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Nursing homes carry a stigma of dreariness, poor medical care, boredom, and being dumping grounds for unwanted seniors unable to care for themselves. Reports of abuse, exploitation and malnutrition are not uncommon. As a result, many elderly people who are disabled and who could benefit from 24-hour care and other amenities are extremely reluctant to enter these facilities. Fortunately, some states are trying to alter the negative perceptions of nursing homes by changing the architecture and culture of these long-term care facilities to make them more home-friendly.

Massachusetts is one state that is instituting a culture change in its nursing homes by offering residents more of a role in how their facility is run and in how they wish to spend their time. The facilities are also more geared now toward improving elderly residents’ quality of life rather than just focusing on their safety and medical care. Staff members are being trained to be more interactive with residents and to perform multiple tasks for each one in order to become more sensitive to that individual’s needs and routine.

To encourage change, state like Rhode Island and has offered increased Medicaid reimbursement rates to facilities that offer homelike facilities. Officials hope to attract more residents since seniors who remain at home typically frequent local emergency rooms more often than those who aren’t at home. This overloads emergency rooms, causes frustratingly long wait times and increases medical costs. Another major concern is that emergency rooms do not offer the individual care many seniors need.

There are about 16,000 nursing homes in the United States. Many are old and will soon need renovation, particularly as the population of seniors aged 85 and older grows to about 15.4 million by 2020. Unfortunately, the nursing home industry is not growing. Budget cutting is now an increased concern for most states.

For managed care companies that are only offered a flat monthly fee for an eligible long-term care recipient, nursing care facilities can be expensive. As a result, it is in their best interests to keep people at home. Nursing homes are also competing with federal incentives that encourage states to consider saving money by serving more long-term care patients at home.

Advocates against nursing home neglect and abuse and who are behind the movement to make facilities homelike will have a continuing uphill funding battle as the aging population keeps growing.