Chronically Ill or Disabled In South Dakota-Is A Nursing Home In Your Future?

The New York Times ran a story on May 2, 2016 that South Dakota is under investigation by the federal government for improperly placing many residents with disabilities in nursing homes instead of providing care in the community. South Dakota Wrongly Puts Thousands in Nursing Homes, Government Says reports that “the Justice Department said … that thousands of patients were being held unnecessarily in sterile, highly restrictive group homes. That is discrimination, it said, making South Dakota the latest target of a federal effort to protect the civil rights of people with disabilities and mental illnesses, outlined in a Supreme Court decision 17 years ago.” 

As the story notes, many individuals need the level of care provided by a nursing home, but others do not.  “But for untold numbers of others — with mental illnesses, developmental disabilities or chronic diseases — the confines of a nursing home can be unnecessarily isolating. Yet when patients seek help paying for long-term care, states often steer them toward nursing homes, even though it may not be needed.”  The article discusses the Olmstead decision and the government’s strategies in these cases to challenge the placement.

South Dakota responded that they have made progress but the federal government sees it as not enough, especially since this is not a recent situation. “In-home health aides can be less expensive than nursing homes because they do not provide unnecessary services. States, though, face a chicken-or-egg conundrum. Does money go to nursing homes because beds are often more readily available than in-home services? Or are there fewer in-home services because less Medicaid money is spent on them? And nursing homes have little financial incentive to encourage patients to seek in-home care….”

This article can be a great starting point for an interesting discussion with students.