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The High Cost of Poor Nursing Home Care in the U.S.

April 12, 2011

Washington, DC – April 8, 2011 –

Twenty years ago, The National Consumer Voice for Quality
Long-Term Care[*] released a compendium of research that proved the axiom “an ounce of prevention is worth a pound of cure.” The High Cost of Poor Care-The Cost Effectiveness of Good Care Practices (1991) showed how good nursing practices and routine assistance with activities of daily living could prevent billions of dollars in medical expenditures.

This week the Consumer Voice publishes a new version of that report, The High Cost of Poor Care: The Financial Case for Prevention in American Nursing Homes. The new report summarizes studies showing the extraordinary cost of treating preventable medical problems in persons over 65-$19 billion for falls; $11 billion to treat pressure sores; and $5 billion in hospital charges for dehydration. It also reports research on the cost-effectiveness of preventive measures. Nursing home residents account for only part of the costs cited above, but rates of avoidable medical conditions and hospitalization are particularly high among the nursing home population. One study quoted in the report concluded 20 to 30 percent of nursing home falls are preventable and that the best fall prevention method is exercise. This is “a relatively simple intervention,” says The High Cost of Poor Care, “with the potential to dramatically lower costs.”

The publication of The High Cost of Poor Care coincides with the House Budget Committee’s release of its FY 2012 Budget Resolution, which would slash Medicaid by $750 billion over the next decade and turn it into a “flexible” state block grant. During a previous congressional attempt to block grant Medicaid, “flexibility” was translated into easing federal nursing home standards and reducing regulations that protect residents. Draconian cuts in federal Medicaid spending would also lead to reduction in nursing staff in facilities that are already critically understaffed. The report notes that routine care by nursing assistants “would be replaced by costly medical care to heal pressure sores and treat the myriad medical problems caused by malnutrition and dehydration.”

The House Budget Resolution puts at risk decades of federal-level efforts to improve nursing home quality and reduce the cost of poor care.

The High Cost of Poor Care can be downloaded from

For more information, contact Janet Wells
, Consumer Voice Director of Public Policy,