A recent study found that more than 10,000 Americans turn 65 every day.^[1] While the population is getting older, individuals are also living longer.

Whether it is with our parents or our grandparents, many will have a conversation regarding how we can provide the best possible care as they age. How do we tell our loved ones they are no longer safe at home and require additional support with daily activities? It is not an easy conversation; it may bring up mixed emotions of failure and relief, coupled with frustration and anger over the reality of aging and the risk of continued independent living.

But it is not the conversation itself that causes pause. It is the question: “Where will Dad go to receive the best possible care?” Our society has become more geographically dispersed, resulting in multiple generations no longer living in one area. As young adults grow up, many are finding jobs in other parts of the state, country, or even the world. This means that family members—and older adults who need assistance—turn to other caregivers in the community to provide care, including assisted living and nursing facilities.

Most people do not have the goal to go to a nursing facility when they are unable to care for themselves at home. Given the choice, nearly 88% of people want to grow old in their own homes, and only 12% would choose to live their final years in a nursing facility.^[2] Yet, that is the reality for over 1.3 million Americans.^[3]

Nursing facilities have been challenged with a reputation for poor care delivery. Amid the current administrative and clinical staff shortages, nursing facilities continue to face increased patient volume, revenue challenges, increased scrutiny from state surveyors, and high expectations of quality of care from residents and family members.

In light of these challenges and the increased volume of Medicare beneficiaries at risk, the U.S. Department of Health and Human Services Office of the Inspector General (OIG) is making this segment of healthcare a priority for the agency. In her keynote address at HCCA’s 2023 Compliance Institute, Inspector General Christi A. Grimm outlined three focus areas developed by OIG to address healthcare in nursing facilities.^[4] All three areas of focus have a great impact on both the quality and cost of care and originated from reports and studies conducted by OIG: