The Slow Exodus From Nursing Homes

If you’ve helped an older relative move into a nursing home in the past year, you’ve likely heard a nurse or administrator pose The Question: “Do you want to talk to someone about the possibility of returning to the community?”

The resident will hear The Question again every three months, when her condition is reassessed. She’ll hear it if there’s a significant change in her condition. Whatever her health issues, whoever is paying the bill, Medicare regulations adopted in October 2010 mandate that she (or a family member or guardian, if she’s not mentally competent) be asked it.

A nursing home resident has always had the legal right to leave. In the past, though, “the question was asked, and nothing had to happen as a result of the answer,” said Barbara Edwards, director of disabled and elderly health programs for the federal Centers for Medicare and Medicaid Services.

Now, The Question has been reworded to make its point — you can go home again — more explicit. As important, a resident’s “yes” now triggers contact with an outside agency that will explain how going home might work.

All this can startle or irritate a new resident’s unwitting relatives. “For most family members, it’s taken a long time to convince a loved one to move into a nursing home,” said Lori Smetanka, director of the National Long-Term Care Ombudsman Resource Center, who’s been hearing an earful about the change.

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A Slow Exodus From Nursing Homes