The Corporatization of Nursing Homes • Hacker News Board

Re: The Corporatization of Nursing Homes

#21

Post by chrisseaton » Fri, Oct 30, 2020, 1:43 AM UTC

harryh wrote: post #19

chrisseaton wrote: post #17

Earlier quoted context omitted.

> putting someone in a skilled nursing facility costs about 10,000/month nominally Who on earth is able to afford this? Everywhere I look there are nursing homes full of ordinary people. I can't believe more than 0.1% of these people are literally able to afford $10,000/month. People live in those places for 20 years sometimes. That's $24,000,000. It just doesn't add up, dude. I think the actual cost is way, way, way…

Medicaid

Do you think most citizens pay in that much tax in their lifetime? How do you imagine this is adding up?

Re: The Corporatization of Nursing Homes

#22

Post by rhizome » Fri, Oct 30, 2020, 1:44 AM UTC

DoreenMichele wrote: post #14

On the upside, modern tech is a potential antidote to this. Some elderly are able to keep their freedom and the dignity and quality of life that go with it by using tech to stay connected, provide reminders and alarms and so forth to mitigate some of the issues that cause us to think they would be better off with supervision in a nursing home. If this concerns you and you are a programmer or similar, you may be able…

>Some elderly are able to keep their freedom and the dignity and quality of life that go with it by using tech to stay connected, provide reminders and alarms and so forth to mitigate some of the issues that cause us to think they would be better off with supervision in a nursing home.

Yeah. My 83 year old Mom with multiple issues views those tools as something only an old lady needs, and so rejects them. She can use Facebook with the same level of skill as it takes to make and receive the phone calls that the social internet supplanted.

Right now, "elderly" is largely people who were born before most people owned televisions, and technological solutions aren't always greeted with a "yay, more!" attitude. I'm sure a lot of prewar and boomer people stopped wanting to learn yet another piece of "modern tech" somewhere between TiVo and smart phones.

Re: The Corporatization of Nursing Homes

#23

Post by dragonwriter » Fri, Oct 30, 2020, 1:47 AM UTC

chrisseaton wrote: post #17

crispyambulance wrote: post #13

Earlier quoted context omitted.

> also seen healthy but less able older folks put in homes so that their kids could collect their inheritances and sell off everything else... Not sure what you mean by this, but putting someone in a skilled nursing facility costs about 10,000/month nominally. The "Deficit Reduction Act" of 2005 (thanks Bush), requires a 5 year look-back period for transactions to family members. Meaning that if a resident spends dow…

> putting someone in a skilled nursing facility costs about 10,000/month nominally Who on earth is able to afford this? Everywhere I look there are nursing homes full of ordinary people. I can't believe more than 0.1% of these people are literally able to afford $10,000/month. People live in those places for 20 years sometimes. That's $24,000,000. It just doesn't add up, dude. I think the actual cost is way, way, way…

> Everywhere I look there are nursing homes full of ordinary people. I can't believe more than 0.1% of these people are literally able to afford $10,000/month.

A substantial majority of nursing home patients in the US are paid for by Medicaid; people who have assets often shed them to qualify for Medicaid if they need nursing care.

> People live in those places for 20 years sometimes

IIRC, the average length of long-term care stay is a more like 2 years, with a fairly small fraction over 5 years. And I would think the longer stays tend to be skewed toward assisted living (which is significantly less expensive), not nursing homes.

Re: The Corporatization of Nursing Homes

#24

Post by lotsofpulp » Fri, Oct 30, 2020, 1:49 AM UTC

chrisseaton wrote: post #21

harryh wrote: post #19

Earlier quoted context omitted.

Medicaid

Do you think most citizens pay in that much tax in their lifetime? How do you imagine this is adding up?

It doesn’t, which is why benefits are the biggest portion of US government spending.

https://www.thebalance.com/u-s-federal-budget-breakdown-3305...

>Mandatory expenditures, such as Social Security, Medicare, and the Supplemental Nutrition Assistance Program account for about 60% of the budget.

Technically Medicaid is from state governments or at least some portion of it, but it probably looks the same there.

Re: The Corporatization of Nursing Homes

#25

Post by redis_mlc » Fri, Oct 30, 2020, 1:52 AM UTC

foo_barrio wrote: post #12

redis_mlc wrote: post #8

Earlier quoted context omitted.

I have some experience with this through family and friends. It's easy to make moral proclamations before spending literally decades attending to somebody with dementia/vegetation, or other chronic conditions. Wasting your own life on somebody who isn't all there is not a great trade-off if there's other options. (My friend inherited a $2 million house for taking care of his gravely ill elderly relative, but that cos…

Unfortunately that incentive exists at home too. I, with my mom, were the primary caretakers of my father with dementia. Without any kind of sedation he was actually more mentally aware but also prone to violence, yelling, sprinting (if in the house easy to trip). On the sedative he was more manageable but also clumsier and more prone to slipping and falling. Overall I'd rather deal with that than having to be a refe…

Note that you're talking about a reasonable medical use of sedatives that your own family decided upon.

I was mainly talking about non-medical, billing-only use of sedatives decided by home administrators when the family is not around to make an informed decision.

If you're not outraged, you should re-read the above paragraph again. That's been reported in local SV newspapers and online.

Re: The Corporatization of Nursing Homes

#26

Post by [deleted] » Fri, Oct 30, 2020, 1:52 AM UTC

chrisseaton wrote: post #17

crispyambulance wrote: post #13

Earlier quoted context omitted.

> also seen healthy but less able older folks put in homes so that their kids could collect their inheritances and sell off everything else... Not sure what you mean by this, but putting someone in a skilled nursing facility costs about 10,000/month nominally. The "Deficit Reduction Act" of 2005 (thanks Bush), requires a 5 year look-back period for transactions to family members. Meaning that if a resident spends dow…

> putting someone in a skilled nursing facility costs about 10,000/month nominally Who on earth is able to afford this? Everywhere I look there are nursing homes full of ordinary people. I can't believe more than 0.1% of these people are literally able to afford $10,000/month. People live in those places for 20 years sometimes. That's $24,000,000. It just doesn't add up, dude. I think the actual cost is way, way, way…

[deleted]

Re: The Corporatization of Nursing Homes

#27

Post by alf365 » Fri, Oct 30, 2020, 1:56 AM UTC

I remember watching a 20/20 Barbara Walters special years ago on the poor conditions of nursing homes.. fast forward to 2020... My former colleague and I built a QR app-based check-in system for nursing & assisted living - home caregivers to ensure they physically check on each resident as required. I was disheartened & dismayed most facilities just want to turn a blind-eye on the under-staffing issues of their facilities and could care less about improvement...There has to be market-demand to demand change and transparency! I'll keep pushing for change. That 20/20 special motivated me.

Re: The Corporatization of Nursing Homes

#28

Post by rhizome » Fri, Oct 30, 2020, 1:58 AM UTC

throwaway-sf wrote: post #7

I'm probably in the minority here but I often think about preventative care like exercise and eating healthy now as insurance against a future where I'd be stuck in a nursing home in my final years.

Getting really old kinda sucks, healthy people die slowly, dying of old age takes a long time, and I wouldn't be surprised if 99%+ of centenarians are in nursing homes for their nth decade. So...y'know...good luck with your plan.

Re: The Corporatization of Nursing Homes

#29

Post by Digory » Fri, Oct 30, 2020, 1:59 AM UTC

chrisseaton wrote: post #21

harryh wrote: post #19

Earlier quoted context omitted.

Medicaid

Do you think most citizens pay in that much tax in their lifetime? How do you imagine this is adding up?

This is why people call it a pyramid scheme.

The breakdown of single-earner families means kids and seniors get institutional care. And there isn’t enough money to socialize care as good as your family.

Re: The Corporatization of Nursing Homes

#30

Post by 55555 » Fri, Oct 30, 2020, 2:07 AM UTC

Digory wrote: post #29

chrisseaton wrote: post #21

Earlier quoted context omitted.

Do you think most citizens pay in that much tax in their lifetime? How do you imagine this is adding up?

This is why people call it a pyramid scheme. The breakdown of single-earner families means kids and seniors get institutional care. And there isn’t enough money to socialize care as good as your family.

> The breakdown of single-earner families means kids and seniors get institutional care. And there isn’t enough money to socialize care as good as your family.

I guess we'd save a lot of money if we just had family structures more like people in asian countries.