How Government Created and Shaped the U.S. Nursing Home Industry

Abstract

Beginning in the 1960s, U.S. government policy largely created, and subsequently facilitated the corporatization of, a powerful, multi-billion dollar nursing home industry. Using data from trade publications, government agency reports, Congressional hearings, newspaper reports and existing scholarly research, I chart the relationship between the state and the U.S. nursing home industry over four time periods to reveal how, at different moments, government policy contributed to first the creation, then the corporatization and consolidation of the industry. I argue that the trajectory of Medicare and Medicaid policy is not wholly neoliberal but neither should it be considered progressive.