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The Corporatization of Nursing Homes

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31–40 of 87 posts

Re: The Corporatization of Nursing Homes

#32

When my wife (46) and I found out that she was terminally ill, I promised her that I'd never let her end up in a Nursing/Hospice home. She'll get care at home. When the time comes, she'll die at home, too. Myself, our adult daughter, and close friends have all banded together to make sure that she never ends up in a home. We reaffirmed this after Covid hit. If she goes into a hospice care facility, I'll never see her…

[deleted]

Re: The Corporatization of Nursing Homes

#33
post #19

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

Which will pay for 2/3rds of it, and cause your social security payment to drop substantially

Re: The Corporatization of Nursing Homes

#34

When my wife (46) and I found out that she was terminally ill, I promised her that I'd never let her end up in a Nursing/Hospice home. She'll get care at home. When the time comes, she'll die at home, too. Myself, our adult daughter, and close friends have all banded together to make sure that she never ends up in a home. We reaffirmed this after Covid hit. If she goes into a hospice care facility, I'll never see her…

I'm probably similar in age to you and am so sorry to hear what you are going through.

Last year, my single mother's health transitioned from self-sufficient, but secretly hiding chronic problems, to completely unable to care for herself in the course of a day (she bore some responsibility for this, it was not completely an accident). I let the US health care system walk us into a nursing home situation. Some of the health care workers there went to the wall to do what they could, some had no business being health care providers.

I'll never forgive myself for the how it turned out. I don't think I would have done anything substantially different. She did not go gently, it was unpleasant at times and she fought us more than she fought to get better. She lived for 6 months in the nursing home. Maybe I could have stretched it out a few years if I had quit my job, moved into her home and taken care of her myself, but she never would have been self sufficient again. I'm pretty sure I would not have "made it" though that experience though, not sure how else to say it.

I would absolutely personally take care of my wife in our home if she fell ill, and I'm saying that knowing a lot more about the end of life than I used to, how difficult and long it can be. I do not want my children to do this for me.

Re: The Corporatization of Nursing Homes

#35
post #27

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 facil…

I don't work in a long-term care facility (I do acute geriatric psychiatric care), but I do work next door to one. We're non-profit so we don't exactly fit the mold, but understaffing isn't something that we are aiming for. We're offering incredible hiring bonuses, reaching out on every single avenue. Our problem is retention - we can get a few people hired, but maybe 1/5 CNAs stay, and 1/4 of the nurses. The long term care center probably has slightly better ratios, but most people don't have the ability to compartmentalize or the resiliency to last in the chronically understaffed units. You end up doing the work of 3 people with people who at best are demanding and at worst are physically attacking you and others.

Additionally, even for a CNA, training takes months and months. We get them out on the floor as soon as possible now, which isn't helping with out retention, but reflects the reality that our residents need care. Most of us are pulling 80+ hour weeks just to meet the federally mandated minimum staffing for how many residents we have at a given moment.

Re: The Corporatization of Nursing Homes

#36
It's mind-blowing that we live like this.

We forced every adult into being a single atomic worker by completely eliminating jobs and benefits that enable single earners to care for their entire family (through the "unpaid" domestic work of the wife). Then, when we need to actually care for our families, we outsource that to the private sector, so that other atomic worker units can do the job for us. We have to do this, because nobody has time to care for our parents; we all have to work!

What did we get for doing this? What life improvements were gained?

The collective grief of the millions of people who have died alone is not worth any of this.

Re: The Corporatization of Nursing Homes

#37
post #36

It's mind-blowing that we live like this. We forced every adult into being a single atomic worker by completely eliminating jobs and benefits that enable single earners to care for their entire family (through the "unpaid" domestic work of the wife). Then, when we need to actually care for our families, we outsource that to the private sector, so that other atomic worker units can do the job for us. We have to do thi…

[deleted]

Re: The Corporatization of Nursing Homes

#38

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…

> 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-…

I have seen financials for a number of nursing homes owned by friends. They get paid by Medicare for short term rehab in their facility and the rate is about $400/day. The majority of the people are long term on Medicaid and the reimbursement is between $120-200 per day depending on case difficulty. There are certain games they play to increase the reimbursement such as getting most of the patients diagnosed with depression. I have heard zingers such as “there is a very fine line between optimizing patient care and Medicaid fraud”. At Medicaid rates the only way it works is if the people providing the care make about $10/hr. All the good caregivers tend to work at the best run facilities, so quality tends to be bimodal.

Re: The Corporatization of Nursing Homes

#39
post #36

It's mind-blowing that we live like this. We forced every adult into being a single atomic worker by completely eliminating jobs and benefits that enable single earners to care for their entire family (through the "unpaid" domestic work of the wife). Then, when we need to actually care for our families, we outsource that to the private sector, so that other atomic worker units can do the job for us. We have to do thi…

Very few people want to take care of their parents

Re: The Corporatization of Nursing Homes

#40
post #36

It's mind-blowing that we live like this. We forced every adult into being a single atomic worker by completely eliminating jobs and benefits that enable single earners to care for their entire family (through the "unpaid" domestic work of the wife). Then, when we need to actually care for our families, we outsource that to the private sector, so that other atomic worker units can do the job for us. We have to do thi…

In the golden olden days in which you allude, no one was paid to take care of children and parents. It's an argument to say we should subsidize those that care for their own parents and children (and there are numerous government programs and tax breaks that already do), but you are undercutting your thesis with this bizarre assertion.

Many old people never had kids, and don't have any family. They need paid workers to take care of them. Many readers of this comment are perhaps planning on not having kids, or even not getting married. Just imagine yourselves in 40 to 60 years - this will be you!

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