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Poor Urban Communities Hit The Hardest With Skilled Nursing Facility Closures

New research reveals poor, urban neighborhoods are taking the hardest hit from the widespread closure of skilled nursing facilities across the nation over the last decade, representing a 5 percent drop. “The country’s minority population is aging at a steeper rate compared with the white population,” said study lead author Zhanlian Feng, an assistant professor at Brown University in Providence, R.I.  “And so the potential need for long term care is rising fastest in minority communities, as skilled nursing home closures are happening more often in their areas,” he added.

This disproportionate impact of skilled nursing home closings on minority and low income communities “will have all sorts of implications in terms of access and quality of care issues,” Feng added. To explore skilled nursing facility trends, Feng and colleagues analyzed information drawn from the National Online Survey Certification and Reporting database on closings of Medicare and Medicaid certified facilities between 1999 and 2008. During that time, the research team found that 11 percent of stand alone skilled nursing facilities, approximately 1,776, and nearly half of all 1,126 hospital based skilled nursing facilities in the country shut their doors. Together, they represent a loss of 16 percent of the 97,000 Medicare/Medicaid certified skilled nursing homes, more than 5 percent of nursing home beds. Based on 2000 U. S. Census figures,  the study authors further noted that overall closure rates were about twice as high in zip codes that are in low income and minority communities than in the richest zip codes.

Skilled Nursing homes in zip codes comprised primarily of Hispanic or African American residents were 37 and 38 percent more likely, respectively, to close than those in areas with the fewest Hispanics or African America. While distances to the nearest operating skilled nursing facilities increased “significantly” in all areas that experienced closures, the researchers found the travel increases greatest for those living in poor and minority localities.The team concluded that nursing homes in minority and low income communities are bearing a greater share of financial pressures and closures, which raises valid concerns about rapidly diminishing senior care options and the quality of care in the remaining facilities in those areas.

An Old Tale by *gilad on deviantART

“There are times when placement in a nursing home is unavoidable,” said Dr. Mitchell H. Katz, director of the Los Angeles County Department of Health Services, who wrote an accompanying editorial. “And then what we should want is a high quality nursing home that is near where a person has lived all their life and where their family and friends are. Moreover, what’s disturbing about this investigation is that it shows that nursing home closures are not random. And that they are more likely to occur in low income neighborhoods.” Katz said more of the people in low income neighborhoods who use nursing homes are Medicaid recipients, whose reimbursement rates are lower than the fees of private pay patients. “So the result is that those places that care for these patients are more likely to close,” he said. More than 27 million Americans will need long term care by 2050, nearly twice as many as in 2000, Katz noted. Either the federal government will have to increase the reimbursement rate for nursing home services, or state and federal policies will have to fund less expensive and perhaps more preferable lifestyle options, such as assisted living, he concluded.

“That would be sensible, and should not cost more, but it requires a more far seeing policy approach than what we have now,” he said. Otherwise, only the wealthy will have access to nursing homes, the authors said. In a separate study published in Archives of Internal Medicine, investigators from the Institute for Aging Research, which is affiliated with Harvard Medical School, found that a significant amount of Medicare money directed toward the care of nursing home residents with advanced terminal dementia may be wasted on aggressive therapies that offer little practical benefit. For patients who stand to gain little from rehabilitative services, for example, the researchers suggested redirecting resources toward high quality palliative care that could provide a more comfortable end of life experience. The findings of the studies are published in the Jan. 10 online edition and the May 9 print issue of the Archives of Internal Medicine.

800Seniors.com is a leading referral system in the Elderly Healthcare industry. We are located on 5400 Atlantis Court, Moorpark, California 93021. 800Seniors.com provides the perfect match between seniors searching for health care provisions such as Home Care, Home Health, Skilled Nursing New York, Hospice Care, Medical Supplies, as well as a variety of Assisted Living and Care Homes nationwide. Take the confusion and hassle out of the search. For more information call 1-800-768-8221, visit http://800seniors.com or fax us your details at (805)517-1623.

About The Author: Gloria Ha’o Schneider is an expert in senior citizen and baby boomer issues. Her topics revolve around Senior Living and Healthcare to provide the latest information to this demographic as well as their families and loved ones.

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