.8% 34 17.1% 21 $77 29Tennessee 19.4% 12 23.1% 12 $83 24Texas 22.0% 7 25.3% 8 $72 30Utah 22.5% 6 26.1% 7 $83 24Vermont 0.9% 43 2.2% 45 $104 13Virginia 18.6% 14 21.9% 14 $79 28Washington 9.2% 30 13.3% 32 $116 8West Virginia 9.0% 31 13.0% 33 $106 12Wisconsin 11.3% 23 16.6% 22 $92 19Wyoming 13.2% 20 11.0% 38 $94 18

Rankings 29

43




Medicare Reimbursement per day forNF care (average), 2000

Data Rank

Private Pay Rate per day in NF(average), 2001

Data Rank

Medicare reimbursement per HomeHealth Visit (average), 2000Data Rank

Alabama $193 39 $123 34 $67 23Alaska $262 7 $448 1 $138 1Arizona $269 5 $162 16 $88 10Arkansas $185 42 $105 42 $64 26California $311 1 $166 13 $108 4Colorado $270 4 $140 27 $83 15Connecticut $232 19 $256 2 $72 21Delaware $231 20 $160 17 $90 9Dist. of Columbia $254 11 $241 4 $97 5Florida $255 10 $153 20 $83 15Georgia $207 34 $114 38 $78 18Hawaii $261 8 $238 5 $110 3Idaho $217 28 $144 25 $88 10Illinois $239 14 $136 30 $91 8Indiana $225 25 $142 26 $78 18Iowa $213 30 $119 35 $66 24Kansas $228 23 $111 40 $73 20Kentucky $203 36 $139 28 $72 21Louisiana $233 18 $99 43 $65 25Maine $222 26 $186 9 $72 21Maryland $237 16 $164 15 $94 6Massachusetts $254 11 $222 6 $79 17Michigan $212 31 $157 19 $92 7Minnesota $205 35 $157 19 $79 17Mississippi $187 40 $118 36 $64 26Missouri $229 22 $112 39 $83 15Montana $209 33 $128 32 $78 18Nebraska $218 27 $138 29 $80 16Nevada $270 4 $165 14 $88 10New Hampshire $240 13 $190 7 $73 20New Jersey $264 6 $222 6 $91 8New Mexico $228 23 $159 18 $79 17New York $252 12 $247 3 $87 11North Carolina $186 41 $146 24 $84 14North Dakota $174 43 $174 12 $72 21Ohio $235 17 $150 21 $84 14Oklahoma $226 24 $110 41 $64 26Oregon $276 2 $160 17 $116 2Pennsylvania $230 21 $187 8 $86 12Rhode Island $232 19 $190 7 $84 14South Carolina $198 37 $127 33 $85 13South Dakota $174 43 $131 31 $76 19Tennessee $209 33 $127 33 $72 21Texas $238 15 $115 37 $76 19Utah $259 9 $131 31 $76 19Vermont $197 38 $182 10 $60 27Virginia $217 28 $139 28 $79 17Washington $275 3 $175 11 $110 3West Virginia $211 32 $136 30 $80 16Wisconsin $216 29 $148 22 $80 16Wyoming $216 29 $147 23 $68 22

Rankings 30

44




Rankings 31

Avg Hourly Rate LPN, 2002Data Rank

Avg Hourly Rate HHA, 2002Data Rank

Alabama $23 51 $13 51Alaska $66 2 $27 1Arizona $42 13 $18 25Arkansas $27 45 $14 48California $36 20 $18 24Colorado $49 7 $22 4Connecticut $43 11 $23 2Delaware $40 15 $19 13Dist. of Columbia $54 5 $16 37Florida $33 33 $15 43Georgia $31 37 $17 30Hawaii $30 40 $19 12Idaho $33 26 $16 36Illinois $35 21 $18 18Indiana $32 36 $19 14Iowa $28 41 $18 22Kansas $27 47 $17 27Kentucky $43 10 $19 11Louisiana $26 49 $13 49Maine $27 43 $18 17Maryland $33 28 $15 44Massachusetts $37 17 $21 6Michigan $30 39 $17 29Minnesota $32 35 $22 3Mississippi $26 48 $13 50Missouri $31 38 $17 31Montana $25 50 $15 42Nebraska $48 8 $19 16Nevada $46 9 $20 9New Hampshire $33 27 $21 7New Jersey $37 19 $18 20New Mexico $33 32 $17 32New York $34 25 $17 33North Carolina $33 29 $17 34North Dakota $43 12 $18 21Ohio $27 44 $16 38Oklahoma $33 30 $16 39Oregon $62 3 $17 26Pennsylvania $32 34 $18 19Rhode Island $34 22 $20 8South Carolina $27 46 $15 46South Dakota $34 24 $14 47Tennessee $27 42 $15 41Texas $34 23 $18 23Utah $37 18 $20 10Vermont $37 16 $17 28Virginia $42 14 $16 35Washington $60 4 $19 15West Virginia $33 31 $16 40Wisconsin $75 1 $21 5Wyoming $53 6 $15 45

45

LONG-TERM CARE MAPS



States with Regs Including Assistedliving philosophy, 2002

Data

States Require Private Rooms inAssisted Living, 2002

Data

States Require Disclosure on special care units, 2002

Data

Alabama No No NoAlaska No No NoArizona Yes Yes NoArkansas Yes Yes YesCalifornia No No YesColorado No No NoConnecticut No Yes NoDelaware Yes No YesDist. of Columbia No No NAFlorida Yes Yes YesGeorgia No No YesHawaii Yes Yes NoIdaho Yes No NoIllinois Yes Yes YesIndiana No No NoIowa Yes Yes NoKansas Yes Yes NoKentucky Yes No YesLouisiana Yes Yes NoMaine Yes No NoMaryland Yes No YesMassachusetts Yes No NoMichigan No No NoMinnesota No No YesMississippi No No NoMissouri No No YesMontana Yes No YesNebraska Yes No NoNevada No No NoNew Hampshire No No NoNew Jersey Yes No NoNew Mexico Yes Yes NoNew York No No NoNorth Carolina No No YesNorth Dakota No No NoOhio No No YesOklahoma No No YesOregon Yes Yes YesPennsylvania No No YesRhode Island Yes Yes YesSouth Carolina Yes No YesSouth Dakota No No NoTennessee No No NoTexas Yes No YesUtah Yes Yes NoVermont Yes Yes YesVirginia Yes No NoWashington Yes Yes YesWest Virginia Yes No YesWisconsin Yes Yes NoWyoming Yes No No

Rankings 32

46

LONG-TERM CARE MAPS



Proportion for-profit nursingfacilities, 2001

Data Rank

States w/ Legislation for Nurse staffshortages 2000

Data

States Mandating CNA trainingabove 75 hours, 2000

Data

Alabama 77.2 5 No NoAlaska 6.7 49 No NAArizona 69.8 18 No YesArkansas 79.6 3 Yes NoCalifornia 75.6 7 Yes YesColorado 63.7 27 No NoConnecticut 76.4 6 Yes NADelaware 45.2 40 No NoDist. of Columbia 28.6 46 No NoFlorida 75.1 9 Yes NAGeorgia 75.6 7 No YesHawaii 44.4 41 No NoIdaho 59.5 32 No YesIllinois 65.8 23 No YesIndiana 68.9 20 No YesIowa 52.1 35 No NoKansas 49.5 36 Yes NAKentucky 65.1 25 No NALouisiana 75.3 8 Yes YesMaine 71.4 15 Yes YesMaryland 57.0 33 Yes NoMassachusetts 70.0 17 Yes NoMichigan 62.4 30 Yes NoMinnesota 28.1 47 Yes NAMississippi 70.9 16 No NAMissouri 63.9 26 Yes NAMontana 35.9 44 Yes YesNebraska 46.1 39 No NANevada 71.7 14 No NoNew Hampshire 53.0 34 No YesNew Jersey 62.4 31 No YesNew Mexico 62.5 29 No NoNew York 48.1 37 No YesNorth Carolina 72.4 12 No NoNorth Dakota 10.3 48 No NoOhio 72.9 11 No NAOklahoma 83.1 1 Yes NoOregon 73.1 10 No YesPennsylvania 43.3 43 No NoRhode Island 75.3 8 No NASouth Carolina 72.1 13 Yes NASouth Dakota 33.0 45 No NoTennessee 67.6 21 No NoTexas 81.3 2 Yes NoUtah 78.3 4 Yes NoVermont 65.9 22 Yes NoVirginia 63.5 28 Yes YesWashington 69.0 19 No YesWest Virginia 65.5 24 No NoWisconsin 47.5 38 Yes NAWyoming 43.6 42 No NA

Rankings 33

47

LONG-TERM CARE MAPS



Proportion of Deaths at home, 1997

Data RankStates Offering Tax Incentives for Long-Term Care Insurance, 2002

Data

Alabama 29.2 9 Tax Credit or Deduction More Generous than FederalAlaska 35.8 1 No Broad-Based State Income TaxArizona 25.5 18 Tax Credit or Deduction More Generous than FederalArkansas 25.0 20 Tax Deduction Same as FederalCalifornia 26.9 13 Tax Deduction Same as FederalColorado 29.0 10 Tax Credit or Deduction More Generous than FederalConnecticut 21.3 35 No Tax IncentivesDelaware 27.7 11 Tax Deduction Same as FederalDist. of Columbia 14.7 44 Tax Deduction Same as FederalFlorida 27.4 12 No Broad-Based State Income TaxGeorgia 19.3 41 Tax Deduction Same as FederalHawaii 22.7 32 Tax Deduction Same as FederalIdaho 32.3 4 Tax Credit or Deduction More Generous than FederalIllinois 19.5 40 Tax Credit or Deduction More Generous than FederalIndiana 23.1 31 Tax Credit or Deduction More Generous than FederalIowa 20.9 38 Tax Credit or Deduction More Generous than FederalKansas 23.2 30 Tax Deduction Same as FederalKentucky 24.6 22 Tax Credit or Deduction More Generous than FederalLouisiana 21.0 37 No Tax IncentivesMaine 23.8 26 Tax Credit or Deduction More Generous than FederalMaryland 26.7 14 Tax Credit or Deduction More Generous than FederalMassachusetts 22.4 33 Tax Deduction Same as FederalMichigan 25.6 17 No Tax IncentivesMinnesota 23.7 27 Tax Credit or Deduction More Generous than FederalMississippi 21.5 34 Tax Deduction Same as FederalMissouri 23.2 30 Tax Credit or Deduction More Generous than FederalMontana 27.7 11 Tax Credit or Deduction More Generous than FederalNebraska 18.8 42 Tax Deduction Same as FederalNevada 31.7 6 No Broad-Based State Income TaxNew Hampshire 23.6 28 No Broad-Based State Income TaxNew Jersey 26.9 13 Tax Credit or Deduction More Generous than FederalNew Mexico 32.1 5 Tax Credit or Deduction More Generous than FederalNew York 21.2 36 Tax Credit or Deduction More Generous than FederalNorth Carolina 23.9 25 Tax Credit or Deduction More Generous than FederalNorth Dakota 18.4 43 Tax Credit or Deduction More Generous than FederalOhio 23.1 31 Tax Credit or Deduction More Generous than FederalOklahoma 24.1 24 Tax Deduction Same as FederalOregon 35.1 2 Tax Credit or Deduction More Generous than FederalPennsylvania 23.2 30 No Tax IncentivesRhode Island 20.9 38 Tax Deduction Same as FederalSouth Carolina 25.1 19 Tax Deduction Same as FederalSouth Dakota 19.3 41 No Broad-Based State Income TaxTennessee 19.8 39 No Broad-Based State Income TaxTexas 23.3 29 No Broad-Based State Income TaxUtah 34.1 3 Tax Credit or Deduction More Generous than FederalVermont 29.6 8 Tax Deduction Same as FederalVirginia 24.9 21 Tax Credit or Deduction More Generous than FederalWashington 30.0 7 No Broad-Based State Income TaxWest Virginia 26.5 16 Tax Credit or Deduction More Generous than FederalWisconsin 24.5 23 Tax Credit or Deduction More Generous than FederalWyoming 26.6 15 No Broad-Based State Income Tax

Rankings 34

49

DataDocumentation

50

Data Documentation

DEMOGRAPHICS

Distribution of Population, by Age, 2000 & 2020 (Projected) – AARP Public Policy Institutecalculations based on (1) 2000: U.S. Census Bureau, Census 2000 Summary File 1, Table: P12. Sexby Age [49]; <http://factfinder.census.gov>; and (2) 2020: Regional Economic Models, Inc.,Demographic Module. These projection data are based on Census 1990 population counts andderived from “State Population Projections” (PE-45, Series A), U.S. Census Bureau, 1996, and tabu-lated by AARP Research Group, 1998. EXPLANATION: 2000: Refers to the count of the total U.S.resident population and the proportion of the population age 50 and over, by age group, as of April1, 2000, including members of the armed forces stationed in the area; 2020 (Projected): Refers tothe projected total U.S. resident population and the percentage of the population age 50 and over, byage group; % Change in Population #: Refers to the projected cumulative percent change in thepopulation numbers in each age group over the 20-year period. For example, the U.S. populationage 50-64 was 41,860,232 in 2000 (14.9% of 281,421,906), and was projected to be 61,377,849 in2020 (18.7% of 327,909,900). Among persons age 50-64, these population numbers represent a46.6% increase from 2000 to 2020. Note: Readers may determine the total numbers for each agegroup in each state by using the percentages in the age group columns and the numbers in the totalpopulation column; however, due to rounding to one decimal point, using the population percent-ages for each age group to calculate, population numbers may not result in a precise match to thenumbers published in the total population column. The total population column reports the exactnumber from the Census.

Minority/Ethnic Population Age 65+ (%), 2000 – AARP Public Policy Institute calculations basedon U.S. Census Bureau, Census 2000 Summary File 1, Tables: PCT H through O, compiled by U.S.Administration on Aging; <http://www.aoa.dhhs.gov/aoa/STATS/2000pop/number65plusxrace-HO.html>. EXPLANATION: Refers to the percentage of the total population age 65 and over whodefine their race as Black/African American, American Indian/Alaska Native, NativeHawaiian/Pacific Islander, Asian, two or more races, or another race, or who define their ethnicityas Hispanic/Latino (of any race).

Minority/Ethnic Population Age 65+ (% change), 1990-2000 – AARP Public Policy Institutecalculations based on (1) 2000: U.S. Census Bureau, Census 2000 Summary File 1, Tables: PCT Hthrough O, compiled by U.S. Administration on Aging; <http://www.aoa.dhhs.gov/aoa/STATS/2000pop/number65plusxrace-HO.html>; and (2) 1990: U.S. Census Bureau, 1990 Census, Table:(ST-99-33) Population of States by Age, Race, Sex, and Hispanic Origin: April 1, 1990;<http://eire.census.gov/popest/archives/state/sasrh/sasrhmars.txt>. EXPLANATION: Refers to thecumulative percent change in the population counts for the population age 65 and over who definetheir race as Black/African American, American Indian/Alaska Native, Native Hawaiian/PacificIslander, Asian, two or more races, or another race, or who define their ethnicity as Hispanic/Latino(of any race).

Rural Population Age 65+ (%), 2000 – AARP Public Policy Institute calculations based on U.S.Census Bureau, Census 2000 Summary File 1, Table: P12. Sex by Age [49] (by geographic compo-nent = rural); <http://factfinder.census.gov>. EXPLANATION: Refers to the population age 65 andover living in rural areas as a percentage of the total population age 65 and over in 2000. The “rural”classification is a territory, population, or housing unit not classified as “urban” which can cutacross other geographic hierarchies and can be located in metropolitan or non-metropolitan areas.

Bachelor Level Education or Higher Age 65+ (%), 2000 – U.S. Census Bureau special analysis ofthe Census 2000 Supplementary Survey for the AARP Public Policy Institute. EXPLANATION:

Note: U.S. figures do not include territories.

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Data DocumentationRefers to the population age 65 and over with a Bachelor’s level degree or higher as a percentage ofthe total population age 65 and over in 2000.

Family Income Age 65+ (median), 2000 – U.S. Census Bureau special analysis of the Census 2000Supplementary Survey for the AARP Public Policy Institute; U.S. income figure based on AARPPublic Policy Institute analysis of the Census 2000 Supplementary Survey. EXPLANATION:Refers to the median family income in 1999 (in 2000 inflation-adjusted dollars) for families with ahouseholder who is age 65 and over.

Poverty Status Age 65+ (%), 1999 – AARP Public Policy Institute analysis of the U.S. CensusBureau, Census 2000 Supplementary Survey. EXPLANATION: Refers to the population age 65 andover at or below poverty level and 101 percent to 200 percent of poverty level as a percentage of thetotal population age 65 and over in 2000. Note: For the population age 65 and over in 2000, povertystatus is based on reported income in the previous 12 months (i.e., poverty status in 1999). In 1999,the poverty threshold for an individual age 65 and over was $7,790, and $10,070 for a two personfamily age 65 and over.

Population Age 85+ (% change), 1990-2000 – AARP Public Policy Institute calculations based onU.S. Census, Census 2000 Summary File 1, Table: PHC-T-13. Population 85 Years and Over, forStates and for Puerto Rico: 1990 and 2000; <http://www.census.gov/population/cen2000/phc-t13/tab07.txt>. EXPLANATION: Refers to the cumulative percent change in the population countsfor the population age 85 and over during the 10-year period.

Men per 100 Women Age 85+ (#), 2000 – AARP Public Policy Institute calculations based on U.S.Census Bureau, Census 2000 Summary File 1, Table: P12. Sex by Age [49]; <http://factfinder.census.gov>. EXPLANATION: Refers to number of men age 85 and over per 100 women age 85and over (i.e., ratio) in 2000.

Women Age 85+ Below Poverty Level (%), 1999 – AARP Public Policy Institute analysis of theU.S. Census Bureau, Census 2000 Supplementary Survey. EXPLANATION: Refers to women age85 and over at or below poverty level as a percentage of the total female population age 85 and overin 2000. Note: For the female population age 85 and over in 2000, poverty status is based onreported income in the previous 12 months (i.e., poverty status in 1999). In 1999, the povertythreshold for an individual age 65 and over was $7,790, and $10,070 for a two person family age 65and over. Estimates identified with “**” in the rankings section are based on fewer than 30 obser-vations; therefore, percentages and resulting rankings are less reliable than those for other states.

Persons Age 65+ Living Alone (%), 2000 – AARP Public Policy Institute analysis of the U.S.Census Bureau, Census 2000 Supplementary Survey. EXPLANATION: Refers to persons age 65and over living alone in household as a percentage of all persons age 65 and over in 2000.

Persons Age 65+ with Activity Limitations, 2000 – AARP Public Policy Institute analysis of theU.S. Census Bureau, Census 2000 Supplementary Survey. EXPLANATION: Self-CareLimitations: Percent of persons age 65 and over with a long-lasting (6 months or more) physical,mental, or emotional condition that made it difficult to dress, bathe, or get around inside the home;Mobility Limitations: Percent of persons age 65 and over with a long-lasting physical or mentalcondition that made it difficult to go outside the home alone to shop or visit a doctor’s office; Self-Care or Mobility Limitations: Percent of persons age 65 and over with a self-care limitation and/ora mobility limitation; Sensory Limitations: Percent of persons age 65 and over with long-lastingblindness, deafness, severe vision, or hearing impairment; Cognitive/Mental Limitations: Percentof persons age 65 and over with a long-lasting physical, mental, or emotional condition that made itdifficult to learn, remember, or concentrate.Note: U.S. figures do not include territories.

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Data Documentation


Homeownership Rate Age 65+ (%), 2000 – AARP Public Policy Institute analysis of the U.S.Census Bureau, Census 2000 Supplementary Survey. EXPLANATION: Refers to householdsowning their home where the householder is age 65 and over as a percentage of total households in2000.

Housing Over 40 Years Old Age 65+ (%), 2000 – AARP Public Policy Institute analysis of the U.S.Census Bureau, Census 2000 Supplementary Survey. EXPLANATION: Refers to owned and rentedoccupied housing units over 40 years old where the householder is age 65 and over as a percentageof total occupied housing units in 2000.

Persons Age 75+ with Driver’s License (%), 2000 – AARP Public Policy Institute calculationsbased on (1) Office of Highway Policy Information, Federal Highway Administration (FHWA),Highway Statistics 2000, October 2001; <http://www.fhwa.dot.gov/ohim/hs00/dl22.htm>; (2) U.S.Census Bureau, Census 2000 Summary File 1, Table: P12. Sex by Age [49];<http://factfinder.census.gov>; (3) Office of Highway Policy Information, Federal HighwayAdministration, Highway Statistics 1999, October 2000; <http://www.fhwa.dot.gov/ohim/hs99/tables/dl22.pdf>; and (4) U.S. Census Bureau, “Population Estimates for the U.S.,Regions, Divisions, and States by 5-year Age Groups and Sex: Time Series Estimates, July 1, 1990to July 1, 1999 and April 1, 1990 Census Population Counts,” March 2000;<http://eire.census.gov/popest/archives/state/st-99-08.txt>. EXPLANATION: Refers to persons age75 and over with a driver’s license as a percentage of the total population age 75 and over in 2000.Notes: For Connecticut and Mississippi, data from 1999 were used because erroneous data for thesestates were reported in 2000. According to the FHWA, caution should be used comparing driverlicensing data across states for the following reasons: (1) drivers may move from one state to anotherand be counted in both states; (2) drivers may obtain licenses in states other than their legal resi-dence; (3) drivers may fraudulently obtain multiple licenses; and (4) states may not purge their data-bases of expired licenses or licenses of deceased individuals on a continual basis.

Persons Age 70+ without a Vehicle (%), 2000 – AARP Public Policy Institute analysis of U.S.Census Bureau, Census 2000 Supplementary Survey. EXPLANATION: Refers to persons age 70and over who have no vehicle in the household as a percentage of the total population age 70 andover in 2000.

Grandchildren Living with Grandparents Age 65+ (%), 2000 – AARP Public Policy Instituteanalysis of the U.S. Census Bureau, Census 2000 Supplementary Survey. EXPLANATION: Refersto the population age 65 and over with grandchildren under age 18 living in their home as apercentage of the total population age 65 and over in 2000.

Medicaid Beneficiaries Age 65+ Receiving Home Health Services (%), 1999 – AARP PublicPolicy Institute calculations based on Center for Medicare and Medicaid Services (CMS),“Medicaid Statistical Information System (MSIS) Report for Federal Fiscal Year 1999” (formerlyHCFA-2082 report); <http://www.cms.hhs.gov/medicaid/msis/msis99sr.asp>. EXPLANATION:Refers to Medicaid beneficiaries age 65 and over receiving home health services as a percentage oftotal Medicaid beneficiaries age 65 and over in 1999. Home health services are a mandatory benefitfor individuals who are entitled to nursing facility services under the state’s Medicaid plan. Servicesmust be provided at a recipient’s place of residence, and must be ordered by a physician as part of aplan of care that the physician reviews every sixty days. Home health services must include nursingservices, as defined in the state’s Nurse Practice Act, that are provided on a part-time or intermittentbasis by a home health agency, home health aide services provided by a home health agency, andNote: U.S. figures do not include territories.

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Data Documentationmedical supplies, equipment, and appliances suitable for use in the home. Physical therapy, occupa-tional therapy, speech pathology, and audiology services are optional services that states may chooseto provide. “NA” = Data not available.

Medicare Beneficiaries Receiving Home Health Services (%), 2000 – AARP Public PolicyInstitute calculations based on (1) Center for Medicare and Medicaid Services (CMS), “MedicareHHA Data for Year 2000 from the HCIS System,” May 14, 2002 [unpublished data]; and (2) U.SCensus Bureau, Statistical Abstract of the United States: 2001, “No. 136. Medicare—Summary byState and Other Area: 1995 and 2000,” May 2002; <http://www.census.gov/prod/2002pubs/01statab/stat-ab01.html>. EXPLANATION: Refers to Medicare beneficiaries receivinghome health services as a percentage of total Medicare beneficiaries in 2000. Medicare home healthservices include: skilled nursing care on a part-time or intermittent basis; physical and occupationaltherapy and speech language pathology services; medical social services; home health aide serviceson a part-time or intermittent basis; and medical supplies and durable medical equipment.

Medicare Home Health Visits per User (average), 2000 – Center for Medicare and MedicaidServices (CMS), “Medicare HHA Data for Year 2000 from the HCIS System,” May 14, 2002[unpublished data]. EXPLANATION: Refers to the average number of home health visits perMedicare home health user in 2000.

Medicaid Beneficiaries Enrolled in Aged/Disabled Waivers, 1992 & 1999 – AARP Public PolicyInstitute calculations based on (1) Martin Kitchener and Charlene Harrington, Department of Socialand Behavioral Sciences, University of California, San Francisco, Medicaid 1915(c) Home andCommunity Based Waivers: Program Data, 1992-1999, August 2001. Data source is HCFA (nowCMS) Form 372 submitted by states; <http://www.hcbs.org/data/waiverdata.htm>. Data used withpermission; (2) Center for Medicare and Medicaid Services (CMS), “Medicaid StatisticalInformation System (MSIS) Report for Federal Fiscal Year 1999” (formerly HCFA-2082 report);<http://www.cms.hhs.gov/medicaid/msis/msis99sr.asp>; and (3) Health Care FinancingAdministration (now CMS), HCFA-2082 report, December 1993; <http://www.cms.gov/medicaid/msis/mcd1992.zip>. EXPLANATION: Refers to Medicaid beneficiaries (unduplicated)in Aged, Aged/Disabled, or Disabled/Physically Disabled home and community-based services(HCBS) waiver programs as a percentage of total Medicaid beneficiaries in 1992 and 1999. Thepackage of services available under a HCBS waiver may include optional Medicaid services that arenot made available to other Medicaid recipients under the state plan, as well as services that are notstrictly medical in nature and would, therefore, not qualify for ordinary Medicaid coverage.Medicaid HCBS, including aged/disabled waiver programs, may provide case management, home-maker/home health aide services, personal care services, adult day health, habilitation, and respitecare. Other services that are approved by CMS may include non-medical transportation, in-homesupport services, special communication services, minor home modifications, and adult day care.Additional HCBS waivers are provided for persons with AIDS and AIDS related conditions, tech-nology dependent/medically fragile conditions, brain injuries, mental retardation/developmentaldisabilities, and mental illness. Note: Hawaii Medicaid enrollment data were not available in 1999.“NA” = Data not available for Hawaii; data not applicable for Arizona.

HOME AND COMMUNITY-BASED RESOURCES

Medicare-Certified Home Health Agencies (per 1,000 Age 65+), 2000 – AARP Public PolicyInstitute calculations based on (1) National Association for Home Care, “Medicare-Certified HomeHealth Agencies and Hospices by State, January 2000”; <http://www.nahc.org/NAHC/Research/


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Data Documentationnumhha.html>; and (2) U.S. Census Bureau, Census 2000 Summary File 1, Table: P12. Sex by Age[49]; <http://factfinder.census.gov>. EXPLANATION: Refers to the number of Medicare-Certifiedhome health agencies per 1,000 persons age 65 and over in 2000. Facilities wanting to participatein the Medicare (or Medicaid) program must meet participation conditions for certification. Statescertify those facilities that request participation in the Medicaid program only. The U.S. Departmentof Health and Human Services certifies facilities requesting participation in both the Medicare andMedicaid programs.

Licensed Adult Day Facilities (#), 1998 – Charlene Harrington, James H. Swan, Valerie Wellin,Wendy Clemena, and Helen M. Carrillo, Department of Social & Behavioral Sciences, Universityof California, San Francisco, 1998 State Data Book on Long Term Care Program and MarketCharacteristics, November 1999. Data used with permission. EXPLANATION: Refers to the totalnumber of licensed adult day facilities in 1998. Adult day facilities provide services on a part-timeand/or intermittent basis. Programs include health, social, personal care, and related supportiveservices to meet the needs of functionally or mentally impaired adults. “NL” = No licensed facili-ties.

Residential Care Beds (per 1,000 Age 65+), 1998 – AARP Public Policy Institute calculationsbased on (1) Charlene Harrington, James H. Swan, Valerie Wellin, Wendy Clemena, and Helen M.Carrillo, Department of Social & Behavioral Sciences, University of California, San Francisco,1998 State Data Book on Long Term Care Program and Market Characteristics, November 1999.Data used with permission; and (2) U.S. Census Bureau, “Population 65 Years and Over and 85 Yearsand Over, Region, and State: 1998,” February 2000; <http://www.census.gov/population/estimates/state/st98elderly.txt>. EXPLANATION: Refers to the number of residential care beds per 1,000persons age 65 and over in 1998. Residential care facilities provide services to individuals notrequiring skilled nursing care. Services are provided on a 24-hour basis and include supportive careservices and supervision for those who are physically and/or mentally impaired.

Personal and Home Care Aides (per 1,000 Age 65+), 2000 – AARP Public Policy Institute calcu-lations based on (1) Occupational Employment Statistics, Bureau of Labor Statistics, “2000 StateOccupational Employment and Wage Estimates,” December 2001; <http://www.bls.gov/oes/2000/oessrcst.htm>; and (2) U.S. Census Bureau, “Census 2000 PHC-T-13. Population and RankingTables of the Older Population for the United States, States, Puerto Rico, Places of 100,000 or MorePopulation, and Counties,” October 2001; <http://www.census.gov/population/cen2000/phc-t13/tab01.txt>. EXPLANATION: Refers to the number of personal and home care aides per 1,000persons age 65 and over in 2000. Personal and home care aides assist elderly or disabled adults inthe person’s home or in a daytime non-residential facility. Duties performed at a place of residencemay include housekeeping (making beds, doing laundry, washing dishes) and preparing meals.Aides may also provide meals and supervised activities at non-residential care facilities, and mayadvise families, the elderly, and disabled on such things as nutrition, cleanliness, and household util-ities. “NA” = Data not available.

Hourly Wage (median), 2000 – Occupational Employment Statistics, Bureau of Labor Statistics,“2000 State Occupational Employment and Wage Estimates,” December 2001; <http://www.bls.gov/oes/2000/oessrcst.htm>. EXPLANATION: Refers to the median hourly wage paid to personal andhome care aides in 2000.

Home Health Aides (per 1,000 Age 65+), 2000 – AARP Public Policy Institute calculations basedon (1) Occupational Employment Statistics, Bureau of Labor Statistics, “2000 State OccupationalEmployment and Wage Estimates,” December 2001; <http://www.bls.gov/oes/2000/oessrcst.htm>;


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Data Documentationand (2) U.S. Census Bureau, “Census 2000 PHC-T-13. Population and Ranking Tables of the OlderPopulation for the United States, States, Puerto Rico, Places of 100,000 or More Population, andCounties,” October 2001; <http://www.census.gov/population/cen2000/phc-t13/tab01.txt>.EXPLANATION: Refers to the number of home health aides per 1,000 persons age 65 and over in2000. Home health aides provide routine, personal healthcare, such as bathing, dressing, orgrooming, to elderly, convalescent, or disabled persons in the home of patients or in a residentialcare facility.

Hourly Wage (median), 2000 – Occupational Employment Statistics, Bureau of Labor Statistics,“2000 State Occupational Employment and Wage Estimates,” December 2001; <http://www.bls.gov/oes/2000/oessrcst.htm>. EXPLANATION: Refers to the median hourly wage paid to home healthaides in 2000.


Total nursing facility residents (#), 2001 – Cowles Research Group, 2001 Nursing HomeStatistical Yearbook, 2002. Data used with permission. Data source is the CMS Online Survey,Certification, and Reporting (OSCAR) database and reflects activity as of December 6, 2001.EXPLANATION: Refers to the total number of nursing facility residents in 2001. Nursing facili-ties are licensed by the state and provide skilled nursing and/or intermediate care, above the level ofroom and board, to residents on a 24-hour basis.

Nursing Facility Residents (% of Age 65+), 2001 – AARP Public Policy Institute calculationsbased on (1) Cowles Research Group, 2001 Nursing Home Statistical Yearbook, 2002. Data usedwith permission. Data source is the CMS Online Survey, Certification, and Reporting (OSCAR)database and reflects activity as of December 6, 2001; and (2) AARP Public Policy Institute analysisof the U.S. Census Bureau, Current Population Survey, March Supplement, 2001; (FERRET)<http://ferret.bls.census.gov/cgi-bin/ferret>. EXPLANATION: Refers to residents in nursing facil-ities as a percentage of the total population age 65 and over in 2001.

Nursing Facility Residents (% change), 1996-2001 – AARP Public Policy Institute calculationsbased on (1) Cowles Research Group, 2001 Nursing Home Statistical Yearbook, 2002. Data usedwith permission. Data source is the CMS Online Survey, Certification, and Reporting (OSCAR)database and reflects activity as of December 6, 2001; and (2) Cowles Research Group, 1996Nursing Home Statistical Yearbook, 1997, published by The Johns Hopkins University Press. Dataused with permission. Data source is the HCFA (now CMS) Online Survey, Certification, andReporting (OSCAR) database and reflects activity as of January 24, 1997. EXPLANATION: Refersto the cumulative percent change in the total number of nursing facility residents from 1996 to 2001.

Residents with Physical Restraints (%), 2002 – Center for Medicare and Medicaid Services(CMS), Nursing Home Resident Measures from the Nursing Home Compare Website as of July2002; <http://www.medicare.gov/nhcompare/home.asp>. Data source is the Minimum Data Set(MDS) Repository. EXPLANATION: Refers to the percentage of nursing facility residents who arein physical restraints daily. Physical restraints cannot be used unless they have been ordered by theresident’s physician to treat the individual’s medical symptoms. Restraints are defined under federallaw as any device, material, or equipment attached or adjacent to the resident’s body that the indi-vidual cannot remove easily, which restricts freedom of movement or normal access to one’s body.Items or devices that may meet the definition of physical restraints include, but are not limited to,leg restraints, arm restraints, hand mitts, soft ties or vests, chairs with lap trays and bed side rails.


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Residents with Pressure (Bed) Sores (%), 2002 – Center for Medicare and Medicaid Services(CMS), Nursing Home Resident Measures from the Nursing Home Compare Website as of July2002; <http://www.medicare.gov/nhcompare/home.asp>. Data source is the Minimum Data Set(MDS) Repository. EXPLANATION: Refers to the percentage of residents who are reported to haveone or more pressure sores. Pressure sores are wounds on the skin. They usually develop on bonyparts of the body such as the tailbone, hip, ankle, or heel, and are usually caused by constant pressureon the skin that damages the top layer of skin. Pressure sores can be a serious health risk and canrange from mild (skin reddening) to severe deep open wounds (exposing muscle and bone).

Nursing Facility Residents by Primary Payer Source, 2001 – Cowles Research Group, 2001Nursing Home Statistical Yearbook, 2002. Data used with permission. Data source is the CMSOnline Survey, Certification, and Reporting (OSCAR) database and reflects activity as of December6, 2001. EXPLANATION: Refers to the percentage of nursing facility residents whose primarypayer source in 2001 was Medicare, Medicaid, or other. Other sources of payment include out-of-pocket spending, private insurance, and other spending. Percentages may not sum to 100 percentdue to rounding.


Nursing Facility Beds (per 1,000 Age 65+), 2001 – AARP Public Policy Institute calculations basedon (1) Cowles Research Group, 2001 Nursing Home Statistical Yearbook, 2002. Data used withpermission. Data source is the CMS Online Survey, Certification, and Reporting (OSCAR)database and reflects activity as of December 6, 2001; and (2) AARP Public Policy Institute analysisof the U.S. Census Bureau, Current Population Survey, March Supplement, 2001; (FERRET)<http://ferret.bls.census.gov/cgi-bin/ferret>. EXPLANATION: Refers to the total number ofnursing facility beds per 1,000 persons age 65 and over in 2001.

Nursing Facility Beds (% change), 1996-2001 – AARP Public Policy Institute calculations basedon (1) Cowles Research Group, 2001 Nursing Home Statistical Yearbook, 2002. Data used withpermission. Data source is the CMS Online Survey, Certification, and Reporting (OSCAR)database and reflects activity as of December 6, 2001; and (2) Cowles Research Group, 1996Nursing Home Statistical Yearbook, 1997, published by The Johns Hopkins University Press. Dataused with permission. Data source is the HCFA (now CMS) Online Survey, Certification, andReporting (OSCAR) database and reflects activity as of January 24, 1997. EXPLANATION: Refersto the cumulative percent change in the total number of nursing facility beds from 1996 to 2001.

Nursing Facility Occupancy Rate (%), 2001 – Cowles Research Group, 2001 Nursing HomeStatistical Yearbook, 2002. Data used with permission. Data source is the CMS Online Survey,Certification, and Reporting (OSCAR) database and reflects activity as of December 6, 2001.EXPLANATION: Refers to the percentage of nursing facility beds occupied by residents. The rateis calculated by dividing the total number of nursing facility residents by the total number of beds.

Nursing Facility Occupancy Rate (% change), 1996-2001 – AARP Public Policy Institute calcu-lations based on (1) Cowles Research Group, 2001 Nursing Home Statistical Yearbook, 2002. Dataused with permission. Data source is the CMS Online Survey, Certification, and Reporting(OSCAR) database and reflects activity as of December 6, 2001; and (2) Cowles Research Group,1996 Nursing Home Statistical Yearbook, 1997, published by The Johns Hopkins University Press.Data used with permission. Data source is the HCFA (now CMS) Online Survey, Certification, andReporting (OSCAR) database and reflects activity as of January 24, 1997. EXPLANATION: Refers

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to the cumulative percent change in the rate of nursing facility beds occupied by residents from 1996to 2001.


Total Medicaid Spending (in millions), 2001 – Brian Burwell, Steve Eiken, and Kate Sredl, TheMEDSTAT Group, May 2002, “Medicaid Long Term Care Expenditures in FY 2001.” Data arederived from CMS-64 reports submitted by the states to Centers for Medicare and MedicaidServices and reflect spending from September 2000 through September 2001;<http://www.hcbs.org/ hcbs_data.htm>. EXPLANATION: Refers to total fee-for-service expendi-tures for services under the Medicaid program in fiscal year 2001. Note: Arizona operates its long-term care system primarily through capitated managed care programs; Minnesota and Texas also payfor part of their long-term care system on a capitation basis.

Medicaid Long-Term Care Spending (% of Total Medicaid), 2001 – Brian Burwell, Steve Eiken,and Kate Sredl, The MEDSTAT Group, May 2002, “Medicaid Long Term Care Expenditures in FY2001.” Data are derived from CMS-64 reports submitted by the states to Centers for Medicare andMedicaid Services and reflect spending from September 2000 through September 2001;<http://www.hcbs.org/hcbs_data.htm>. EXPLANATION: Refers to total fee-for-service expendi-tures for long-term care (LTC) services under the Medicaid program in fiscal year 2001. Long-termcare services under the Medicaid program include nursing facility, ICF/MR, home health, personalcare, and home and community-based waivers. Note: Arizona operates its long-term care systemprimarily through capitated managed care programs; Minnesota and Texas also pay for part of theirlong-term care system on a capitation basis.

Per Capita LTC Spending, 2001 – Brian Burwell, Steve Eiken, and Kate Sredl, The MEDSTATGroup, May 2002, “Medicaid Long Term Care Expenditures in FY 2001.” Data are derived fromCMS-64 reports submitted by the states to Centers for Medicare and Medicaid Services and reflectspending from September 2000 through September 2001; <http://www.hcbs.org/hcbs_data.htm>.EXPLANATION: Refers to the amount of Medicaid long-term care fee-for-service spending perperson in the state in fiscal year 2001. Note: Arizona operates its long-term care system primarilythrough capitated managed care programs; Minnesota and Texas also pay for part of their long-termcare system on a capitation basis.

Per Capita Nursing Facility Spending, 2001 – Brian Burwell, Steve Eiken, and Kate Sredl, TheMEDSTAT Group, May 2002, “Medicaid Long Term Care Expenditures in FY 2001.” Data arederived from CMS-64 reports submitted by the states to Centers for Medicare and MedicaidServices and reflect spending from September 2000 through September 2001;<http://www.hcbs.org/ hcbs_data.htm>. EXPLANATION: Refers to the amount of Medicaidnursing facility fee-for-service spending per person in the state in fiscal year 2001. Note: Arizonaoperates its long-term care system primarily through capitated managed care programs; Minnesotaand Texas also pay for part of their long-term care system on a capitation basis.

Per Capita ICF/MR Facility Spending, 2001 – Brian Burwell, Steve Eiken, and Kate Sredl, TheMEDSTAT Group, May 2002, “Medicaid Long Term Care Expenditures in FY 2001.” Data arederived from CMS-64 reports submitted by the states to Centers for Medicare and MedicaidServices and reflect spending from September 2000 through September 2001;<http://www.hcbs.org/ hcbs_data.htm>. EXPLANATION: Refers to the amount of MedicaidICF/MR facility fee-for-service spending per person in the state in fiscal year 2001. Note: Arizona

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operates its long-term care system primarily through capitated managed care programs; Minnesotaand Texas also pay for part of their long-term care system on a capitation basis.

Per Capita Home Health Spending, 2001 – Brian Burwell, Steve Eiken, and Kate Sredl, TheMEDSTAT Group, May 2002, “Medicaid Long Term Care Expenditures in FY 2001.” Data arederived from CMS-64 reports submitted by the states to Centers for Medicare and MedicaidServices and reflect spending from September 2000 through September 2001;<http://www.hcbs.org/ hcbs_data.htm>. EXPLANATION: Refers to the amount of Medicaid homehealth fee-for-service spending per person in the state in fiscal year 2001. Note: Arizona operatesits long-term care system primarily through capitated managed care programs; Minnesota and Texasalso pay for part of their long-term care system on a capitation basis.

Per Capita 1915(c) HCBS Waiver Spending, 2001 – Brian Burwell, Steve Eiken, and Kate Sredl,The MEDSTAT Group, May 2002, “Medicaid Long Term Care Expenditures in FY 2001.” Data arederived from CMS-64 reports submitted by the states to Centers for Medicare and MedicaidServices and reflect spending from September 2000 through September 2001;<http://www.hcbs.org/ hcbs_data.htm>. EXPLANATION: Refers to the amount of Medicaid1915(c) home and community-based (HCBS) waiver fee-for-service spending per person in the statein fiscal year 2001. The package of services available under a waiver may include optional Medicaidservices that are not made available to other Medicaid recipients under the state plan, as well asservices that are not strictly medical in nature and would, therefore, not qualify for ordinaryMedicaid coverage. Medicaid HCBS, including aged/disabled waiver programs, may provide casemanagement, homemaker/home health aide services, personal care services, adult day health, habil-itation, and respite care. Other services that are approved by CMS may include non-medical trans-portation, in-home support services, special communication services, minor home modifications,and adult day care. Additional HCBS waivers are provided for persons with AIDS and AIDS relatedconditions, technology dependent/medically fragile conditions, brain injuries, mentalretardation/developmental disabilities, and mental illness. Note: Arizona operates its Medicaidlong-term care program under a capitation arrangement using an 1115 waiver. “NA” = Not appli-cable.

Per Capita Personal Care Spending, 2001 – Brian Burwell, Steve Eiken, and Kate Sredl, TheMEDSTAT Group, May 2002, “Medicaid Long Term Care Expenditures in FY 2001.” Data arederived from CMS-64 reports submitted by the states to Centers for Medicare and MedicaidServices and reflect spending from September 2000 through September 2001;<http://www.hcbs.org/ hcbs_data.htm>. EXPLANATION: Refers to the amount of Medicaidpersonal care fee-for-service spending per person in the state in fiscal year 2001. Note: The personalcare program is an optional Medicaid benefit by which states may choose to provide beneficiarieswith assistance with daily living activities; thirty-two states were operating the program in 2000.“NA” = Not applicable.

Medicaid Aged/Disabled HCBS Waiver Spending per $100 of Nursing Facility Spending, 2001– AARP Public Policy Institute calculations based on (1) Steve Eiken and Brian Burwell, TheMEDSTAT Group, May 2002, “Medicaid HCBS Waiver Expenditures, FY 1995 through FY 2001.”Data are derived from CMS-64 reports submitted by the states to Centers for Medicare and MedicaidServices and reflect spending from September 2000 through September 2001;<http://www.hcbs.org/ hcbs_data.htm>; and (2) Brian Burwell, Steve Eiken, and Kate Sredl, TheMEDSTAT Group, May 2002, “Medicaid Long Term Care Expenditures in FY 2001.” Data arederived from CMS-64 reports submitted by the states to Centers for Medicare and MedicaidServices and reflect spending from September 2000 through September 2001;

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<http://www.hcbs.org/hcbs_data.htm>. EXPLANATION: Refers to the amount of Medicaid HCBSaged/disabled waiver spending per $100 of Medicaid nursing facility spending (i.e., ratio) in fiscalyear 2001. Note: Medicaid Aged/Disabled HCBS waiver data were not reported for Michigan andWyoming; Arizona offers comparable long-term care services to waiver programs under a federalresearch and demonstration waiver. “NA” = Data not available.

Medicaid Aged/Disabled Waiver Expenditures (% of Total 1915(c) HCBS Waivers), 2001 –AARP Public Policy Institute calculations based on Steve Eiken and Brian Burwell, The MEDSTATGroup, May 2002, “Medicaid HCBS Waiver Expenditures, FY 1995 through FY 2001.” Data arederived from CMS-64 reports submitted by the states to Centers for Medicare and MedicaidServices and reflect spending from September 2000 through September 2001;<http://www.hcbs.org/ hcbs_data.htm>. EXPLANATION: Refers to Medicaid 1915(c) HCBSwaiver expenditures for recipients in Aged, Aged/Disabled, or Disabled/Physically Disabled waiverprograms as a percentage of all Medicaid 1915(c) HCBS waiver spending in fiscal year 2001. Note:Medicaid HCBS waiver data were not reported for Michigan and Wyoming; Arizona offers compa-rable long-term care services to waiver programs under a federal research and demonstration waiver.“NA” = Data not available.

Medicaid Federal Matching Funds (%), FY 2003 – Office of the Assistant Secretary for Planningand Evaluation (ASPE), “Federal Medical Assistance Percentages and Enhanced Federal MedicalAssistance Percentages, Effective October 1, 2002 - September 30, 2003 (Fiscal Year 2003),”November 2001; <http://aspe.os.dhhs.gov/health/fmap03.htm>. EXPLANATION: Refers to thefederal medical assistance percentages used to determine the amount of Federal matching for Statemedical assistance (Medicaid). “NA” = Not applicable.

Allocation of Medicaid LTC Expenditures for Nursing Facilities, ICF/MR Facilities, and Homeand Community-Based Services, 1996 & 2001 – AARP Public Policy Institute calculations basedon Brian Burwell, Steve Eiken, and Kate Sredl, The MEDSTAT Group, May 2002, “Medicaid LongTerm Care Expenditures in FY 2001.” Data are derived from CMS-64 reports submitted by thestates to Centers for Medicare and Medicaid Services and reflect spending from September 2000through September 2001; <http://www.hcbs.org/hcbs_data.htm>. EXPLANATION: Refers to theproportion of total Medicaid long-term care expenditures allocated for nursing facility services,ICF/MR facility services, and home and community-based services (including home healthservices, HCBS 1915(c) waivers, and personal care services) in 1996 and 2001.

Medicaid Reimbursement per day for Nursing Facility Care (average), 1998 – CharleneHarrington, James H. Swan, Valerie Wellin, Wendy Clemena, and Helen M. Carrillo, Department ofSocial & Behavioral Sciences, University of California, San Francisco, 1998 State Data Book on LongTerm Care Program and Market Characteristics, November 1999. Data used with permission.EXPLANATION: Refers to the average Medicaid daily rate paid for nursing facility services in 1998.

Medicare Reimbursement per day for Nursing Facility Care (average), 2000 – Center forMedicare and Medicaid Services (CMS), “Medicare Non-Swing SNF Data Calendar Year 2000”[unpublished data]. EXPLANATION: Refers to the average Medicare daily rate paid for skillednursing facility (SNF) non-swing beds in 2000. The daily rate does not include beds that “swing”between hospital and SNF levels of care. Medicare payments for SNF services are covered by a perdiem prospective payment system, covering all routine, ancillary, and capital costs related to theservices furnished to beneficiaries under Medicare Part A.

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Private Pay Rate per day in Nursing Facility (average), 2001 – AARP Public Policy Institutecalculations based on GE Financial, Long Term Care Division, GE Long Term Care InsuranceNursing Home Survey, March 2002. Data used with permission. EXPLANATION: Refers to theprivate daily rate paid by nursing facility residents for a stay in a nursing home. The survey evalu-ated the cost of assistance in a nursing home with the activities of daily living for a person sufferingfrom a debilitation such as Parkinson’s disease. It did not include costs for therapy, rehabilitation, ormedications.

Medicare Reimbursement per Home Health Visit (average), 2000 – AARP Public Policy Institutecalculations based on Center for Medicare and Medicaid Services (CMS), ‘Medicare HHA Data forYear 2000 from the HCIS System,” May 2002 [unpublished data]. EXPLANATION: Refers to theaverage Medicare reimbursement rate paid for each home health visit.

Home Care Agency Hourly Rates (average), 2002 – AARP Public Policy Institute calculationsbased on MetLife Mature Market Institute, MetLife Market Survey on Nursing Home and HomeCare Costs 2002, April 2002. Data used with permission. EXPLANATION: Licensed PracticalNurse (LPN): Refers to the hourly rate charged to clients by home care agencies for care providedby a licensed practical nurse. Licensed practical nurses provide care for clients under the supervi-sion of physicians and registered nurses. They provide basic bedside care and, where states allow,LPNs may administer prescription medication or start intravenous lines; Home Health Aide(HHA): Refers to the hourly rate charged to clients by home care agencies for care provided by ahome health aide. Home health aides provide personal care and help clients with activities of dailyliving (ADLs). They work under the supervision of a nurse to report a client’s condition andprogress, and report changes in the client’s condition to a registered nurse (RN) or case manager.Their duties range from making beds to taking vital signs.

LONG-TERM CARE MAPS

States with Regulations that Include Assisted Living Philosophy, 2002 – Robert Mollica,National Academy for State Health Policy, State Assisted Living Policy: 2002, October 2002. Dataused with permission. EXPLANATION: Refers to states, as of 2002, that reported having regula-tions on assisted living that include a philosophy of assisted living. Such a philosophy represents aconsumer model focused on the delivery of services around the resident rather than the facility.Inclusion of a statement of philosophy, to some extent, expands and gives more prominence to provi-sions sometimes found in sections dealing with resident rights. States with regulations that includean assisted living philosophy emphasizing consumers often use terms such as independence, dignity,privacy, decision-making, and autonomy.

States Requiring Private Rooms in Assisted Living, 2002 – Robert Mollica, National Academyfor State Health Policy, State Assisted Living Policy: 2000, October 2002. Data used with permis-sion. EXPLANATION: Refers to states, as of 2002, that allow assisted living units/bedrooms to beshared only by choice of the residents.

States Requiring Disclosure on Special Care Units, 2002 – Robert Mollica, National Academy forState Health Policy, State Assisted Living Policy: 2000, October 2002. Data used with permission.EXPLANATION: Refers to states, as of 2002, with disclosure requirements included in regulationsfor special care facilities or units that care for people with Alzheimer’s disease. These provisionstypically require that facilities advertising themselves as operating special care facilities or units, orthat care for people with Alzheimer’s disease, describe in writing how they are different from other

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facilities. The regulations may require a description of the philosophy of care, admission/dischargecriteria, the process for arranging a discharge, services covered and the cost of care, special activi-ties available, and differences in the environment.

Proportion of For-Profit Nursing Facilities, 2001 – AARP Public Policy Institute calculationsbased on Cowles Research Group, 2001 Nursing Home Statistical Yearbook, 2002. Data used withpermission. Data source is the CMS Online Survey, Certification, and Reporting (OSCAR)database and reflects activity as of December 6, 2001. EXPLANATION: Refers to nursing facili-ties in 2001 that are for-profit as a percentage of all nursing facilities, including non-profit and government.

States with Legislation Addressing Nursing Facility Staffing Shortages, 2000 – U.S. GeneralAccounting Office, Nursing Homes: Sustained Efforts Are Essential to Realize Potential of theQuality Initiatives (GAO/HEHS-00-197), September 2000; <http://www.gao.gov/>. EXPLAN-TION: Refers to states, as of 2000, that have enacted legislation establishing wage pass-throughs,wage supplements, or related programs to provide supplemental wages, fringe benefits, or funds foradditional nursing home staff. Note: There may be additional states that have enacted legislationsince 2000.

States with Regulations Mandating CNA Training Above 75 Hours, 2000 – ParaprofessionalHealthcare Institute and the National Citizens’ Coalition for Nursing Home Reform, NationalSurvey on State Initiatives to Improve Paraprofessional Health Care Employment: October 2000Results on Nursing Home Staffing, October 2000; <http://www.directcarealliance.org/sections/pubs/st_staffing_survey/national_survey_on_state_initiat.htm>. EXPLANATION: Refers to states, as of2000, that mandate additional hours of training for certified nurse assistants (CNAs) above thefederal requirement of 75 hours. CNAs provide basic patient care under the direction of nursingstaff, and they perform duties such as feeding, bathing, dressing, grooming, or transferring patientsin or out of bed.

Proportion of Deaths Occurring at Home, 1997 – Joan Teno, Brown University, Center forGerontology and Health Care Research, Facts on Dying: Site of Death: 1989-1997, accessed April2002; <http://www.chcr.brown.edu/dying/factsondying.htm>. Data used with permission.EXPLANATION: Refers to deaths in 1997 occurring at home as a percentage of total deaths,including deaths in nursing homes, hospitals, and other locations.

States Offering Tax Incentives for Long-Term Care Insurance, 2002 – AARP Public PolicyInstitute analysis of state income tax forms, tax instructions, and personal communication with offi-cials at state departments of revenue. EXPLANATION: Refers to states, as of 2002, with tax deduc-tions and credits for the purchase of long-term care insurance policies that are more generous or thesame as the federal tax deduction threshold. In order to receive the federal tax deduction for aportion of long-term care insurance premiums: (1) the policy must meet federal standards for a “taxqualified” policy; (2) individuals must itemize their deductions; (3) individuals’ medical expensesmust exceed 7.5 percent of adjusted gross income (AGI); and (4) individuals must meet annuallyupdated age criteria for the deducted portion of the premium. In states with a tax credit or a deduc-tion more generous than the federal deduction, individuals must meet the specific criteria requiredby their particular state to qualify. Other states either offer no state tax incentives or have no broad-based income tax.

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AARPState Offices

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AARP State Offices*ALABAMA STATE OFFICE201 Monroe StreetRSA Tower, Suite 1880Montgomery, AL 36104Office: 334-954-3042Fax: 334-954-3050

ALASKA STATE OFFICE3601 “C” Street, Suite 1420Anchorage, AK 99503Office: 907-341-2277Fax: 907-341-2270

ARIZONA STATE OFFICE302 North First Ave #410Phoenix, AZ 85003Office: 602-256-2277Fax: 602-256-2928

ARKANSAS STATE OFFICE 1701 Centerview Drive #205Little Rock, AR 72211Office: 501-227-7740Fax: 501-227-7710

CALIFORNIA STATEOFFICESLos Angeles 3460 Wilshire Boulevard #300Los Angeles, CA 90010Office: 213-380-1800Fax: 213-637-2200Sacramento980 9th Street #700Sacramento, CA 95814Office: 916-446-2277Fax: 916-556-3000

COLORADO STATE OFFICE 1301 Pennsylvania St #200Denver, CO 80203Office: 303-830-2277Fax: 303-764-5999

CONNECTICUT STATEOFFICE21 Oak Street #104Hartford, CT 06106Office: 860-240-7544Fax: 860-249-7707

DELAWARE STATE OFFICEOne Rodney Square North1100 N. Market Street, #1201Wilmington, DE 19890-001Office: 302-571-8791Fax: 302-571-1984

DISTRICT OF COLUMBIASTATE OFFICE601 E Street NW A1-200Washington, DC 20049Office: 202-434-7700Fax: 202-434-7710

FLORIDA STATE OFFICESSt. Petersburg400 Carillon Pkwy #100St. Petersburg, FL 33716Office: 727-571-2277Fax: 727-571-2278South Florida3350 SW 148th Ave #120Miramar, FL 33027Office: 954-499-4132Fax: 954-438-7871Tallahassee200 W College Ave Ste 304Tallahassee, FL 32301Office: 850-222-7344Fax: 850-222-8968

GEORGIA STATE OFFICE 999 Peachtree St NE #1645Atlanta, GA 30309Office: 404-881-0292Fax: 404-881-6997

HAWAII STATE OFFICE1132 Bishop Street 19th flHonolulu, HI 96813Office: 808-545-6000Fax: 808-537-2288

IDAHO STATE OFFICEEagle Road Professional Ctr II3080 Gentry Way, Suite 100Meridian, ID 83642Office: 208-288-2277Fax: 208-288-4424

ILLINOIS STATE OFFICES222 N. LaSalle St. #710Chicago, IL 60601Office: 312-458-3600Fax: 312-372-2204Springfield 225 South College StreetSpringfield, IL 62704Office: 217-522-7700Fax: 217-522-7796

INDIANA STATE OFFICEOne North Capitol Ave #1275 Indianapolis, IN 46204Office: 317-423-2277Fax: 317-423-2299

IOWA STATE OFFICE600 E. Court Avenue, Suite CDes Moines, IA 50309Office: 515-244-2272Fax: 515-244-7767

KANSAS STATE OFFICE555 S. Kansas Avenue # 201Topeka, KS 66603Office: 785-232-4070Fax: 785-232-8259

KENTUCKY STATE OFFICEPlainview Center, Suite 12110401 Linn Station RoadLouisville, KY 40223Office: 502-394-0277 Fax: 502-394-9918

LOUISIANA STATE OFFICEOne American Place301 Main Street, #301Baton Rouge, LA 70825Office: 225-376-1141Fax: 225-387-3400

MAINE STATE OFFICE1685 Congress StreetPortland, ME 04102Office: 207-775-7774Fax: 207/775-5727

MARYLAND STATE OFFICE200 St. Paul Place #2510Baltimore, MD 21202Office: 410-837-4300Fax: 410-837-0269

MASSACHUSETTS STATE OFFICE One Boston Pl #1900Boston, MA 02108Office: 617-720-5600Fax: 617-305-0538

MICHIGAN STATE OFFICE309 N. Washington Sq #110Lansing, MI 48933Office: 517-482-2772Fax: 517-482-2794

MINNESOTA STATE OFFICE30 East 7th Street, #1200St. Paul, MN 55101Office: 651-221-0101Fax: 651-221-2636

MISSISSIPPI STATE OFFICE6360 Ridge Wood Rd #160Jackson, MS 39211Office: 601-206-1880Fax: 601-991-3342

MISSOURI STATE OFFICE700 West 47th Street #110Kansas City, MO 64112Office: 816-561-0044Fax: 816-561-3107

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AARP State Offices*MONTANA STATE OFFICE1325 Euclid Avenue, Suite 2Helena, MT 59601-2170Office: 406-441-2277Fax: 406-441-2230

NEBRASKA STATE OFFICE301 S. 13th Street, # 201Lincoln, NE 68508Office: 402-323-6900Fax : 402-323-6913

NEVADA STATE OFFICE5820 S. Eastern Avenue # 190Las Vegas, NV 89119Office: 702-967-2277Fax: 702-938-3225

NEW HAMPSHIRE STATE OFFICE900 Elm Street #702Manchester, NH 03101Office: 603 629 9559Fax: 603-629-0066

NEW JERSEY STATEOFFICE Forrestal Village, 132 Main StPrinceton, NJ 08540Office: 609-987-0744Fax: 609-987-4634

NEW MEXICO STATEOFFICE535 Cerrillos Road, Suite ASanta Fe, NM 87501Office: 505-820-2277Fax: 505-820-2889

NEW YORK STATE OFFICES780 Third Avenue 33rd flNew York, NY 10017Office: 212-758-1411Fax: 212-644-6390AlbanyOne Commerce Plaza #1947Albany, NY 12260Office: 518-434-4194Fax: 518-434-6949

NORTH CAROLINA STATEOFFICE 225 Hillsborough St #440Raleigh, NC 27603Office: 919-755-9757Fax: 919-755-9684

NORTH DAKOTA STATEOFFICE107 West Main Avenue #125Bismarck, ND 58501Office: 701-221-2274Fax: 701/255-2242

OHIO STATE OFFICE1 South High StreetColumbus, OH 43215Office: 614-224-9800Fax: 614-224-9801

OKLAHOMA STATE OFFICE126 N. Bryant AveEdmond, OK 73034Office: 405-844-4888Fax: 405-844-7772

OREGON STATE OFFICE8440 SE Sunnybrook Blvd #101Clackamas, OR 97015Office: 503-652-8855Fax: 503-652-9933

PENNSYLVANIA STATEOFFICE30 No. Third Street #750Harrisburg, PA 17101Office: 717-238-2277Fax: 717-236-4078

PUERTO RICO STATEOFFICE654 Munoz Rivera Ave #901San Juan, PR 00918Office: 787-754-2275Fax: 787-754-2211

RHODE ISLAND STATEOFFICE10 Orms Street #200Providence, RI 02904Office: (401) 276-3714Fax: 401-272-0596

SOUTH CAROLINA STATEOFFICE1201 Main Street #1280Columbia, SC 29201Office: 803-765-7374Fax: 803-765-4374

SOUTH DAKOTA STATEOFFICE5101 S. Nevada Street #150Sioux Falls, SD 57108Office: 605-361-2278Fax: 605-361-2323

TENNESSE STATE OFFICE140 4th Avenue N. #180Nashville, TN 37219Office: 615-259-2277Fax: 615-313-8414

TEXAS STATE OFFICE98 San Jacinto Blvd #750Austin, TX 75231Office: 512-480-9797Fax: 512-480-9799

UTAH STATE OFFICE6975 Union Park Center #320Midvale, UT 84047Office: 801-561-1037Fax: 801-561-2209

VERMONT STATE OFFICE112 State Street, 5th flMontpelier, VT 05602Office: 802-229-1333Fax: 802-224-9057

THE VIRGIN ISLANDSSTATE OFFICE93B Estate DiamondSunny IsleSt. Croix, VI 00820Office: 340-692-2504Fax: 340-692-2544

VIRGINIA STATE OFFICE707 East Main Street #910Richmond, VA 23219Office: 804-819-1902Fax: 804-819-1923

WASHINGTON STATEOFFICE9750 Third Avenue NE #102Seattle, WA 98115Office: 206-517-9348Fax: 206-517-2278

WEST VIRGINIA STATEOFFICE300 Summers Street, #400Charleston, WV 25301Office: 304-344-4740Fax: 304-344-4633

WISCONSIN STATE OFFICE3 S. Pinckney #801Madison, WI 53703Office: 608-251-2277Fax: 608-251-7612

WYOMING STATE OFFICE2020 Carey Ave, MezzanineCheyenne, WY 82001Office: 307-634-2274Fax: 307-634-3808

*Information is current as of October 2002. National TTY 877-434-7598. For more information on an office in yourstate, please call AARP at 800-424-3410.

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Notes

across the states 2002 - aarp · states with regulations mandating cna training above 75 hours ......

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