Answer to Question 1
D
Answer to Question 2
Nursing homes were created as an alternative to expensive hospital care and are substantially supported by the federal government through Medicaid and Medicare. About 1.5 million older people now live in extended-care facilities, making nursing homes a billion-dollar industry. There are more patient beds in nursing homes than in hospitals. One scandal after another characterizes care in some nursing homes. Patients have been found lying in their own feces or urine. In some nursing homes, the food is so unappetizing that some residents refuse to eat it. Some homes have serious safety hazards. In some homes, boredom and apathy are common among staff as well as residents. A number of nursing homes fail to meet food sanitation standards and have problems administering drugs and providing personal hygiene for residents. At present, people of all ages tend to be prejudiced against nursing homes, even those that are well run.
The cost of care for indigent nursing home residents is largely paid by the Medicaid program. Because the federal government has set limits on what will be reimbursed under Medicaid, other problems may arise. There may be an effort to keep salary and wage levels as low as possible and the number of staff to a minimum. A nursing home may postpone repairs and improvements. Food is apt to be inexpensive dishes such as macaroni and cheese and may be high in fats and carbohydrates. Congress has mandated that every nursing home patient on Medicaid is entitled to a monthly personal spending allowance. The homes have control over these funds, and some homes keep this money. Another danger of nursing home care is the potential abuse of the residents by staff members. Complaints about the physical facilities of nursing homes include not enough floor space or too many people in a room. The call light by the bed may be difficult to reach, or the toilets and showers may not be conveniently located. And the building may be in a state of decay.
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