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Nursing Homes in Trouble

What you need to know to protect elderly loved ones — and yourself

By Rachael Kennedy


Rachael Kennedy

Baby boomers today are at a strange age; nearing retirement, most are experiencing the happiness inherent in becoming a grandparent as well as the often painful challenges associated with aging parents and eldercare. Everyone in this age group needs to know about the nursing home industry to protect their loved ones and also themselves in the future.

An Industry in Trouble

The U.S. Department of Health and Human Services (HHS) ran a study over the course of 2005, 2006, and 2007. The study used data from OSCAR, a survey system used by the Centers for Medicare and Medicaid Services (CMS) to monitor the nursing home industry. No nursing home may participate in Medicare and Medicare services without first being certified; and to be certified, a nursing home must participate in random CMS OSCAR surveys once at least every 15 months.

The HHS survey found that 91 percent of nursing homes in OSCAR’s system were reported for “deficiencies,” i.e. when a nursing home fails to meet more than one Federal standard for care; 17 percent were reported for deficiencies that caused harm or placed nursing home residents in immediate danger.

These deficiencies have one root cause: The nursing home industry needs more staff than is available. According to HHS, 90 percent of U.S. nursing homes are gravely understaffed; 53 percent of nursing homes surveyed by HHS conveyed that their lack of an adequate staff was a barrier to effectively providing care, and 47 percent stated that high staff turnover rates were also a quality care barrier.

Increased Strain in the Future

Unfortunately, the strain on the nursing home industry is only expected to worsen in the future. The baby boomer generation (those born between 1946 and 1964) now includes 76 million people and represents about 25 percent of the U.S. population.

With that size, however, comes the expectation that the demand for professional elder care will increase. According to data from the Centers for Disease Control (CDC), there were 1.5 million nursing home residents in 2004. Based on Census data and the fact that 90 percent of nursing home residents are above the age of 65, about 3.73 percent of those who are age 65-plus were in Medicaid/Medicare-certified nursing homes in 2004. If that demand rate continues, it can be projected that somewhere between at least 2.8 million baby boomers will need nursing home care sometime in the next 20 to 30 years. According to the 2004 CDC data, there are only enough nursing home beds in the U.S. to accommodate 1.7 million residents; because baby boomers will not be the only ones utilizing nursing homes, it is obvious that the nursing home industry and government need to develop a plan quickly.

When it gets to the point where your loved one needs a caregiver and you can no longer provide for them what they need, you may begin to consider a nursing home. Here are some ways to protect your loved one:

Choose the Right Nursing Home

• Thoroughly research and visit all of the nursing homes you are considering.

• During your visits, use Medicare’s Nursing Home Check List.

• Trust your gut; if something feels wrong, it probably is.

Follow Up

• Visit often; those residents who rarely or never have family visit are more likely to experience abuse than those who do

• Know the signs of elder abuse 


• If you find that your loved one is being abused, you need to act quickly

• Contact the local, state, and federal authorities and services

• Contact nursing home abuse lawyers to see if you have a personal injury case; this will allow you to ensure that another’s loved one does not endure the same injustices

How to Protect Your Future

The best way to protect your future is to have a plan:

• Have legal documents drafted that determine who will take care of you or make decisions concerning your care when you can longer take care of yourself

• Research nursing homes and care facilities to determine which features you want your facility to have; you may be a long way away from elder care, but knowing what you want out of a facility is imperative to communicate to, and document for, your trustee; some facilities even allow people to apply to live in their care facility long before their services are needed

• Determine your budget for your future care

• Talk to your loved ones about the signs of elder abuse

Rachael Kennedy is a freelance writer bringing to us what every baby boomer needs to know about nursing homes. A University of Texas graduate, her career currently revolves around the problem of nursing home abuse.

Christine Crosby

About the author

Christine is the co-founder and editorial director for GRAND Magazine. She is the grandmother of five and great-grandmom (aka Grandmere) to one. She makes her home in St. Petersburg, Florida.

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