-
Public poorhouses also known as "almshouses" are created by religious groups to provide hospitality, shelter, and care for the poor and the homeless. They began catering to people with disabilities, infectious diseases, the mentally ill, orphans, widows, and the elderly. They were known for their lack of safety and sanitation standards. Also, for their poor quality of care.
-
Almshouses started to empty their beds by sending their chronic patients to seek long term care in non-public nursing homes. Many elderly patients had no choice but to stay.
-
Almshouses closed in large amounts due to the Social Security Act banning old age assistance to residents in public facilities. Allowing private facilities to receive government fundings.
-
The number of nursing homes began to grow, making them more institutional and less homely.
-
Nursing homes transition to a medical model when government regulations are put in place to end abuse in nursing homes. Including fire hazards and inadequate diets.
-
Amendments to the act granted public money to build nursing homes. This introduces federal regulations due to public funding. Public Health Service is designated as the agency responsible for creating safety and staffing regulations and guidelines.
-
Nursing homes were already largely medicalized when Medicare was introduced. The introduction of Medicare caused the need for nursing homes to become short-term or acute care facilities. This created the current nursing home systems we have in place today.