7 Pivotal Milestones for Long Term Care Facilities

Although under seemingly constant government and media scrutiny, long-term care facilities have undergone many improvements. Every year we see developments in the nursing homes and facilities that care for our country’s oldest citizens. From its humble, often unsafe beginnings of locally run “poor farms” to our current 15,000 long-term care facilities nationwide, nursing homes have made many advancements over the decades.

Pre-1900s:  Women’s groups and churches organized almshouses for elderly and widowed women to be cared for. Otherwise known as “poorhouses,” these almshouses were of the poorest conditions and were considered a last resort with inadequate care.

1935:  The passing of the Social Security Act provided general welfare for the elderly population. These federal benefits did not extend to institutions such as almshouses, which motivated people to move out of poor conditions and seek other help.

1940s-1960:  New nursing home facilities began opening as the older ones were being shut down. This process was referred to as the closing of “mom and pop” operated facilities. The data records indicate that, including the closures, there was an overall increase in nursing home facilities.

1960s:  Nursing homes were now in abundance, which lead to the U.S. Congress and Senate creating policies such as “Conditions of Participation”. This assured seniors who were receiving benefits from Medicare were provided high quality care. These policies formed from the discovery that many nursing homes were fire hazards, which resulted in many multi-fatality nursing home fires.

1968:  The Moss amendments were implemented for nursing homes that accept Medicaid to satisfy new operational standards. These amendments went hand in hand with the Kennedy amendment requiring state licensure of administrators of long term care facilities.

1972:  Supplemental Security Income (SSI) was created and Medicare was extended to disabled populations.

1987:  The Omnibus Budget Reconciliation Act (OBRA) requires standards that need to be met for the highest physical, mental and psychosocial care in institutions and facilities for long term care patients.

2000-Present:  Currently, there are over 15,000 long term care facilities nationwide with 1.4 million residents. Of these, approximately 67% of nursing homes are proprietary, with 7% being voluntary and nonprofit and 6% being government owned or other. Long term care and nursing home residents that are using the primary paying source of Medicaid make up approximately 64%, the remaining paying with Medicare make up 14% and private/other sources 22%.

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