A D A P T |

A D A P T  Action Report |

Site Index | Tom Olin's Photographs | Send a Message to the Marchers | View all the messages sent to the Marchers | Profiles of Marchers | Press Room | Sept. 3 |  DAY 1 | DAY 2 | DAY 3 | DAY 4 | DAY 5 | DAY 6 | DAY 7 | DAY 8 | DAY 9 | DAY 10 | DAY 11 | DAY 12 | DAY 13 | DAY 14 | Rally |

September 14, 2003

Why America needs to reform Medicaid with S 971 and HR 2032 the Medicaid Community Attendant Services and Supports Act.

by Tim Wheat

Nursing homes destroy American lives 
Hundreds of thousands of Americans are inappropriately institutionalized. 

EDITOR'S NOTE: Today's report features the photos by Mike McCarty.

Contrary to destroying people’s lives, most Americans see nursing homes and other long-term care institutions as a regrettable final step in life; an unfortunate but necessary choice based on objective medical assessments. This concept is reinforced by the hospital-like environment and referring to the people that live in “the home” as patients. The fact is, for most Americans that need long-term care; the choices of how they will live and control of the funds for their long-term care are turned over to institutions.

Nursing homes are not hospitals. Some long-term care facilities are in hospitals, but for the most part a nursing home resident that needs medical care will have to go to the hospital to get attention. The 1995 Medicare Current Beneficiary Survey found that “twenty-eight percent of … [people in nursing homes] had at least one inpatient hospital stay in 1995, compared with approximately 18 percent of the community-only residents [Health and Health Care of the Medicare Population]. Nursing home “placement” in most cases is not a choice, but a combination of poverty and disability that leaves an individual with no other option. In many cases, the individual being “placed” is not directly consulted, and ends up in the institution because of the recommendations of social workers.

It is a misapprehension also that nursing home residents are more “sick, ” require a greater level of care, or are unable to receive long-term care services in the community. Feldstein found in 1988 and confirmed by DHHS in 1997 that “for every aged nursing home resident, there are about twice as many aged community residents who require a similar level of long-term care.” 

Although most people in nursing homes are elderly, it is not age that qualifies an individual for an institution. The common thread is disability. If anyone wants to live in a nursing home or desires institutional care, Medicaid in all U.S. states currently requires the institutional option. If someone does not want to live in “the home;” however, the choices are fewer. In Tennessee, 99% of all Medicaid funding for the long-term care of individuals was funneled into institutions. Nationally, only about 23% of public funding provides Americans with alternatives to nursing homes.

Deborah Cunningham, the Executive Director of The Memphis Center for Independent Living has helped many individuals escape nursing homes to live in the community. Because the nursing home industry dominates federal Medicaid funding in Tennessee, community services for someone leaving a nursing home are few. Deborah has created an “Underground Railroad,” moving people to states with community options.

“To date I have helped nine or ten people leave Tennessee on the Underground Railroad,” said Deborah, “some to avoid placement and some right out the back door of the nursing home with their discharge marked ‘against doctor’s orders.’”

“I would be dead if I would have stayed in Tennessee,” said LaTonya Reeves, who Deborah helped to escape nursing home placement. LaTonya now lives and works in Denver Colorado.


- Tim Wheat

Get the official ADAPT Free Our People T-Shirt.

T-Shirt Order Form.

ADAPT’s FREE OUR PEOPLE “Songs of Freedom.” 

CD Order Form.

Original artwork from the Free Our People March - By Sher Stewart.

Photos of her work.