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Are nursing homes becoming less home and more hospital?

Editor’s note: This article was written by guest blogger Anthony Cirillo, FACHE, ABC, a healthcare marketing and experience management expert and elder advocate. For more information about the author, please see our About page.

Recently, I read that West Virginia nursing homes are taking care of younger drug addicts and sex offenders. Their admission is based on medical issues and space availability. The facilities themselves are considering special wings for these patients. Of course we know that more and more SNFs are moving into the rehabilitation business and sub-acute care.

As you talk to people in the industry, there seems to be less focus on residential care in skilled nursing. This could lead you to believe that, when all is said and done, these facilities will become step-down units from hospitals in the future. Of course there is a money motive here, as this direction is more profitable.

Also, in my opinion, the general feeling is that people want to age in place. No argument here. But look around. The U.S. is 37th in the World Health Organization. The latest obesity data says we are getting fatter and the latest mortality statistics show some plateau in longevity. We are becoming less healthy as a nation.

This is accompanied by an entitlement attitude. Many people think, ‘If I let myself go, it’s okay because I will have insurance and there will be a procedure, drug, or implant for me.’ But even with all the great technology available, there will be people who simply cannot age in place and will have needs that far surpass assisted living capabilities. So where will they live?

Will nursing homes simply become hospital adjuncts? Will assisted living now take residents in need of more care than they can provide? Some would argue, myself included, that they already do that. And as accountable care becomes more defined in aging services, will it not be incumbent for providers to figure it all out? After all, if in theory there will be one payment made for an elder’s encounter with the aging system, shouldn’t the system be figuring out the most appropriate care setting for our elders? And at the very least, if assisted living now becomes the residential default doesn’t that call for increased regulation of them as well?

I know that if my soon to be 89-year-old mother needs care, I would want her in the most appropriate care setting and not rejected from one because a more profitable patient waits in the wings. There needs to be some collective soul searching and a collective vision for aging services in this country.

Let me know what you think. Email me at Cirillo@4wardfast.com

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