The Long-Term Care Market: Nursing Homes, Home Care, Hospice Care, and Assisted Living

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Published Jan 1, 2006 | 218 Pages | Pub ID: KLI1163943

The U.S. long-term care industry experienced strong growth from 1999 through 2004 and this growth is expected to continue through the end of the decade. Indeed, the aging of the U.S. population will push unprecedented demand for all forms of long-term care, but ongoing cost containment issues continue to pressure both private and public managed care organizations and make competition in this dynamic environment challenging.

This comprehensive study from Kalorama Information details four segments of the long-term care industry, including:

  • Nursing Homes,
  • Home Care,
  • Hospices, and
  • Assisted Living Facilities

For each of the segments, the report provides key data such as:

  • Market size and growth for the historical years 1999-2004,
  • Revenue forecasts through 2009,
  • Market share of leading competitors,
  • Demographics of the resident populations,
  • Number and characteristics of facilities,
  • Data on funding from the various payer sources,
  • And much more

The report thoroughly examines the issues and trends affecting the long-term care marketplace, including regulatory and quality issues, insurance and managed care, and consumer attitudes and preferences. Extensive demographic information about the U.S. elderly population—information vital to strategic decisions about long-term care facilities and their future customers—includes racial/ethnic make-up, marital status, and detailed forecasts of age group populations in the United States through 2030.

Profiles of 10 top competitors includes information on their history and lines of business, recent financial situation, and corporate strategies for the future.

Historical information for this report was gathered from a wide variety of published sources including company reports and filings, government documents, legal filings, trade journals, newspapers and business press, analysts’ reports and other sources. Interviews with company representatives were conducted to capture the perspectives from industry participants’ point of view and assess trends, and form the basis of the forecasting and competitive analysis.

CHAPTER ONE: Executive Summary
  • Scope and Methodology
  • Overall Market Size
  • Long Term Care Services
  • Demographics
    • Geographic Concentrations
    • Activities of Daily Living
    • Chronic Illness
    • Income

  • Quality of Care
  • U.S. Health Expenditures
  • Consumer Preferences and Lifestyle Issues
  • Fees and Payment
    • Public Payments
    • Long Term Care Insurance

  • Preparing for the Future
  • Nursing Homes
    • Number of Facilities
    • Resident Population
    • Issues and Trends
    • Market Size and Forecast
    • Competitor Analysis
    • Market Analysis

  • Home Care
    • Number of Facilities
    • Resident Population
    • Issues and Trends
    • Market Size and Forecast
    • Competitor Analysis
    • Market Analysis

  • Hospices
    • Number of Facilities
    • Resident Population
    • Issues and Trends
    • Market Size and Forecast
    • Competitor Analysis
    • Market Analysis

  • Assisted Living
    • Number of Facilities
    • Resident Population
    • Issues and Trends
    • Market Size and Forecast
    • Competitor Analysis
    • Market Analysis

CHAPTER TWO: Long Term Care Industry, Issues, and Trends

  • The U.S. Health Care Industry
    • Long Term Care
    • Nursing Homes
    • Home Care
    • Hospices
    • Assisted Living

  • Demographics
    • U.S. Population
    • Aging of the Population
    • Racial Trends
    • Marital and Living Arrangements
    • Geographic Concentrations
    • Activities of Daily Living
    • Chronic Illness
    • Income

  • Quality of Care
    • Quality Initiatives
    • Staffing Concerns
    • Certification and Accreditation

  • U.S. Health Expenditures
  • Consumer Preferences And Lifestyle Issues
    • The Elderly
    • Caregiver Issues

  • Fees and Payment
    • Medicare
    • Medicaid
    • Long Term Care Insurance
    • Numbers of Insured
    • Cost of Coverage and Affordability
    • The Managed Care Environment

  • Preparing For The Future
    • Staffing and Human Resources
    • Information and Education Initiatives
    • Medicaid Reform
    • Building of New Facilities

CHAPTER THREE: Nursing Homes

  • Services
  • Number of Facilities
  • Resident Population
    • Demographic Data
    • Functional Data
    • Length of Stay
    • Insurance Coverage

  • Issues and Trends
    • Medicare Reforms
    • Patient Dumping
    • Quality of Care
    • Federal Quality Improvement Initiatives
    • State Quality Improvement Initiatives
    • Legal Actions
    • Safety
    • Industry Data

  • Market Size and Forecast
    • Cost of Care
    • Size of the Market

  • Competitor Analysis
  • Market Analysis

CHAPTER FOUR: Home Care

  • Description of Facilities
    • Services
    • Number of Facilities

  • Resident Population
    • Demographic Data
    • Functional Data
    • Insurance Coverage

  • Issues and Trends
    • Medicare Reimbursement
    • Medicaid Reimbursement
    • Medicare and Medicaid Co-payments
    • Disease Management
    • Technology and Telemedicine

  • Market Size and Forecast
    • Cost of Care
    • Size of the Market

  • Competitor Analysis
  • Market Analysis

CHAPTER FIVE: Hospices

  • Description of Facilities
    • Services
    • Number of Facilities

  • Resident Population
    • Demographic Data
    • Functional Data
    • Insurance Coverage

  • Issues and Trends
    • Fraud and Abuse
    • Telemedicine
    • Proprietary Technologies
    • Profitability

  • Market Size and Forecast
    • Cost of Care
    • Size of the Market

  • Competitor Analysis
  • Market Analysis

CHAPTER SIX: Assisted Living

  • Description of Facilities
    • Services
    • Number of Facilities

  • Resident Population
    • Demographic Data
    • Functional Data
    • Length of Stay
    • Insurance Coverage

  • Issues and Trends
    • Quality of Care
    • Federal Quality Improvement Initiatives
    • State Quality Improvement Initiatives
    • Legal Actions
    • Mergers and Acquisitions
    • Data on the Industry

  • Market Size and Forecast
    • Cost of Care
    • Size of the Market

  • Competitor Analysis
  • Market Analysis

CHAPTER SEVEN: Market Summary

  • Overview
  • Issues and Trends
    • Continuum of Care
    • Reimbursement and Regulatory Changes
    • Specialty and Post-Acute Care

  • Market Size and Forecast

CHAPTER EIGHT: Company Profiles

  • Alterra Healthcare Group Inc./ Brookdale Senior Living
    • History and Lines of Business
    • Long-Term Care Business
    • Financial Information
    • Mergers and Acquisitions
    • Corporate Strategies

  • American Retirement Corp Inc.
    • History and Lines of Business
    • Long-Term Care Business
    • Financial Information
    • Mergers and Acquisitions
    • Corporate Strategies

  • Apria Healthcare Group Inc.
    • History and Lines of Business
    • Long-Term Care Business
    • Financial Information
    • Mergers and Acquisitions
    • Corporate Strategies

  • Beverly Enterprises, Inc.
    • History and Lines of Business
    • Long-Term Care Business
    • Financial Information
    • Mergers and Acquisitions
    • Corporate Strategies

  • Emeritus Corporation
    • History and Lines of Business
    • Long-Term Care Business
    • Financial Information
    • Mergers and Acquisitions
    • Corporate Strategies

  • Extendicare, Inc.
    • History and Lines of Business
    • Long-Term Care Business
    • Financial Information
    • Mergers and Acquisitions
    • Corporate Strategies

  • Manor Care, Inc.
    • History and Lines of Business
    • Long-Term Care Business
    • Financial Information
    • Mergers and Acquisitions
    • Corporate Strategies

  • National Senior Care, Inc.
    • History and Lines of Business
    • Long-Term Care Business
    • Financial Information
    • Mergers and Acquisitions
    • Corporate Strategies

  • Sun Healthcare Group Inc.
    • History and Lines of Business
    • Long-Term Care Business
    • Financial Information
    • Mergers and Acquisitions
    • Corporate Strategies

  • Sunrise Senior Living Inc.
    • History and Lines of Business
    • Long-Term Care Business
    • Financial Information
    • Mergers and Acquisitions
    • Corporate Strategies

APPENDIX: Company Directory
List of Exhibits
CHAPTER ONE: Executive Summary

  • Table 1-1: The Overall U.S. Long Term Care Market by Type (Nursing Home
  • Care, Home Care, Hospice Care, Assisted Living) 1999-2009

CHAPTER TWO: Long Term Care Industry, Issues, and Trends

  • Table 2-1: U.S. Resident Population by Age Group (Under 65, 65-69, 70-74, 75-79, 80-84, 85+) 1990 vs 2000
  • Table 2-2: Projected U.S. Resident Population by Age Group (Under 65, 65-69, 70-74, 75-79, 80-84, 85+) 2009, 2015, 2020, 2025, 2030
  • Table 2-3: U.S. Expectation of Life at Birth by Sex and Race, 2003
  • Table 2-4: U.S. Life Expectancy in Years by Sex 1999-2009
  • Table 2-5: U.S. Elderly Resident Population by Sex and Age Group (65-69, 70-74, 75-79, 80-84, 85-89, 90+) 2000
  • Table 2-6: U.S. Resident Population, by Age Group (Under 65, 65-74, 75-84, 85+), Hispanic Origin, and Race 2000, 2005, 2010, 2025
  • Table 2-7: U.S. Resident Population Percent Distribution by Age Group (Under 65, 65-74, 75-84, 85+), Hispanic Origin, and Race 2000, 2005, 2010, 2025
  • Table 2-8: Proportion of Total U.S. Resident Population, by Age Group (Under 65, 65-74, 75-84, 85+), Hispanic Origin, and Race 2000, 2005, 2010, 2025
  • Table 2-9: Characteristics of U.S. Household Population of Persons 65 and Older 2000
  • Table 2-10: Marital Status of U.S. Elderly Residents by Age Group (65-74, 75-84, 85+) and Sex 2000
  • Table 2-11: Percent Distribution of Marital Status of U.S. Elderly Residents by Age Group (65-74, 75-84, 85+) and Sex 2000
  • Figure 2-1: U.S. Senior Population in Top 10 States, 2000
  • Table 2-12: Number of Nursing Homes in Top 15 States 2003
  • Table 2-12b: U.S. Resident Population by State and Age (Under 65 and Over 65) 2000
  • Table 2-13: Disability Prevalence by Age 2000
  • Table 2-14: Frequencies of Selected Diseases (Diabetes, Ulcers, Kidney Disease, Liver Disease, Arthritis, Chronic Joint Symptoms) among Older U.S. Persons by Age Group (Under 65, 65 to 74, 75+) 2003
  • Table 2-15: Frequencies of Selected Diseases (Diabetes, Ulcers, Kidney Disease, Liver Disease, Arthritis, Chronic Joint Symptoms) as a Percentage of Older U.S. Persons by Age Group (Under 65, 65 to 74, 75+) 2003
  • Table 2-16: U.S. Median Income by Householder Age Group (15-24, 25-34, 35-44, 45-54, 55-64, 65+) 2004
  • Table 2-17: Estimated U.S. National Health Expenditures by Payer Type (Private, Public, Federal, State and Local) 1999-2004
  • Table 2-18: Estimated U.S. Per Capita National Health Expenditures by Payer Type (Private, Public, Federal, State and Local) 1999-2004
  • Table 2-19: Estimated National Health Expenditures by Type of Expense (Services & Supplies, Personal Healthcare, Hospital Care, Physician & Clinic Services, Other Professional Services, Dental Services, Other Personal Healthcare, Nursing Home, Home Healthcare, Retail Outlet Sales, Prescription Drugs, Other Medical Products) 1999-2004
  • Table 2-20: Funding for Personal Health Expenditures by Source (Consumer Out of Pocket, Private Insurance, Other Consumer Payments, Federal, and State and Local) 1999-2004
  • Table 2-21: Estimated Funding for National Health Expenditures by Type of Expense and Source 2004
  • Figure 2-2: Estimated Funding for Home Health Care and Nursing Home Care by Source 2004

CHAPTER THREE: Nursing Homes

  • Table 3-1: Nursing Home Size by State (Total Number of Beds, Average Number of Beds per Facility) 2003
  • Table 3-2: Leading Nursing Home Deficiencies
  • Table 3-3: U.S. Nursing Home Deficiencies by State Average Number of Deficiencies per Facility, Percentage of Facilities with Serious Deficiencies) 2003
  • Table 3-4: The U.S. Nursing Home Market 1999-2009
  • Figure 3-1: Nursing Home Care Expenditures, Distribution by Payment Source, Calendar Years 1999-2004*
  • Table 3-5: Nursing Home Care Expenditures Distribution by Payment Source 1999-2004
  • Table 3-6: Leading Competitors in the U.S. Nursing Home Market by Revenues and Market Shares 2004

CHAPTER FOuR: Home Care

  • Table 4-1: Home Healthcare Payments by Source (Medicare, Medicaid, State & Local, Private Insurance, Out-of-Pocket, Other) 2002 and 2003
  • Table 4-2: Medicare Fee-for-Service Home Health Outlays, Visits, Clients, Payment/Client, and Visits/Client 1994-2004
  • Table 4-3: The U.S. Home Health Care Market 1999-2009
  • Figure 4-1: Home Care Expenditures, Distribution by Payment Source, Calendar Years 1999-2004
  • Table 4-4: Home Care Expenditures Distribution by Payment Source 1999-2004
  • Table 4-5: Leading Competitors in the U.S. Home Health Care Market by Revenues and Market Shares, 2004

CHAPTER FIVE: Hospices

  • Table 5-1: Number of Facilities by Type (Freestanding, Home-Health Based,
  • Hospital Based, Skilled Nursing Facility Based) 2003*
  • Figure 5-1: Usage of Hospice Services by Race, 1998 - 2002
  • Table 5-2: Average Medicare Reimbursements for Hospice Care by Type Routine, Continuous, Inpatient Respite, General Inpatient, Physician Services) FY 2005
  • Table 5-3: Medicare Hospice Outlays, Clients, and Days per Client, Dollar Amount per Client FY94-FY 2004
  • Table 5-4: The U.S. Market for Hospice Care 1999-2009
  • Table 5-5: Leading Competitors in the U.S. Hospice Market by Revenues and Market Shares 2004

CHAPTER SIX: Assisted Living

  • Table 6-1: Assisted Living Residents Requiring Assistance with Daily Living Activities (Percentages by Level of Assistance and Activity)
  • Figure 6-1: Assisted Living Residents Requiring Assistance with Daily Living Activities
  • Table 6-2: The U.S. Market for Assisted Living 1999-2009
  • Table 6-4: Leading Competitors in the U.S. Assisted Living Market by Revenues and Market Shares 2004
  • Table 6-4: Leading Competitors in the U.S. Assisted Living Market by Bed Capacity 2004

CHAPTER SEVEN: Market Summary

  • Table 7-1: The U.S. Long Term Care Market by Type (Nursing Home Care, Home Care, Hospice Care, Assisted Living) 1999-2009
  • Table 7-2: Long Term Care Industry Distribution of Revenues by Sector 1999, 2004, 2009
  • Figure 7-1: Long Term Care Industry Revenues by Sector 1999, 2004, 2009
  • Figure 7-2: Long Term Care Industry Revenues by Year

Chapter Eight: Company Profiles

  • Table 8-1: Financial Performance for American Retirement Corporation 2002 - 2004
  • Table 8-2: Financial Performance for Apria 2002 - 2004
  • Table 8-3: Financial Performance for Beverly Enterprises 2002 - 2004
  • Table 8-4: Financial Performance for Emeritus Corp. 2002 - 2004
  • Table 8-5: Financial Performance for Extendicare 2002 - 2004
  • Table 8-6: Financial Performance for Manor Care 2002 - 2004
  • Table 8-7: Financial Performance for Sun Healthcare Corp. 2002 - 2004
  • Table 8-8: Financial Performance for Sunrise Senior Living 2002 - 2004

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