July 6, 2003

KDS Moving is a Tragedy to the Community

By Tim Wheat

The Commercial Appeal reported last month that the nursing home on McLemore once called the Home for the Incurables is moving east to Bartlett. The article never said the moving was a good thing, however, those interviewed had glowing comments about the future of King’s Daughters and Sons Home.

The article failed to interview residents that have been abused, neglected and isolated by KDS. 

Nursing homes are an antiquated idea; they have no real value to a community. Nursing Homes have become a method to profit off of the needs of our most marginalized citizens. Forty years ago, before Medicaid, there was no nursing home industry.

But the Great Society initiative has developed into a large and stable industry relying on poverty and disability. Even with the public backlash to corporate welfare, more than two-thirds of a nursing home’s income are public funds for long-term care (that includes KDS administrator Ron Arrison’s $110,000.00 salary). Home and community-based services are a more desirable and cost-effective form of long-term care but they are not required by federal Medicaid regulations. Here in Tennessee, 9 of 10 long-term care dollars is spent on institutional care. Nursing homes are the most expensive and least desirable kind of long-term care.

Bartlett officials seemed pleased about the move. Although nursing homes are almost universally repugnant, the revenue the institution may bring can please the Bartlett community. The Bartlett populace need not be concerned by the abhorrent treatment and substandard care the nursing home will provide.

Nursing homes isolate people, and society rationalizes the existence of nursing homes by asserting that nursing home residents need to be isolated. Former inmates of nursing homes report that they are neither nursing nor homes. They are “warehouses with drugs.” They are not hospitals either. Nursing homes only provide long-term care; residents have to go to the hospital to get medical care.

Earlier this year the US Department of Justice released its review of Laguna Honda Hospital a nursing home in San Francisco. The city had intended to rebuild the facility, but advocates filed complaints to prevent rebuilding the institution. In the era of the 1990 Americans with Disabilities Act, rebuilding the institution constitutes segregating people with disabilities rather than integrating them into the community. 

There are some good lessons in the USDOJ report for the citizens of Bartlett to attend to:

• [p. 6] The regulations promulgated pursuant to the ADA provide that "[a] public entity shall administer services, programs, and activities in the most integrated setting appropriate to the needs of qualified individuals with disabilities." 28 C.F.R. § 35.130(d)(the integration regulation).
• The preamble to the regulations defines "the most integrated setting" to mean a setting "that enables individuals with disabilities to interact with nondisabled persons to the fullest extent possible." 28 C.F.R. pt. 35, App. A at 450.
• In construing the anti-discrimination provision contained within the public services portion (Title II) of the ADA, the Supreme Court held that "[u]njustified [institutional] isolation ... is properly regarded as discrimination based on disability." Olmstead v. L.C., 527 U.S. 581, 597, 600 (1999).
• The Court explained that "institutional placement of persons who can handle and benefit from community settings perpetuates unwarranted assumptions that persons so isolated are incapable or unworthy of participating in community life." Id. at 600.
• The Court added that "confinement in an institution severely diminishes the everyday life activities of individuals, including family relations, social contacts, work options, economic independence, educational advancement, and cultural enrichment."

Welcome to Bartlett, Tennessee.