Wednesday, June 1, 2011

Nursing Home Closures Hit Low Income Communities

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By: canada leo

Nursing home closures across America have resulted in a significant drop in the number of available nursing home beds. These closures have hit both poor and affluent neighborhoods, with the urban neighborhoods being hit the hardest.

The minority (black/Hispanic) population of America is aging at a fast rate in comparison to the white population. As a consequence of this, the need for long-term, post-retirement care is on the rise in minority communities. Nursing home closures are therefore of great concern to residents in these areas.

Zhanlian Feng of the Center for Gerontology and Health Care Research at Brown University in Providence, R.I. has been investigating the impact of nursing home closures on minority communities. Feng and his team analyzed information derived from the National Online Survey Certification and Reporting database on closings of Medicare- and Medicaid-certified facilities between the years of 1999 and 2008. Closures were found to have hit half of all hospital-based nursing homes in America and 11 percent of all stand-alone nursing homes. Together, 2,902 nursing homes faced closures during the time period investigated. This represents a loss of 16% of nursing homes certified by Medicare/Medicaid.

The researchers also made use of data from the 2000 U.S. Census to find that overall nursing home closure rates were twice as high in the low income and minority communities as in the affluent communities. Nursing homes in minority communities were around 37.5% more likely to close than in affluent areas. Nursing home closures have inevitably led to elderly individuals having to travel further to reach their nearest centers. However, it was found that the traveling distances were greater for those living in minority communities.

It is not just the nursing home closures in low-income and minority communities that are of concern. The diminishing options of nursing home care for seniors, and the quality of those that remain in existence, are also of primary concern.

For many individuals, there comes a time when nursing home placement is unavoidable. However, individuals should be free to choose a high-quality nursing home in close proximity to their previous place of residence and within short distance of their family and friends. This freedom of choice is diminishing for residents of minority and low-income neighborhoods.

The majority of individuals in low-income communities who make use of nursing homes are a part of the Medicaid program. The reimbursement rates of these individuals are much lower than the fees paid by private-pay individuals. As a result, Medicaid program nursing homes are increasingly likely to face closures.

It is estimated than in excess of 27 million American residents will require long-term care by the year 2050. This is almost twice the number of individuals who required care in the year 2000. It has therefore been proposed that the federal government will either need to increase the rate of reimbursement for nursing home care, or federal and state policies will need to fund more inexpensive care options, such as assisted living. If they fail to do so, only wealthy individuals will be able to access nursing home care.

An independent study conducted by researchers from the Harvard Medical School affiliated Institute for Aging Research found that a significant portion of the Medicare budget is being directed towards impractical yet aggressive therapies for terminal dementia as opposed to dementia care based in nursing homes. The researchers have therefore suggested that the budget currently put towards these therapies would be better put towards high-quality palliative care.

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