America’s Senior Living System is Broken: Here’s How to Fix It

There is no shame in aging, but there is shame in failing the elderly.

It’s a failing that leads to isolation, depression, and a disproportionate suicide rate among older Americans.

There are two types of senior living facilities: government-provided programs (through Medicare and other social services) and private entities. But government facilities are often poorly resourced, dilapidated, and staffed by a mix of low-paid workers and overstretched professionals. To address these challenges as part of a broader Medicare reform plan, we must increase funding for senior living programs.

Again, just because someone cannot afford private care, that does not mean they deserve inadequate care.

That is not to say that private care is the answer. Private facilities have their own problems.

. Here regulation is a benefit to the private sector: it helps prevent new competitors from entering the market. But the effect is that most families are forced into paying very large sums for mediocre facilities.

For starters, there are not enough of them. Excluding the most expensive and luxurious programs, many private facilities belong to a regional or national network. And because of the regulatory and structural costs that go into setting up a private senior living facility, these networks often hold effective local monopolies. Here regulation is a benefit to the private sector: it helps prevent new competitors from entering the market. But the effect is that most families are forced into paying very large sums for mediocre facilities.

Remember the law of supply and demand. High demand and low supply means higher prices. With families unlikely to put an elderly loved one through the stress of moving every few months, senior facilities can charge exorbitant rates. They cultivate families to believe they’ve bought peace of mind. This insulates private facilities from scrutiny.

Moreover, rapid turnover in residents is highly profitable. While most eldercare facilities offer various rental brackets in relation to care needs, those who need the most help obviously receive priority attention. Unfortunately, those who are in relatively good health tend to be ignored and more susceptible to injuries, such as pressure wounds. According to the Centers for Disease Control, more than 1 in 10 assisted-living residents has such a wound at any time.

With families unlikely to put an elderly loved one through the stress of moving every few months, senior facilities can charge exorbitant rates.

My anguish is personal here. My grandfather lives at a Sunrise facility in northern Virginia. Though 92-years-old, he is in relatively good health. His only real needs at Sunrise are occasional basic medical assistance and maintenance support. What’s concerning, however, is the support he’s currently receiving. Here are few tidbits.

He recently suffered a bout of mild pneumonia. It took a nurse two hours to respond to his call for assistance. On another occasion, staff members took 20 minutes to respond to a panic button. Calling 911 would have been quicker. And when fixtures in his apartment break, it takes the on-site repair team two to three days of cajoling to fix them. For this, my family and I pay more than $5,000 a month.

“Calling 911 would have been quicker.”

We’re not getting good value for the money. Yet we have few alternatives—and Sunrise knows it.

So what can be done?

First, we need more competition. To do that, regulations should be structured to reduce barriers to entry. We need more construction and permits, which will allow for more facilities. The need is there—and growing by the year as Baby Boomers age. If getting more facilities constructed requires expanding federal- and state-backed loan programs, so be it.

Second, we need more helpers. Inadequate staffing is a nationwide problem with assisted living facilities. State licensing rules should be reexamined and in some cases relaxed to let certain personnel provide more services. For example, Florida in 2015 passed legislation allowing nurses and unlicensed staff to provide more assistance for the basic needs of residents in senior living facilities.

State licensing rules should be reexamined and in some cases relaxed to let certain personnel provide more services. For example, Florida in 2015 passed legislation allowing nurses and unlicensed staff to provide more assistance for the basic needs of residents in senior living facilities.

Finally, we need more accountability. California has taken steps to regulate certain advertising practices, for example. Turns out, these companies don’t like it when the government scrutinizes their sales pitches. But we also need to harness the power of crowds. If doctors and hospitals are easily reviewable online, why can’t the same be true for assisted-living facilities?

I’m just one of many Americans with these concerns. But my grandfather’s experience is the norm rather than the exception. Speak to a resident of a senior living facility and you will likely hear stories of neglect or disinterest. Those stories speak to a trend. In America today, by accepting extortionate mediocrity, we are denying dignity to some of our most vulnerable loved ones.

Tom Rogan is a columnist for Opportunity Lives and National Review, a former panelist on The McLaughlin Group and a senior fellow at the Steamboat Institute. Follow him on Twitter @TomRtweets. Email him at Thomas.RoganE@gmail.com.