On Sunday, September 27, 2026, people in more than 35 states around the country who care about the treatment of our elders in the Long-Term Care system, ie., nursing homes, will be walking to raise awareness of the need for Long-Term Care reform. This is the first national walk, through the brand new non-profit organization, ROAR4LTC.org (Respect. Oversight. Advocacy. Reform. for Long Term Care), founded by fillmmaker, Susie Singer Carter, after her mom was in a nursing home and witnessing what she went through there.
I’ll be leading the NC walk. One of the walk leaders in Connecticut, Dr. Eilon Caspi, wrote a great article explaining the reasons we’re walking and why your participation in this movement is needed, 31 Reasons Why Your Participation in the 1st National Walk for Long-Term Care is Urgently Needed.
Here are 9 of the top reasons:
1. Profits versus Vulnerable People: About 70% of nursing homes in America operate under for-profit ownership. Prioritizing profits often comes at the expense of residents’ dignity, care, safety, and life. This is a longstanding problem. Nursing homes’ profits are often hidden and diverted away from direct care through sophisticated corporate web of ownership structures. Then, claiming razor-thin profit margins, nursing home companies go to lawmakers and ask for more money. Real Estate Investment Trusts (REITs) and private equity firms are permitted to divert profits away from direct care, leaving residents suffering from lower quality of care and increased mortality. They buy nursing homes, drive the quality of care to the ground (such as by cutting down staffing levels), and put vulnerable elders at risk of harm while enriching themselves. Their goal is to make quick profits and then sell the nursing home after a few years (this practice has been described as “wash and rinse”). Then when lawsuits (such as for deadly neglect) are filed against them, they “pretend they don’t have control over the ground level of care,” says elder abuse attorney Laraclay Parker who has extensive experience with REITs’ tricks of the profit trade. While lawmakers in many states are doing nothing, some states have started to take action to address this growing problem in nursing homes. Some for-profit nursing home chains (such as the PACS Group) grow at a rapid pace and rake in hundreds of millions of dollars while deadly neglecting their vulnerable residents.
2. Longstanding Racial Disparities in Quality of Care: Socioeconomic, racial disparities, and “pervasive inequities” have long existed in U.S. nursing homes. Decades ago, experts have recognized these disparities, saying that in effect, there are two tiers of nursing homes in America (see journal article titled “Driven to Tiers”). In recent years, experts have called to eliminate the “systemic racism” in America’s nursing homes. However, a recent study showed that racial disparities in nursing homes persist largely as they were several years ago when the call was made.
3. Systemic Abuse and Neglect: The longstanding problem of mistreatment (including abuse, neglect, and financial exploitation) of people living in nursing homes has been repeatedly shown to be widespread. For example, a review of studies has found that more than half of staff members admitted that they committed acts of mistreatment against individuals living in long-term care homes (psychological abuse, 33%, physical abuse, 14%, neglect, 12%, and sexual abuse, 2%). It invites the question: Would people accept chronic and widespread mistreatment of disabled children who live in childcare settings?
4. Sexual Abuse – Horrific, Deeply Traumatic, and Devastating but Largely Hidden: Several years ago, a CNN investigation titled “Sick, Dying, and Raped in America’s Nursing Homes” documented the long history of horrific sexual abuse incidents in these care settings.
5. Social Media Abuse – A Relatively New Form of Elder Mistreatment: A relatively new form of mistreatment – social media abuse – harms elders, many of whom with dementia in nursing homes nationwide. These disturbing incidents occur when staff take unauthorized photos and videos of residents – often with demeaning and abusive content – and then they post them on social media such as Snapchat, Facebook, and TikTok. Despite CMS 2016 guidance for addressing this form of abuse (titled “Protecting Resident Privacy and Prohibiting Mental Abuse Related to Photographs and Audio/Video Recordings by Nursing Home Staff”), Dr. Caspi’s report shows that many nursing homes still fail to prevent it. Since most abusive acts are never reported to State Survey Agencies, it is likely that many other social media abuse incidents in nursing homes remain invisible. Elders living with dementia have also been found to be victims of this form of abuse in Memory Care Assisted Living Facilities.
6. Food Quality: Concerns about the quality of the food provided to people living in nursing homes are longstanding and common. This should not come as a surprise when many nursing homes spend so little on food. This was recently described in a report titled “The Hunger Games: Many Nursing Homes Feed Residents on Less Than $10 a Day.” This systemic problem exists despite the fact that food and mealtimes are a central part of elders’ dignity, well-being, and quality of life in nursing homes. It is a longstanding problem.
7. Wrongful Involuntary Discharges – “Speak up and risk eviction”: Being wrongfully evicted from a nursing home is a longstanding and common problem in nursing homes nationwide. Nursing homes come up with all kinds of unwarranted reasons to evict residents. One of them occurs when they wrongfully label the person as “difficult” so they can get rid of him or her.
8. Poor Staffing Levels – A Recipe for Neglect and Abuse: Safe staffing levels of well-trained direct care staff members (Certified Nursing Assistants [CNAs], Licensed Practical Nurses, and Registered Nurses) at all times (including evenings and weekends) is one of the most important factors contributing to quality of care and safety in nursing homes. Despite this well-known fact, a review conducted by professor Charlene Harrington and her colleagues has found that “dangerously low staffing levels” existed in thousands of nursing homes during the years prior to the COVID-19 pandemic.
9. Insufficient CNA Training Requirements: The federal nursing home law and regulations require a minimum of 75 hours of training to become a Certified Nursing Assistant (CNA) in nursing homes. The requirement, which comes from the Omnibus Budget Reconciliation Act of 1987 and its implementing regulations (42 CFR 483.152), is nearly 40 years old and it was never meant to be a ceiling. The federal minimum has not been raised since. This dated federal requirement represents a major concern given the increasing care needs and complex health care conditions of older adults and other people with disabilities living in nursing homes nationwide.
Read ALL 31 reasons and the related research findings right here: 31 Reasons Why Your Participation in the 1st National Walk for Long-Term Care is Urgently Needed.
For more information and to get involved to demand Respect, Oversight, Advocacy, and Reform, go to: ROAR4LTC.org.
And watch No Country for Old People on Amazon!
