A Brief History Of Long-term care.Early 1900s Almshouses, poor farms for elderly "inmates"; homes for the aged (often sponsored by religious or ethnic groups) founded or in their early years; "rest homes" and "convalescent con·va·les·cent adj. Relating to convalescence. n. A person who is recovering from an illness, an injury, or a surgical operation. convalescent 1. pertaining to or characterized by convalescence. 2. homes" emerge. 1925 U.S. Dept. of Labor finds "dilapidation DILAPIDATION. Literally, this signifies the injury done to a building by taking stones from it; but in its figurative, which is also its technical sense, it means the waste committed or permitted upon a building. , inadequacy and even indecency INDECENCY. An act against good behaviour and a just delicacy. 2 Serg. & R. 91. 2. The law, in general, will repress indecency as being contrary to good morals, but, when the public good requires it, the mere indecency of disclosures does not suffice to exclude ," particularly smaller almshouses. 1926 1926: Harry Evans's The American Poor Farm and Its Inmates creates early public demand for reform. 1935 Social Security Act creates Old Age Assistance to bolster incomes of needy elderly but forbids OAA OAA Older Americans Act OAA Ontario Association of Architects OAA Open Agent Architecture OAA Old Age Assistance OAA Obstetric Anaesthetists' Association OAA Office of Academic Affiliations (Department of Veterans Affairs) payments to inmates of almshouses. 1950 Social Security amendments lift the ban on payments to public long-term care institutions; also permit direct government "vendor" payments to providers and require state licensure programs for nursing homes. (Also, Nursing Homes Magazine founded.) First geriatric nursing textbook published (Geriatric Nursing, by Kathleen Newton; published by Mosby). 1954 Hill-Burton Act amendments allow federal grants to public and not-for-profit organizations to build nursing homes; also provide first federal standards for design and construction of these facilities. 1956-1959 For-profit organizations made eligible to receive Small Business Administration and Federal Housing Administration Federal Housing Administration (FHA) Federally sponsored agency chartered in 1934 whose stock is currently owned by savings institutions across the United States. The agency buys residential mortgages that meet certain requirements, sells these mortgages in packages, and insures financing for nursing homes, following a campaign by the American Nursing Home Association. 1960 Kerr-Mills Act provides for federal-state matching funds for medically indigent, including those in skilled nursing facilities. 1964 First training program for geriatric nursing assistants (intended to create a level of nursing between a nurse's aide and a licensed practical nurse li·censed practical nurse n. Abbr. LPN A nurse who has completed a practical nursing program and is licensed by a state to provide routine patient care under the direction of a registered nurse or a physician. ) approved, with funding coming from the Federal Manpower Development Training Act. The program started in Tennessee, with the cooperation of the Tennessee Employment Security and the State Department of Vocational Education. 1965 Medicare and Medicaid Medicare and Medicaid U.S. government programs in effect since 1966. Medicare covers most people 65 or older and those with long-term disabilities. Part A, a hospital insurance plan, also pays for home health visits and hospice care. created; Medicare to cover post-hospital "extended care" (100 days), but no specific nursing home provisions for Medicaid other than continuation of federal matching funds to states. 1967 Medicare extended-care provisions go into effect. 1968 Moss amendments to Social Security Act set new operational standards for nursing homes accepting Medicaid. Kennedy amendment requires state licensure of nursing home administrators. 1969 Medicare begins restricting extended-care services (Intermediary Letter 371). 1970 Dept. of Health, Education and Welfare issues regulations based on Moss amendments. HEW accused of weakening the intent of Moss amendments. 1971 Office of Nursing Home Affairs created in HEW. Disbands two years later. Intermediate Care Facility (ICF (Internet Connection Firewall) The built-in firewall in Windows XP. It provides a stateful inspection of packets which accepts only responses to requests originated by the user. ) category created. 1972 Social Security amendments extend Medicare coverage to the disabled. Supplemental Security Income Supplemental Security Income A Social Security program established to help the blind, disabled, and poor. (SSI (1) See server-side include and single-system image. (2) (Small-Scale Integration) Less than 100 transistors on a chip. See MSI, LSI, VLSI and ULSI. 1. (electronics) SSI - small scale integration. 2. ) created. "Skilled nursing facilities" (SNFs) defined. Medicaid "reasonable cost" reimbursement authorized to SNFs and Intermediate Care Facilities (ICFs). 1974 Federal health planning legislation adopted creating certificate-of-need. Mary Adelaide Mendelson's Tender Loving Greed targets Medicaid fraud. 1977 Congress adopts Medicare and Medicaid Antifraud and Abuse amendments. 1982-1997 Series of National Institute on Aging The National Institute on Aging is a division of the U.S. National Institutes of Health, located in Bethesda, Maryland. Formed in 1974, NIA's mission is to improve the health and well-being of older Americans through research. It is the primary U.S. studies shows a declining rate in geriatric disability. 1983 Medicare Diagnosis-Related Groupings (DRGs) created; lead to nursing home-based post-acute care. 1987 Omnibus Budget Reconciliation Act (OBRA '87) incorporates nursing home reform; creates state survey and enforcement system. 1995 Congress passes legislation repealing OBRA '87 and establishing Medicaid block grants. President Clinton vetoes. Clinton Administration issues beefed-up survey-enforcement regulations. 1997 Congress passes Balanced Budget Act establishing Prospective Payment System for Medicare-funded post-hospital care. 1999 First PPS-related bankruptcies among proprietary chains occur. NAB notes 25% drop in applicants for nursing home administrator licensure examination. |
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