On Aug. 29 the Tribune ran a story about a national nursing home chain, National HealthCare Corp., leaving the state. The article went on to imply that the loss was somehow a blow to residents and their families.

Should we lament the departure of any for-profit chain from this state? Let's examine some facts: These chains, NHC among them, are among the worst caregivers in the state. The corporate-owned chains are 80 percent more likely to make it to Florida's ``Watch List.'' (The list is compiled by the state and identifies homes that have had too many deficiencies.) Nationally, the federal government just completed an eight-year study that found a majority of nursing homes to be understaffed to the point that residents' lives were in danger. They went on to state that the worst offenders are the financially troubled for-profit chains! They further concluded that this profit-driven shortage was causing direct and immediate ``jeopardy'' to residents.

The major nursing home chains are in deep financial trouble because they engaged in lavish spending and an uncontrolled buying spree in the early 1990s. (This was cited in a 1999 Government Accounting Office report to Congress.) This was compounded by the fact that they engaged in widespread fraud and mismanagement (as chronicled in a 1995 GAO report to Congress) that resulted in the broad-reaching fraud reduction measures in the 1997 Balanced Budget Act. (The federal government has since recovered hundreds of millions of dollars that nursing home corporations stole from taxpayers.)

Should we mourn the loss of NHC? No, we should celebrate the possibility that local owners and operators may take over operations. Hopefully, local ownership will put the decision makers closer to the care they are supposed to provide. This model has been found, time and time again, to make a substantial difference in the delivery of care. However, let's not fool ourselves. We must accept the fact that warehousing the elderly is a failed concept.

We must begin the process of moving away from our singular dependence on skilled nursing facilities and offer families real options when it comes to long-term care: community-based care systems, adult family homes, home help programs and other such proven concepts. We can save taxpayers money, allow seniors to age with dignity and make institutionalized nursing care an option of last resort.

 

 

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