Race and Nursing Homes

According to a study to be published in a medical journal Health Services Research, black nursing home residents in Maryland and Virginia are more likely than white residents to be sent to hospitals for dehydration, poor nutrition, bedsores and other ailments because of a gap in the quality of in-house medical care. Researchers affiliated with Brown University’s medical school found that 23 percent of black nursing home residents in Maryland were hospitalized in 2000, compared with 17 percent of white residents. That year in Virginia, the researchers found, 20 percent of black nursing home residents were hospitalized, compared with 18 percent of white residents.

In the article a representative of National Citizens’ Coalition for Nursing Home Reform was quoted as saying they believe that it is a civil rights issue.

The equation presented is that nursing homes with primarily Medicaid residents offer poorer quality care.

Some do. But I spend a lot of time in nursing homes from the high end facilities in CCRCs to the facilities in some of the most down trodden areas. And you know what, race and care are not an issue in my eyes. It is about the staff and the management, the resident experience and the compassion. I have been to Medicaid facilities that have won quality awards, facilities comprised of mostly African American residents.

So to me it isn’t about race. Why do people jump on that immediately? It is pretty frustrating when I see the care in many places. Not all mind you.

For professionals in the industry this is just another in the ongoing image problems that need to be addressed. For the consumer, it still comes down to doing you homework. Not all facilities are the same and not all facilities in poorer neighborhoods with primarily poor residents are bad. And here is another thing. For many, even affluent people, if they have not purchased long term care insurance and they have exhausted their savings and can’t pay for the care out of pocket, guess who pays? The same Medicaid program that is associated with bad care and bad outcomes. A race issue – no. A health care system in crisis – yes.