Changes Seen in Nursing Home Usage by Blacks

Tuesday's Orlando Sentinel published an article about the increased use of nursing homes in the black community, both in Florida and around the country. This is a changing trend. In the 1970s, blacks were half as likely as whites to be in nursing homes. Today, they are more likely to be.

The increase of blacks in nursing homes is largely because of Medicare and Medicaid funding changes in the 1980s and 1990s, Smith said. Under the new rules, hospitals were encouraged to discharge patients to nursing homes. But nursing homes received less funding for residents who didn't need skilled care.

The change led to a proliferation of private assisted-living facilities that attracted whites who could afford them. But blacks, who traditionally have lower incomes, less health insurance and smaller retirement incomes, often don't have that option -- and end up in nursing homes where their care is paid for by Medicaid.

The article also states that although it is less expensive to provide community-based care in the home, demand for those programs has outpaced funding, and many services have waiting lists.