Nursing Home Closures Hit

A five percent drop in available nursing home beds across the United States have affected many but worst hit are poor, urban neighborhoods.

According to new research, the country’s minority population is aging at a steeper rate compared with the white population.  The study conducted by the Center for Gerontology and Health Care Research at Brown University in Providence, R.I. found that the potential need for long-term care is rising fastest in minority communities, even as nursing home closings are happening more often in their areas.

“The impact of nursing home closings on minority and low-income communities will have all sorts of implications in terms of access and quality of care issues for all,”  states Jesse Slome, executuive director of the American Assopciation for Long-Term Care Insurance.  “We are heading to a twp-class society, those who can pay and those dependent on whatever government programs exist.” 

The study findings, published in the Archives of Internal Medicine, explored nursing home trends and analyzed information drawn from the National Online Survey Certification and Reporting database on closings of Medicare- and Medicaid-certified facilities between 1999 and 2008. 

During that time, the research team found that 11 percent of stand-alone nursing homes (1,776) and almost half (1,126) of all hospital-based nursing homes in the country shut their doors. Together, they represented a loss of 16 percent of all Medicare/Medicaid-certified nursing homes and nearly 97,000 — or more than 5 percent — of nursing home beds. 

Using U.S. Census data from 2000, the authors further noted that overall closure rates were about twice as high in zip codes that are home to low-income and minority (black/Hispanic) communities than in the richest zip codes. 

Nursing homes in zip codes comprised primarily of Hispanic or black residents were 37 and 38 percent more likely, respectively, to close than those in areas with the fewest Hispanics or blacks. 

The team concluded that nursing homes in minority and low-income communities are bearing the lion’s share of financial pressures and closures, which raises concerns about rapidly diminishing senior care options and the quality of the remaining facilities in those places. 

Experts explain that people in low-income neighborhoods who use nursing homes are generally Medicaid recipients, whose reimbursement rates are lower than the fees of private-pay patients. The result is that those places that care for these patients are more likely to close. 

More than 27 million Americans will need long-term care by 2050, nearly twice as many as in 2000.  Either the federal government will have to increase the reimbursement rate for nursing home services, or state and federal policies will have to fund less expensive — and perhaps more preferable lifestyle — options, such as assisted living, the study researchers concluded.  Otherwise, only the wealthy will have access to nursing homes, the authors said.

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