Editorial: The Death of Nursing Homes

Elders often tell their adult kids to shoot them rather than send them off to the nursing home. We may not be disposing of our parents, but we are killing the nursing homes, at least as we know them. In not too many years, long-term care nursing home beds may be as rare as Republicans in Massachusetts.

Many may cheer at this news. But the need for the intensive level of care provided by skilled nursing facilities isn’t going away. As hospitals discharge patients “quicker and sicker,” many need a level of assistance they cannot receive at home. As medical technology keeps people with horrific injuries and severe illness alive for years, they will need careful monitoring and drug treatments that are beyond the abilities of most family caregivers or part-time paid aides. So where will they get this care?

The trend away from nursing homes is already clear. The number of facilities has fallen by nearly 1,000 to about 15,700 since 2000. More than 80,000 beds have been shuttered over those nine years. And the number of Medicaid-only beds—those certified for long-term care stays-- has plunged by half since 1995, to about 114,000.

All this is happening even as the population of those 75 and older—those most likely to need long-term services—has grown from 16.6 million to almost 19 million.

Why the change? In part, it is because Medicaid is gradually providing more long-term care at home, although the pace of change remains slow.

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The Death of Nursing Homes