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New Report Gives New Hampshire Low Scores on Long-Term Care System


New Hampshire ranks #47 when it comes to offering services that help keep people in their homes and communities as they age.  AARP warns more must be done – at an accelerated pace – to meet changing demographic demands.  New Hampshire’s long-term care system needs serious overhaul in order to give people the care they want, in the setting of their choices, at a lesser price.  Nearly all – 95% -- of New Hampshire residents say they want to age at home, and not a nursing home.

Picking up the Pace of Change:  A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers – the third in a series of reports – ranks each state overall and on 25 specific indicators in 5 key dimensions:  affordability and access; choice of setting and provider; quality of life and quality of care; support for family caregivers; and effective transitions between nursing homes, hospitals and homes.  The Scorecard is a collaboration among AARP, The Commonwealth Fund and SCAN Foundation.

“The vast majority of older Granite Staters want to live independently at home as they age, most with the help of unpaid family caregivers,” said AARP New Hampshire Associate State Director of Advocacy Doug McNutt.  “Even facing tight budgets, most states made clear progress to help older residents achieve that goal.  It’s time for New Hampshire to pick up the pace and this Scorecard shows what we have to do.”  AARP serves nearly 231,000 residents age 50 and older in New Hampshire.

The single strongest predictor of a state’s long-term care system is the reach of its Medicaid long-term care safety net.  That’s why AARP has been fighting to expand services provided at home and in the community, by shifting funds away from less desirable and more expensive nursing home care.  Unfortunately, New Hampshire ranks #47 – near the bottom of the pack – in the percentage of Medicaid long-term care dollars that support care provided at home and in the community, the care setting most residents prefer.

“We need to look at the costs of home care vs. nursing home care,” continued McNutt.  “Nursing home care is about three times more expensive than home care.  But we still spend eight out of 10 taxpayer dollars on this type of care.  This fact, along with the desire of people to age in place, points to needed change and highlights the need to allocate resources differently as New Hampshire ages.  The trends are impressive:  By 2026, the leading edge of the baby boomers will turn 80!”

Not all is gloom and doom.  New Hampshire ranks #2 in its Aging and Disability Resource Centers, more commonly known throughout New Hampshire as ServiceLink.  These local centers provide support to Granite Staters, their caregivers, and their families in navigating the complex long-term care system.  Over the years, AARP has been instrumental in supporting the funding for these vital resources.  ServiceLink was recently honored by AARP Public Policy Institute as a “Promising Practice” for their person- and family-centered practices, using an interactive process that reflects and individual’s and family’s strengths, preferences, needs and values.  ServiceLink indeed “links” people living in communities with the care and services they need to remain there.

“This shows that New Hampshire can be a leader,” concluded McNutt.  “But we need to do more and we need to do it soon!”

Long-term care – also called long-term services and supports – is a diverse set of services designed to help older people and those with disabilities.  Services can be provided in a person’s home, in a community setting such as an adult day center, or in a group residential facility like a nursing home.

The full Scorecard, along with an interactive map of state rankings and information, is available at

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