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Nursing Homes Vs. Home Care - Is There Really Any Question

  • Synopsis: Published: 2009-07-13 (Revised/Updated 2010-04-15) - An editorial concerning the debate over nursing home care vs at home care and the Community Choice Act - Disabled World.

Main Document

There are tens of thousands of people living in nursing homes who would rather be living in their own homes, yet they remain in nursing homes, rehabilitation centers, or state hospitals because of a historic bias towards institutionalized care. The costs are higher, but that does not seem to matter. Taxpayers continue to pay the bills.

Senator Barack Obama was a co-sponsor of the Community Choice Act, legislation that would give persons who receive Medicaid the option of receiving equal access to services in their own communities while not forcing them into institutions such as nursing homes. The Obama administration has recently stated that it would not address the issue as a part of its proposed health care reform. The anger from Disability Rights Advocates has been immense.

A decade ago, the United States Supreme Court stated that bias was tantamount to discrimination. They made this statement this very same day ten years ago; although now, even as Disability Rights Advocates celebrate the anniversary of this same ruling - worries over the Obama administration's move away from this pledge give them great concern that people with disabilities will not have the option to live at home.The anger has been growing among advocates, to the point where in April around ninety were arrested during a protest outside of the White House.

Discrimination has been very difficult to end; even as we watch Ms. Sotomayor proclaim herself to be the perfect affirmative action candidate for the Supreme Court. Andrew Imparato, President of the American Association of People with Disabilities stated:

"I don't think most policymakers see it as a civil rights issue, I don't think most people see the ability of getting out of bed and dressing in your own home as a civil right."

The same Supreme Court that Ms. Sotomayor is claiming affirmative action gave her a boost into is the Supreme Court and affirmative action that supposedly supports people with disabilities. Meanwhile; thousands upon thousands of people with disabilities continue to live in institutions such as nursing homes and rehabilitation centers, instead of their own homes. Approximately 270,000 people currently living in nursing homes stated that they would rather be living in their own homes, according to a survey performed by the Centers for Medicare and Medicaid Services.

An unidentified spokesman for the President said that President Obama continues to support efforts to help people with disabilities move out of nursing homes. Disability Advocate Mark Johnson of Atlanta stated, "If you can't hear the thunderstorm coming, you're not listening." Living at home, "is what people would want for themselves and their families." The year 2007 found more than 331,000 people on waiting lists for community-based services.

President Obama's staff declined to say what his current position is in regards to making community programs mandatory. The White House website had said that President Obama would support the Community Choice Act. Now the site states that he would, 'build on existing efforts to encourage states to shift more of their services away from institutions.'

Disability advocates state that allowing people to receive services at home will save money - one of the very goals that President Obama has for health care reform. The average cost of staying in a nursing home nationally is approximately seventy-five thousand dollars. Community-based services would allow people to stay in their homes for around twenty-three thousand dollars a year instead.

The Carlyle Group bought out ManorCare Health Services, and apparently continued the despicable level of nursing home care that had already been in place. In a comment from a person whose mother had been in their care:

"After the Carlyle Group buyout of ManorCare Health Services, continued despicable nursing home care, an uncaring oversight agency (Pennsylvania Department of Health), an unsolicited phone call from CMS in Baltimore, strongly encouraging me to remove her from ManorCare for her health and safety, the Sping Township Police Chief gladly assisted me in securing my mother's safe removal from the home in March of this year. A federal complaint inspection found their infection rate twice to four times the national CMS average."

"Now I'm the sole unpaid caregiver for my mother (again), now age 94. There are millions of us home caregivers who do this without any support at all. I too heard that as Senator, Barack Obama co-sponsored legislation that would give Medicaid recipients equal access to services in the community and not force them into institutions. And to find out that the administration would not address the issue as part of its proposed health care overhaul, is distressing."

"In the past few years, a wave of new owners and investors have purchased nursing home chains. These private-equity firms are unregulated and new to the nursing home market. The top priority for these new owners are profits, rather than providing the staffing and resources necessary to ensure top quality care for our loved ones."

"The nursing home sector accounts for roughly 6 percent, or $124.9 billion of the more than $2 trillion that we invest annually in healthcare. The question is,
'are we getting any value for our money'"

Demand for community services will only continue to grow in the coming decades. People continue to age, and technological improvements assist more people to survive serious injuries, often with disabilities. The baby-boom generation is demanding alternatives to nursing homes as well.

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