The quality of nursing home care becomes a national concern. 1950-1959 The quality of nursing home care becomes a national concern.

Home Care Drops in Popularity By 1952, Metropolitan Life discontinued the visiting nurse program they launched in 1909. The home care industry floundered with little funding and no clear sense of direction.

Governments Pay Providers Directly for Services Nursing home operators could now contract directly with the states for payment, providing nursing homes with a new and more reliable source of income. In 1956 the Social Security Act was again amended to eliminate the cap on payments.

States Create Nursing Home Licensing The 1950 SSA amendments for the first time demanded that states that received federal matching funds must create systems to licensing both nursing homes and hospitals. A number of nursing homes which couldn't meet the new standards closed in the 1950's, while others demolished their old buildings and built new ones.

Thomas Jefferson Southard House, Richmond, ME Built 1855 as private home. Converted to Russian Home for the Aged around 1953.

Charles Bissell House, Rochester, NY Built 1852-1854 as private home. Became Rochester Methodist Home in 1952. Modern addition built in 1955.

Government Inventories Nursing Homes It was determined that a national survey of the facilities was needed to identify how many nursing homes there were and other basic characteristics of the facilities. Most of the early ones were called "Master Facility Inventory Surveys". Four classifications: nursing care homes, personal care with nursing homes, personal care homes, and domiciliary homes, and decided to count all facilities with 3 or more beds.

Government-Owned Nursing Homes Evolve Federal matching funds were finally made available for the cost of providing for aged and blind persons in "public medical institutions. By the middle of the 1950s new drugs to treat tuberculosis had been discovered so state and county tuberculosis sanitariums began to close or be converted to hospitals or nursing homes.

John E. Andrus Memorial Home, Hastings-on-Hudson, NY, 1955 Built as a nursing home in 1953.

Hotel St. Regis, Cleveland, OH Built 1905, Remodeled into efficiency units in 1929. Converted to a retirement home in 1959, later became Abbey Nursing Home.

Nursing Homes Treated as Healthcare Facilities In 1954 the Hill-Burton Act was amended to provide funds to nonprofit organizations for the construction of skilled nursing facilities that met certain hospital-like building standards, if built "in conjunction with a hospital". Restricting the funds to hospital-affiliated non-profits was intended to increase the quality of nursing homes, but it had the opposite effect.

Social Security is Expanded 1950 - domestic workers; farm workers; non-farm, non-professional self-employed persons; and federal civilian employees 1951 - railroad workers with less than 10 years of service 1954 - homeworkers and all self- employed persons except lawyers and medical professionals 1956 - members of the military and all remaining self-employed persons except doctors

Government Becomes Primary Payer for Nursing Home Care Half of the residents in private nursing homes were public assistance recipients. Federal, state, and local governments were paying about half the total cost of all nursing home care in the country. In 1956, due to an amendment, the federal government paid more than half of the cost of OAA in the poor states, and continued to pay half of the cost in richer states.

Boom in For-Profit Nursing Home Construction The FHA loans offered low down- payments, generous terms, "guaranteed" reimbursement from the government in payment for services, and income tax benefits. It is possible that about 3,000 nursing homes may have disappeared in the 1950's.

Windsor Park Nursing Home, 212-240 Hillside Avenue, Jamaica, NY, 1957

Plains Convalescent Home, Plains, GA Built as Wise Sanitarium, a hospital, in 1921. Former President Jimmy Carter is born here in 1924.Converted to a nursing home in 1957.

New Construction Financing Available for Elderly Housing Legislation authorized the Small Business and Federal Housing administrations (SBA and FHA) to help finance construction and operation of proprietary nursing homes and nonprofit housing for the elderly. federal mortgage insurance to enableF private lenders to make low-interest loans for the construction or rehabilitation of nursing homes,

Section 202, provided direct, low-interest loans only to non-profit operators for the construction of housing for the elderly. The medical criteria laid out in the Hill- Burton Act were not required for nursing homes built or remodeled using FHA or SBA funds.

Quality of Nursing Home Care National Concern The day after the Warrenton fire in 1957 a bill to require sprinkler systems in all nursing homes and other institutions in the state was immediately introduced. In 1957 the Public Health Service began to work with the states to create the "Nursing Home Standards Guide“. In 1959, a special Senate Subcommittee on "Problems of the Aged and Aging" was established.