ABSTRACT

The nursing home industry is a multibillion dollar business in the United States, characterized by rapid growth in profits and large chain-owned corporations. This chapter describes the nursing home industry as it has evolved with its high growth and profits rates. The industry, while private in nature, is effectively a public program defined by public policies, particularly by the Medicaid program. Nursing home residents and their families are seldom organized and have little recourse in influencing both public policies and the activities and quality of care in individual nursing homes. Until consumers are better represented with consumer lobbyists and able to influence public policies and political decisions, the balance of power will remain in the hands of the nursing home industry. Efforts to restructure the nursing home industry and the whole long-term care system will require new vision and concentrated energy on the part of many groups, families, friends, physicians and health professionals, legislators and public policy makers.