New York, NY—In a sweeping transformation of eldercare across the United States, a growing number of skilled nursing facilities are transitioning to community-based models, reflecting a trend toward decentralization in the healthcare sector. This shift not only indicates a significant change in the location and management of elderly care but also underscores evolving preferences for more personalized, home-like environments for long-term care.
Bruce Chernof, President and CEO of the SCAN Foundation, highlighted the urgency of this evolution, stating, “There exists a profound need to re-envision how we provide skilled nursing services, making them more accessible, flexible, and in tune with the desires of those they serve. People overwhelmingly prefer to receive care in their homes or communities rather than in institutional settings.”
This pivot from institutions to communities is partly driven by demographic pressures, with the American Association of Retired Persons (AARP) reporting that 87% of adults age 65+ want to stay in their current home and community as they age. This consumer preference lays the groundwork for a radical rethinking of how and where skilled nursing care is delivered.
In response, various models have emerged, ranging from at-home care teams, integrating nursing and therapy services, to small, community-centered facilities that house fewer patients but provide a more homelike atmosphere. Innovations in technology, including telehealth and remote monitoring systems, have further facilitated this decentralization, allowing for high-quality care outside of traditional nursing home settings.
However, this evolution is not without its challenges. Financing the shift towards community-based care, ensuring a well-trained workforce is available to meet varied needs, and creating a regulatory framework that supports rather than hinders innovation are critical hurdles that policymakers and practitioners alike are grappling with.
Despite these obstacles, the momentum for change appears to be growing. With Medicare and other payers beginning to recognize and reimburse for a broader array of community-based services, the foundation is being laid for a system that is more responsive to the needs and preferences of the aging population.
As the landscape of eldercare continues to evolve, the shift from institutions to communities represents not just a change in setting, but a fundamental reimagining of what skilled nursing care can and should be in the 21st century—more personal, more accessible, and more integrated into the fabric of everyday life.
The decentralization of skilled nursing points not only to a significant health and social care shift but also marks an important step towards a more humane, responsive, and sustainable model of care for the nation’s aging population. With the right support and innovation, the future of eldercare could well be rooted in the heart of the community, reshaping lives and systems for decades to come.