January 11, 2011

Nursing Homes Closing in Poor Areas

(Ivanhoe Newswire) -- A new study reveals nursing home closures in the United States happen more often in poor, urban and minority neighborhoods.

Researchers from Brown University found, between 1999 and 2008, the country lost about 96,902 nursing home beds as wealthier patients opted for assisted-living or other forms of home and community-based care. Nonhospital nursing homes were twice as likely to close in the poorest areas of the country compared to the richest. Nursing homes were also 1.38-times more likely to close in the most predominantly black neighborhoods and 1.37-times more likely to close in the most predominantly Hispanic neighborhoods.

"This is an issue that is not going to go away, precisely because of the aging population and the increasing bifurcation of society into rich and poor," Vince Mor, a Florence Pirce Grant University Professor of Community Health at Brown University and senior author of the paper, was quoted as saying.

The researchers also found many people living in poor, urban neighborhoods have to travel further to a nursing home. In ZIP codes where at least one nursing home closed during the study period, the shortest distance to another nursing home increased from 2.73 miles to 3.81 miles.

"The further the patient is from their neighborhood, the more difficult it is for their family members and their neighbors to come visit them," Mor said.

The researchers say more nursing homes have become vulnerable to the economy. Those that rely on Medicare and Medicaid for most of their revenue also serve the poorest patients and have suffered the most pressure. Lack of money sometimes leads to a lack of quality care, which can prompt officials to consider shutting down a facility.

"This leads to a moral dilemma," Mor said. "If the local nursing home is closed because their quality is so poor, that's good, but the cost of that closure is disproportionately borne by a community. How much do you invest in a failing facility and how do you make that investment without rewarding a bad actor who runs a lousy place?"

SOURCE: Archives of Internal Medicine, January 10, 2011