Across the U.S., the muttering at local levels about nursing home and other institutional closures is rising to a roar. It’s so far been a turgid tale of budgets, funding issues, and Medicaid. But the subject has been thoroughly ducked by state authorities, and public comments by officials are noticeably absent. How is this possible?
Here is the more increasingly common situation: Some nice old soul whose main preoccupation has been trying to pay for medication has been told to leave, and the family, grappling with the recession, is running around trying to find a decent level of care. Meanwhile, silence. No information, no clarification.
In New Jersey, 5 out of 7 institutional care facilities are threatened with closure as a result of a revamp of the state budget.
In Toledo, OH, the Arbors at Toledo nursing home has been sold as a purely business exercise. 120 workers will lose their jobs in March 2010.
In Tuscaloosa, AL, the main topic of conversation in the local news is an administrative appeal about the closure of the venerable Alice Kidd Nursing Home, which is described as the last in the state.
In Albany, NY, a new nursing home may only continue to be constructed if the 2010 budget goes through, after 109 layoffs at another facility.
The likely result of this national trend is a floating population of people across the country in need of care. The last thing on everyone’s mind, apparently, is having a source of support for those who need it. Years of failed economics are the primary reason for this culture. The basic concept of doing things properly in health care has vanished. This is the result.
This is looking very much like the traditional bad business model that is inevitable when people try to run important services like they are retail businesses. A nursing home is not a drug store, and it shouldn’t be operated like one. The bottom line has kept rising, thanks to the “user pays” approach, which has always been a recipe for increasing charges up and down any supply chain. The idea of sharing a cost load has vanished.
State budgets, which in medical terms have been on life support for decades, haven’t exactly been ideal for planned health care. If there’s no Federal money around, too bad. The resulting mass of dislocated people will therefore hit the rest of the health system, making surviving facilities harder to operate effectively. That could crash quite a few more homes and institutions because of the demand on costs.
This was once the most advanced, efficient health care system in the world. It now ranks behind just about every other Western country. Nowhere else in the English speaking world do health care professionals and the public have to tolerate these situations. The inexplicable, not to say inexcusable, lack of comment from top officials looks like the whole issue has been put in the too hard basket. It’s either maladministration or incompetence.
The nursing homes are experiencing business situations that first year management trainees are taught to avoid. There are no excuses. Nor is there any business logic to support the current mess. A few weeks ago we did a story on a very strong business model operated by Canada’s Nurse Next Door franchise which is having no trouble in this market, and is expanding like crazy. There’s no reason why nursing homes can’t be adapted to run on trustworthy operating principles like these. It’s time for those responsible to stop ducking issues and earn their highly paid jobs.
This is looking like Amateur Hour. “Disgrace” at this point, is a mild euphemism.