I read Mac McKerral's "Home, sour home" (Editor's Notebook in the Aug. 3-9 edition) and had expected the usual cry for more regulations and more money to "fix" our nation's nursing homes.

Mr. McKerral makes several excellent points, but his most compelling comes in his conclusion that nothing will change unless we take matters into our own hands.

In order for us to do that, however, we must accept the reality that warehousing the elderly as a primary care option simply does not work. Consider these facts:

• According to the U.S. General Accounting Office, Medicare spending on skilled nursing facilities (nursing homes) grew at an annual rate of 30 percent per year from 1986 through 1998.

• According to the Center for Medicare Advocacy, combined state and federal spending more than doubled from 1990 through 1998.
• Last year, Congress appropriated an additional $31 billion over 5 years -- essentially guaranteeing a continued annual increase of 10 percent.

Yet despite this constant increase in funding for our nation's nursing homes, we have two reports in the past 12 months that show just how badly broken the system is. In August of 2000, the Health Care Financing Administration released a study that found a majority (54 percent) of nursing homes in America to be dangerously short of staff. And just last week a Congressional report found that the number of homes putting residents in "immediate jeopardy" had continued to rise every year since 1996.

These reports of course do not include the hundreds of millions of dollars in fines and penalties the major nursing home corporations have had to pay as a result of the widespread fraud found throughout the industry.

How many reports do we need? How many stories of abuse and neglect must we endure before we accept the fact that warehousing the elderly in institutional settings is a failed concept?

We must begin the process of moving this country away from our primary dependence on institutional settings and toward community-based care programs such as small group homes, foster care, adult day care, home help and other such proven concepts. Proponents envision a voucher of sorts for families who might otherwise be in need or qualify for a nursing home.

Families would be allowed to choose from a host of options and not just nursing homes.

A review by the University of South Florida Policy Exchange Center on Aging states that these types of programs have dramatically decreased costs while improving access to tens of thousands of families.

Additionally, one study taken from a 1995 issue of the Journal of Gerontology found that, if this model were to be put to its best use, nursing home occupancy could be cut in half.

Imagine that. We can reduce our dependence on nursing homes while saving taxpayers money and offering families real options best suited to their needs. That truly would be a means of taking this problem into our own hands.

Jim Wilkes, an attorney and founding partner of Wilkes & McHugh PA, is an advocate for nursing home residents. He can be reached at (800) 255-5070.

 

 

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