"Putting people in nursing homes as a first choice has to change."

In the national survey, Massachusetts ranked 40th among the states and the District of Columbia last year for the percentage of Medicaid beneficiaries first receiving long-term care services in a home- or community-based setting, rather than in an institution. It ranked 30th for overall affordability and quality of long-term services and supports. The survey evaluated 25 different measures such as home care, assisted living and nursing home facilities.
Massachusetts received its worst rankings on two affordability measures, scoring 46th for the high costs of both private home care and private nursing home care, when compared with median household income. The state also got low ratings for support for family caregivers, 39th place.
"This is very disturbing," said Al Norman, executive director of Mass Home Care, which advocates for community care. "Hundreds of people referred to nursing homes don't have to be there."
Ten percent of the state's nursing home residents could manage at home if necessary services were provided, the scorecard showed.
Gov. Deval Patrick, D, pledged in 2008 that his administration would help ensure that older and disabled residents could live independently, which most people want. But Norman said the administration has not done nearly enough. Only 31 percent of people needing long-term support are first given the option of in-home care, he said. "Putting people in nursing homes as a first choice has to change."