Government Support of Nursing-Home Care

Abstract

Government finances the major share of the country's nursing-home services. Three kinds of institutions provide these and related services. Skilled nursing homes provide long-term skilled nursing care financed under Medicaid. Extended-care facilities provide post-hospital care financed for limited periods under Medicare. Intermediate-care facilities provide long-term supportive care, currently authorized under Medicaid. Federally related programs made the first attempt to impose on nursing homes comprehensive national regulations. However, they have frequently supported low-quality, inadequate and misallocated care that has not met government standards. The government has taken steps to improve the nursing-home care that it supports, but more efforts are needed. It must find new ways to encourage physicians to assume more responsibility for nursing-home care. It must also develop a spectrum of co-ordinated health care and related programs for the elderly, with special emphasis on alternatives to institutional care.