Rural nursing homes closing, creating hardship, heartbreak

"More than 440 rural nursing homes have closed or merged over the last decade, according to the Cowles Research Group, which tracks long-term care, and each closure scattered patients like seeds in the wind," Jack Healy reports for The New York Times. "Instead of finding new care in their homes and communities, many end up at different nursing homes far from their families."

Ramona Labrensz with a photo of her husband Harold
(Photo by Kristina Barker, The New York Times)

Healy's story begins with the tear-jerking tale of Harold Labrensz, an 89-year-old man in South Dakota who has to move to a North Dakota nursing home 220 miles away because his 87-year-old wife Ramona "could not find any nursing home nearby to take him, and she could not help him if he took a fall at home." Then he shows the problem's broad scope in rural America: "There are few choices for an aging population. Home health aides can be scarce and unaffordable to hire around the clock. The few senior-citizen apartments have waiting lists. Adult children have long since moved away to bigger cities."

Healy gives the business side: "Thirty-six rural nursing homes across the country have been forced to close in the last decade because they failed to meet health and safety standards. But far more have collapsed for financial reasons, including changing health care policies that now encourage people to choose independent and assisted living or stay in their own homes with help from caregivers. Some nursing homes cannot find people to do the low-paying work of caring for frail residents. Others are losing money as their occupancy rates fall and more of their patients’ long-term care is covered by Medicaid, which in many states does not pay enough to keep the lights on."

Healy adds, "On paper, South Dakota and other rural states still have enough long-term care beds for people who need round-the-clock care. The problem is where they are. When a nursing home closes in a small town, the available beds are often so far away that elderly spouses cannot make the drive, and the transferred residents become cut off from the friends, church groups and relatives they have known all their lives."