By Steve Moran

We keep dancing around this issue, this truth: nursing homes are obsolete, they are past their prime, they need to be put out to pasture for something a lot better. With a few exceptions, nursing homes need to go away, they need to disappear, they need to become the Palm Pilots, Blackberries, or fax machines.

They are the Pony Express, Horse-drawn wagons of the past.

They are expensive.

They are over-regulated.

Nobody wants to live in them, even when they are needed.

They are almost always an unpleasant horrible experience. Don’t get me wrong, I know there are a few great ones. I’ve written some stories about them.

But you know what? I’ve been in 1000s of them, and have only been in maybe a dozen that were truly, truly terrific, and another dozen that, even though old and obsolete, they felt really good.

There’s simply not enough money to do it right the way we are doing it now.

I don’t think they’re going to go all the way away, although they might. I see nursing homes as part of Life Plan Communities or CCRCs. They are a necessary part of the continuum of care and most of them are pretty nice.

But the truth remains, most nursing homes are terrible. Residents don’t like them, they degrade the quality of life and degrade the people who are living there. They degrade the staff.

Most of what’s being done in nursing homes, or at least much of what’s being done in nursing homes, can be done in assisted living. Recently, Politico published an article titled  Will the Nursing Home of the Future be an Actual Home? They might be onto something.

What Can We Do?

We need to think about this. Not only that, we need to talk about it. Because it represents a great opportunity for those of you who are doing medically-based assisted living.

It’s a huge opportunity for those of you who are in traditional nursing homes. It is an opportunity to rethink how you care for the most medically needy and complex older people. While the Green House model has never taken off, there is something worth looking at in the small home model. It might mean abandoning and abolishing the buildings that you have and starting over from scratch. Because you do know better than anyone how to care for these individuals.

We as a nation, as an industry, have to do better than this if we are serious about doing the right thing for our older population.

I’d love to hear your thoughts.

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