The History of Nursing Home Care

Nursing homes have not had a proud history in the United States. Until recently they were poorly regulated and highly stigmatized. Even today, some senior citizens remember the reputations of early nursing homes and fear having to live in one of "those places."

Poor Farms

• Poor farms, also known as almshouses, cropped up in the early 1900s. They were publicly owned, largely unregulated, and considered a place of last resort for elderly or disabled people with no one to care for them. Poor farms were known for their horrifying living conditions.

Social Security

• The Social Security Act that passed in 1935 banned people in public facilities from receiving "Old Age Assistance." This ban was not lifted until the 1950s, a period of reform for nursing homes.

1950s

• During the 1950s, the federal government required states to set standards for licensing nursing homes. In 1954, federal grants were given to nursing homes who modeled themselves after hospitals. Nursing home care was slowly but surely becoming accepted as part of the healthcare system rather than part of the welfare system, and care gradually improved.

Reimbursement

• In April of 1969, Medicare stopped providing coverage for long-term care. In 1972, Medicaid began covering the costs of long-term care for people with little income and few resources.