Nursing Home Reform – 1950 and Beyond


Previously, we learned how the concept of the elderly living in a care home began with the horrible, degrading almshouse of the early 19th century. Now we are entering the 1950s and we will see the struggle politicians and health care advocates have had in making adequate and affordable care available for our senior citizens.

The desire to do away with the concept of the almshouse succeeded by the early 1950s. A significant Amendment to the Social Security Act included the requirement that states had to have some form of licensing for nursing homes. Nursing home scandals began to make the news in the early 1960s due to noncompliance by staff and financial irregularities.

Medicare and Medicaid

During the mid to later 1960s, nursing home standards continued to improve due to legislation, particularly Medicaid and Medicare. Because of such standards set by the government, nursing homes were unable to comply, and the intermediate-care facilities were established to qualify for federal reimbursement. Because less resources and skilled nursing were required, less government costs meant a lowered standard of care.

Sweeping legislation in 1972 Medicaid into the nursing home equation. Also during the 1970s, nursing home scandals again made headlines although little change was accomplished.

Increased Privatization of Nursing Homes

Privatization of nursing homes increase dramatically during this time. Statistics show that despite the ability of government run homes to provide care to the elderly, almost 80 percent of the elderly lived in commercially run homes that unfortunately provided substandard care.

It seemed society had gone back to the almshouses of yesterday-year, bringing fear to the elderly and guilt to their relatives who felt they were abandoning their loved ones.

The 1980s found more regulations as the federal government and various states struggled to provide adequate care for their senior citizens at a cost more families could afford.

The 1990s led to a new field, sub-acute care. When people are released from the hospital, they sometimes need more care than found in intermediate-care nursing facilities. In recent years, legislation has continued to lead to better care and higher costs.

The Baby Boomers Come of Age

Although long-ago policy makers wanted to close the almshouse down and provide adequate care and assistance to seniors, they underestimated the number of elderly that would need their help. Due to the sheer number of baby boomers coming through the pipeline, government funds are stretched beyond their wildest expectations.

Legislation that was meant to get senior citizens out of their dire and inadequate living conditions, and provide them with adequate housing and care not only shut the door on the poorhouse of the times, but also birthed a completely new industry.

Nursing homes have become a multi-billion dollar industry largely subsidized by Medicaid, Medicare, and the families or the seniors themselves.

As our most recent President attempts to push health care reform through the congressional juggernaut, senior citizens and their family members await anxiously for any change that will help them receive the best care possible in their remaining years.




Leave a Reply

Your email address will not be published. Required fields are marked *