The average rate for private rooms in assisted-living facilities in Washington state, excluding Seattle, is about $5,000 a year less than the national average and is rising much less quickly than it is nationally, according to a national survey.


For most other types of long-term care, including in-home care and at skilled nursing centers, Washington is at or above the national average in cost, says the survey, published earlier this year by Genworth Financial Inc., a Richmond, Va.-based financial-services company.


I have seen private rates go up more in the last year than in the year before that, says Bill Ulrich, owner of Consolidated Billing Services Inc., a Spokane company that does billing for long-term care providers.


Nationally, the price of assisted-living care has risen an average of 6 percent a year since 2004, the Genworth study says, while rates in Washington state outside of the Seattle area have risen an average of 2 percent a year. In Seattle, assisted-living care has risen about 4 percent a year during the same period. In all of its findings, the survey breaks out the Seattle market from overall state averages.


Long-term care rates in every category have risen annually since 2004 in Washington. In the Spokane area, long-term care professionals say rates are rising more rapidly now because operating costs are increasing faster than state reimbursement rates. States reimburse long-term care providers for care they provide to patients who are eligible for Medicaid assistance. Because care costs now often exceed that reimbursement rate for such patients, providers typically increase the rates they charge for private-pay patients to help cover the shortfall, says Ulrich.


The cost of providing long-term care has increased significantly over the last year due to sharply rising fuel, food, and wage costs, he says. With state reimbursements adjusted just 1.99 percent for inflation as of July 2008, Ulrich says the state is not keeping up with its share of costs for skilled-nursing centers, which he says often have resident populations made up of about 65 percent Medicaid recipients and, after hospital stays, Medicare recipients.


The Genworth survey says the price of skilled-nursing care here is slightly higher than the national average.


The survey says that among Washington state facilities outside of the Seattle market, skilled-nursing rates for semi-private rooms rose an average of 4 percent annually between 2004 and 2008, with average rates of $193 a day, or about $70,300 a year. Meanwhile, the national average for such care is $187 day, or $68,400 a year. For private rooms, the national average is $209 a day, or $76,500 a year, while for Washington facilities, except in Seattle, the average is $211 a day, or $77,000 a year.


At St. Josephs Care Center, a skilled-nursing center operated by Renton, Wash.-based Providence Health & Services network, prices for private-pay rooms can range from $219 to $325 a day, depending on the level of service required, says Sally Denton, the facilitys executive director.


St. Josephs has just 9 private-pay beds, however, and has a population of about 65 percent Medicaid patients, on each of whom the facility loses about $20 a day at the current rates, she says. Rates at the facility rise about 3 percent each year, she says.


At Alterra Clare Bridge, a northwest Spokane facility that provides assisted-living care for patients with dementia, prices have increased between 5 percent and 6 percent a year, says Pat Johnson, the facilitys director.


Johnson says smaller than needed increases in Medicaid reimbursements contributes to the increase in the amount charged to private patients for care. Alterra Clare Bridge has seven beds for Medicaid patients, and 56 residents altogether. She says Washington state increased reimbursements for Alterra Clare Bridges clients this year by only about 3 percent, while the cost of providing care rose about 8 percent.


Johnson says families that have members who need long-term care face now serious financial issues. Most people in long-term care facilities today dont have long-term care insurance, and considered their homes their largest asset in planning for retirement, she says. She says now people are putting off going to long-term care facilities because of the turmoil in the housing markets.


Meanwhile, non-Medicaid certified, licensed home health aide rates average $19 an hour in Washington, excluding Seattle, where the cost per hour is about $23, the Genworth survey says. Nationally, the average cost is $19 an hour, it says.


Many retirees still living in their own homes receive part-time or respite care at an adult day center.


The survey indicates that the average annual cost of adult day health care in Washington is about $58 a day. In Seattle, the average daily cost is $52, and nationally, the average cost is $59 a day.


Jim Lippold, executive director of Holy Family Adult Day Centers here, says the cost for services at the centers here is $66 a day, which is the maximum daily rate in Washington identified in the Genworth findings.


The cost of services at the Holy Family centers would be about $16,500 if a person were cared for all 250 days each year that the center is open. Lippold says, however, that most clients attend just two days a week.


Lippold says the centers, which have about 200 clients altogether in two facilities, is the sole provider of such services in northeastern Washington.


This is the first year Genworth has included adult day health centers in its survey, so the study doesnt include a rate trend, but Lippold says the price here is rising about 2 percent annually, as the centers try to keep up with rising costs.


Lippold says he believes such services will become more important in the future as fewer people have family and friends available to help care for them on a volunteer basis as they seek to stay in their homes.


Genworth says the survey, which includes data from 10,000 nursing homes, assisted-living facilities providers in all 50 states, and the District of Columbia, is intended to help consumers plan so they can meet long-term care costs.


Ulrich says its hard to project how much rates will increase in an uncertain economy, but he says if unemployment continues to rise, more people will keep loved ones at home even longer, which could create more competition among long-term care providers.