McKnight's November 21, 2025
Everyone has heard about someone who lost their life’s savings to the high cost of long-term care. The media is full of such stories. KFF Health News and the New York Times highlighted many in their Dying Broke series.
Nevertheless, I’d like to ask senior living operators and investors these questions. How often do you see catastrophic LTC spend down occur among your clientele? Is that outcome widespread or only anecdotal? Have you ever seen hard evidence that LTC spending down into impoverishment is commonplace?
I’ve followed the literature on Medicaid financial eligibility and LTC spend down for decades. Over the years, many scholars of fine repute have published extremely high estimates of personal out-of-pocket LTC spending. A few examples...
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