is placed in a nursing home, the first thing their loved ones think about is: "Is my mother or father going to be happy in that home?" In order to make an elderly person happy when you take them from their own home to a nursing home is to make their period of adjustment a pleasant and speedy one. Elderly people cannot stand much changes. In order to accomplish this, you must have a kind and sympathetic nursing staff who are stable. A person could never get the personal and individual attention in a State institution as they receive in a private nursing home. A good nursing home does not have the large turnover in personnel as that found in State institutions. This alone is an important factor in the welfare of the patients. The nursing home must always thrive to make it known to the patients that they are not just put away in a home and not wanted. Elderly people are very much like children inasmuch as they get sick quickly and if neglected, their ailment can become serious in a short time. Only a closely supervised nursing home can give the type of care so necessary in caring for the aged and chronically ill. A tiny blister, the size of a pea, can if neglected turn into a vicious bed sore. So very often you find personnel in the large institutions who try to get by with doing the least possible work. A private nursing home is run by a responsible administrator, who is constantly watching over his patients to see that they get the necessary nursing care. It is true that we have an inadequate number of nursing homes throughout the country but we sincerely believe the answer to this problem lies in the passing of H. R. 7700. Bill H. R. 7700 will allow administrators of private nursing homes to make a reasonable loan to build new nursing homes or remodel their present building thus giving more and better nursing home facilities. The passing of Senate bill (S. 2758) would mean socialized nursing care, one step ahead of socialized medicine. We all are aware of the danger of socializing any form of profession, especially the care of elderly people. It is our belief that we should always try to preserve the freedom of free enterprise. It was this belief of democracy that made mine and millions others who went into service an easier task to perform. It would be wise to visit the patients in proprietary nursing homes and those in State institutions and get firsthand information as to how these people feel about their surroundings. I feel sure that you will find those in private nursing homes much happier than those found in State institutions. We think that it would be worth the try to permit the proprietary nursing homes to take care of the aged and chronically ill by allowing them to make reasonable longterm loans to build more facilities. Please give the private nursing home administrators an opportunity to do the job themselves. Sincerely yours, HARRY D. HELMAN, President. THE MINNESOTA ASSOCIATION OF NURSING HOMES, SENATE SUBCOMMITTEE ON LABOR AND PUBLIC WELFARE, (Attention: Mr. Melvin Sneed, Professional Staff.) GENTLEMEN: The Minnesota Association of Licensed Nursing Homes wishes to record its protest in opposition to those portions of Senate bill S. 2758 and House bill 8149 providing for appropriation of Federal funds for the construction of public nonprofit nursing homes on the following grounds: 1. The privately owned and operated licensed nursing homes have adequately filled the need for the care of chronically ill and convalescent patients in our State. Nursing homes are not to be confused with the many church and charitable homes whose patients or guests are almost 100 percent ambulatory and not in need of nursing care or medical supervision. The need for nursing and medical care for the aged and infirm during the past decade has been met by the private nursing homes who furnished the only proper care available when the only alternative was the old-fashioned county poorhouse. The privately owned homes have expanded their existing facilities as rapidly as the need for these services arose, and, in addition, have added 84 new privately operated homes during the period from 1947 to 1950 in our State alone. We feel that, as an important segment of the system of private enterprise in our country, we will continue to adequately meet any need for our facilities as this need arises. Amplifying the above statement regarding the importance of our position in the field of private enterprise, we wish to call your attention to the accompanying statistics on attached exhibit which give an accurate picture of the financial activities of the private nursing homes in the State of Minnesota. 2. Privately owned and operated licensed nursing homes are better suited for giving nursing home care than large institutional type homes. The average size of a private nursing home is between 20 and 30 beds. Some are considerably smaller, having as few as 9 beds, and some as many as 50 beds. This type of operation can be carried on in a reconverted mansion or smaller new home which does not require the expensive facilities associated with a hospital. Also, from this type of home, a convalescent or chronically ill person is allowed to choose the one in which he or she wishes to reside; the care is much more intimate and personal; and the transition from residence with their own families to a nursing home is much less sharp. Nursing homes must be distinguished from convalescent hospitals in that the term "hospital" honestly implies the need and usage of many highly technical types of equipment similarly employed in the regular hospitals. This technical equipment is not necessary in the ordinary nursing home. Patients and their families have repeatedly expressed their happiness and contentment in the home like atmosphere found in the private nursing homes as compared to the institutional atmosphere inescapable in the large publicly run institutions. The Government sponsored or financed institution usually is a large institution involving hundreds of beds and necessitating a large initial investment. This type of institution pays no taxes, and their histories of operation show them to be costly and a real added burden to all taxpayers. Costs of patient care in private nursing homes are strictly regulated by our State, county, and city agencies. These agencies regularly inspect our homes to insure adequate facilities for the proper care of patients. This results in a balance between services rendered and the amounts paid therefor which would not be possible in the State or county homes. Government sponsored nursing homes violate the principle that the aged should have the right to choose the home in which they are to be placed, by making them wards of the county or State and forcing them to be subjected to institutional care, such as existed in the old type of poor farms now generally abandoned. Government sponsored homes would be the beginning of socialized medicine for persons over 65 years of age receiving old-age assistance. It means that the care of the convalescent and chronically ill of our aged population would become subiect to political pressures, rather than remaining part of the free enterprise system of our country. It means a highly increased tax burden to pay for the cost of constructing Government sponsored nursing homes. 3. Government financed nursing homes would destroy large investments in private nursing homes made in response to growing need for nursing home care and put Government in direct competition with private enterprise. They necessarily involve large single institutions that discourage private investment, and would revive the old poor farm system for the care of the aged, which the social security law was intended to eliminate. Private nursing homes have expanded private employment, made use of many old properties, and have paid large sums in taxes to the State and Federal Governments, all of which would be seriously affected by this bill. 4. We feel that the reasonable solution to this problem is the insuring by the Federal Government of reasonably long term low interest loans to the private nursing homes to aid and encourage them to still better meet any future need for expansion as conditions might dictate and save our Government the millions of expense now being considered in these bills which cannot help but add to the country's and taxpayers' financial burdens. Very truly yours, ALVIN COSTELLO, President. Annual extent of operations of private nursing homes in Minnesota Rural Minnesota. 1,885 Paul.. 716 $923, 658. 54 $720, 175. 48 $131, 921. 91 $90, 839. 85 $33, 427. 84 1,218 486 866, 022. 07 490, 549. 92 79, 960. 78 91,867.67 Total.... 3, 103 1, 202 1,789,680.61 1,210,725.40 211, 882. 69 182, 707. 52 $161, 246. 10 29, 123.84 141, 254. 56 302, 500. 66 NOTE. The Conservative estimate of the value of the investment in private nursing homes in the State of Minnesota would be at least $6 million. Many homes have installed, and are installing, sprinkler systems in the interest of eliminating fire hazards, which as a single item are averaging between $6,000 to $10,000 per home. The figures for the metropolitan area of Minneapolis-St. Paul are separate from the rest of the State because of differences in costs between city and rural areas. We believe these figures to be very conservative, and, if they err, they do so on the low side. THE GEORGIA ASSOCIATION OF NURSING HOMES, Mr. MELVIN SNEED, Professional Staff, Senate Committee on Labor and Public Welfare, Capitol Building, Washington, D. C. April 1, 1954. DEAR SIR: We, the private nursing homes of Georgia, speaking through the Georgia Association of Nursing Homes, respectfully voice our objections to the Government appropriating $60 million for nonprofit nursing homes for the aged as provided in pending bills, S. 2758, H. R. 8149, and for grounds say: In the State of Georgia we have 84 homes licensed by the State Hospital Services Division of the State Board of Health with a total bed capacity of 2,686 patients and with prospects of other nursing homes being built through private enterprise. Each of these nursing homes represent an investment of from $15,000 to $50,000. In addition, they are staffed with medical practitioners and nurses who, for the most part, own the establishments, or the majority interests therein. Should the Federal Government pass Senate bill S. 2758, H. R. 8149, unfair competition, that of subsidized governmental nursing homes against the unsubsidized ones, would immediately result, probably forcing the 84 privatelyfinanced nursing homes out of business because of the larger, more modern facilities available only through subsidy of the taxpayers. The nursing homes occupy a more important place in the community in that it is a bridge between those patients who are not able to enter hospitals for financial reasons but are able to afford the lesser expenses involved in the nursing homes. The greatest need of private enterprise in this field would be to obtain longterm, low-interest loans from the Federal Government that would help each home raise its standards by adding extra beds, more doctors and nurses, and more modern equipment. Another need of the private nursing homes which might be provided by the Government without undue cost to the taxpayer would be closer laboratory cooperation provided between the private nursing homes with United States Public Health laboratories. Likewise, making available to private nursing homes surplus armed services equipment such as hospital beds, laboratory and hospital equipment, and other equipment which is no longer needed for military purposes, would be of untold benefit. This latter type of aid would assist the nursing homes and the public immeasurably and would enlarge the base of service the private nursing homes are presently rendering their communities. If desired, a representative of this office would be pleased to appear before an appropriate committee considering these bills or supplemental information will gladly be furnished upon request. Yours very truly, JOHN L. MCCALLUM, President. TEXAS NURSING HOME OPERATORS ASSOCIATION, Mr. MELVIN SNEED, Professional Staff, Senate Committee on Labor and Public Welfare, Capitol Building, Washington, D. C. DEAR SIR: Please refer to Senate bill 2758, which is the Senate version of House Resolution 8149, a bill to amend the hospital survey and construction provision of the Public Health Service Act. I would like for the members of the Senate subcommittee to consider the following facts as they study this legislation. The Public Health Service Act that is to be amended did not include nursing homes. This act was not intended to subsidize nonprofit organizations to compete with private enterprise. Hospitals were originally organized by groups of religious people as nonprofit institutions. Nursing homes were originally organized by small-business people, engaged in free and private enterprise. Nursing homes have remained in the category of private enterprise. Hospitals are, predominantly, nonprofit organizations. Therefore, nursing homes should not be included in this bill. The term "nonprofit organizations" is very broad. The bill does not specify that the organization must have been chartered to care for the sick and helpless. It does not specify that the nonprofit organization must be a part of the nonprofit hospital organization. Again the original intent of the bill to be amended has been forgotten. The figures presented to the Committee on Interstate and Foreign Commerce, February 4, did not include the commercial nursing-home beds. Until a proper survey is made, including the beds in licensed nursing homes in the United States, no person or group should be willing to ask for legislation appropriating such an enormous amount of money. How can a need be determined without these beds being counted? How can the people engaged in private enterprise survive and compete with Government grants for which they must help provide the money? Every State in the Union now has a licensing agency for nursing homes. This agency has the figures covering their State. Why should $2 million be spent to make a survey that can be made by the licensing agency of each State? They have inspectors and representatives employed and in most cases have the figures available. On the 24 and 25 of this month I held an open State meeting for nursing home operators of Texas. Over 75 operators attended this meeting. Every section of the State was represented. Open discussion brought out time after time that there is no shortage of facilities for the chronically ill in Texas. The director of the Texas State Department of Health, Dr. George W. Cox, has stated repeatedly that we have no shortage of facilities in Texas. We definitely need to do some remodeling and it would be very good if we could replace some of our homes with new construction. We would like very much to have funds made available on long-term 2- to 3-percent interest loans. The commercial loan companies will not loan money at this low rate and if we are able to obtain such loans the money would need to be appropirated by legislation for this purpose. Would it not be better to make these funds available to experienced people on a loan basis than it would be to grant it to inexperienced nonprofit organizations that do not pay taxes and who would not be required to pay it back? The people who have invested their money and spent many years of their life in this humanitarian work were completely ignored when this bill was written. At the same time Senate bill 2758 will legislate them out of business. This bill discourages private enterprise; it discourages small-business people. You know, and I know, that the very foundation of the American way of life is private enterprise and that the phenomenal growth of our country is the results of fair and clean competition: the competition resulting from people starting in small businesses, investing their own money and labor, surviving and growing as they improved the service they had to offer or the article they had to sell. Should our legislators permit the passage of a bill that would tend to destroy the American way of life? There is not a professional group of people in America who have given as much in return for the dollars they have received as the nursing home people have given. They started, in most instances, with a small amount of money, a desire to serve suffering humanity, and two hands that were accustomed to hard work. They have reinvested their profit and many of them have modern, well-staffed homes; some are still striving for better physical plants and have not reached their goal. I humbly ask that you conscientiously study Senate bill 2758 and I pray that you, too, will see the injustice of this legislation. Yours very truly, MRS. OSCAR YELLOTT, President. LICENSED NURSING HOMES ASSOCIATION OF NEW JERSEY, INC., Hon. ALEXANDER SMITH, United States Senate, Washington, D. C. DEAR SENATOR SMITH: The Licensed Nursing Homes Association of New Jersey is opposed to S. 2758 principally for the reason that the bill, as it now stands, completely ignores private enterprise and attempts to build federally sponsored nursing homes in direct competition with the estimated 120 proprietary nursing homes that have pioneered the movement in caring for the indigent, aged, and chronically ill in New Jersey for the past 20 years without aid or favor by the county, State, or Federal Government. Nursing-home operators have spent their time, energies, and fortunes to develop and promote nursing homes throughout our State. Some may have fallen by the wayside, but, nevertheless, the greater majority have shown that private enterprise can provide for a social service that our statesmen and leaders have forsaken for so long a time. Now apparently, in their anxiety to establish reforms, the administration casts violently and shockingly aside all basic principles of private enterprise, the very foundations which we all cherish, fight, and work for. In New Jersey, there are approximately 120 nursing homes with an average value of $50,000 per home. We employ nurses, cooks, maids, handymen, and pay substantial sums of money in salaries and taxes. The gross volume of business in New Jersey alone is over $10 million per year, distributed to craftsmen, carpenters, plumbers, food suppliers, and so forth. And now, with one grand swoop, privately owned nursing homes will find it impossible to compete with the nonprofit homes, because S. 2758 encourages the creation of the nonprofit group to form and take over, by unfair competition, that which private enterprise has created by arduous efforts throughout the past years. We do not condemn the basic principle of the bill but do condemn the utter disregard for the proprietary nursing home. All we request is that the administration encourage private enterprise in the nursing field as it encourages nonprofit groups, and that long-term, low-mortgage loans be made available to the nursing-home operators. In closing, we should like to reply to your survey which indicates a shortage of nursing home beds. Nursing home operators in the many communities throughout New Jersey always had vacancies, and they have them now. In some communities, a shortage of beds may exist only for indigent patients, and that is because of the inadequate grant the governmental agencies will allow for room, board, nursing care, and services. A reevaluation of operating costs and allowances for the maintennace of welfare patients, would be informative and reflect well upon those of us who, in our limited way, have provided nursing care and services to indigents at a loss. Your survey also indicates that it is less costly to build and operate public or nonprofit nursing homes than hospitals, but it should also state that private enterprise can build and operate for less than either. Respectfully yours, LEWIS GASH, President. Mr. MELVIN SNEED, TENNESSEE STATE ASSOCIATION OF NURSING HOMES, March 27, 1954. Professional Staff, Senate Committee on Labor and Public Welfare, DEAR MR. SNEED: In conenction with hearings on S. 2758, March 19, 1954, the Tennessee State Association of Nursing Homes wishes to enter the following into the committee hearing record. We oppose that portion of S. 2758 which would make available grants for the construction of nonprofit nursing homes for the reasons hereinafter stated. |