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Nursing Home Administrators


Institutions for the elderly have not always been clean and cheery places. Nevertheless, such institutions have existed in the United States dating back to colonial times, before the country even became the United States. One institution in use was the poor house, modeled after the English almshouse. Elderly people without means of support or families to care for them often ended up living their final days in these dismal places. Religious institutions, such as convents, also offered places for the old and sick to stay. And, of course, families provided care for their senior members, often with several generations living in one household.

It was not until the 20th century, however, that the long-term care of seniors became organized into a business. According to the American Health Care Association, the first nursing homes in the United States came into existence around 1900. Originally these homes were boarding houses, places where people paid rent that covered rooms and meals. As boarding house residents aged, some became physically unable to care for themselves and needed help with everyday activities. In addition, those without other family members, who otherwise would take care of them, sought places that offered basic medical care in addition to meals and lodging. Boarding house owners recognized the need to provide housing and medical services for these older residents. Those who began to supply these services became the first people to run nursing homes and were, essentially, the first nursing home administrators.

By 1920, state health departments developed licensure programs for nursing homes within their jurisdiction to better regulate facilities and their services. The 1930s saw the development of the Social Security and Old Age Assistance programs, government programs designed to give the elderly financial support that they could use for their care. In 1965, the programs Medicare and Medicaid were added to the Social Security Act. These two programs paid providers of care services directly and helped to spur the growth of the long-term care industry.

Today, as the country's senior population expands, as medical and technological advances are made, and as lifestyles change, the need for well-managed, comfortable, clean, and affordable long-term care for the elderly is greater than ever.

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