Poll shows 70% of Americans are uncomfortable with prospect of being admitted to nursing home

More than 40% of Americans say nursing homes are unsafe and 7 in 10 say they would be uncomfortable with ever having to be admitted to one even if they needed such care, while more than 6 in 10 (61%) feel similarly anxious about the prospect of admitting family members, according to the latest survey from West Health and Gallup.

Safety was a particular area of perceived concern; 41% of respondents say nursing homes are not safe, 26% say they are, and about a third say they don't know. Notably, the survey found that people over 35 were much more likely to view nursing homes as unsafe than their younger counterparts (44% versus 34%).

Concerns over quality (70%), cost (49%) and the possible negative impact on mental health (45%) were among the top reasons for the uneasiness, but fears of losing independence (34%), dying in a nursing home (28%) and threats to physical safety (27%) were also factors. When asked to grade the overall quality of care in nursing homes, Americans, on average, gave the facilities a barely passing grade of "D+." Only 18% of U.S. adults said they would feel comfortable moving into a nursing home if it became necessary.

The survey findings come as the Biden Administration has proposed first-ever mandatory minimum staffing levels for nursing homes participating in Medicare or Medicaid. The U.S. is home to roughly 15,500 nursing homes that care for more than 1.2 million people, according to data from the Centers for Disease Control and Prevention, and low staffing is widely considered a root cause of inadequate care in the facilities.

Most states set some level of minimum staffing, but the new federal proposal goes further. Nursing homes would have to provide a minimum of 0.55 hours of care from a registered nurse per resident per day, as well as 2.45 hours of care from a nurse aid per resident per day. They would also be required to have a registered nurse on site at all times.

"Nursing homes serve a vital role in our society, but improvements are needed beyond staffing that will ensure quality and restore confidence in a system of care that most Americans have serious concerns about," says Tim Lash, president of West Health, a family of nonprofit, nonpartisan organizations dedicated to improving aging and health care in America. "Meanwhile, home- and community-based services, which are often preferred choices for care, are struggling to meet demand due to worker shortages, low wages and poor provider reimbursement. Policymakers must also do more to support these programs that offer an alternative to institutional settings."

Overall, Americans polled in the West Health-Gallup survey gave the quality of care in nursing homes a "D+." Only a third (33%) gave them a satisfactory grade of "C," and high marks were virtually non-existent, with only 1% saying they deserve an "A" and 8% saying they would give a "B."

"Nursing homes are perceived poorly by most Americans, many of whom share trepidation about the prospect of ever needing one for themselves or a family member," says Dan Witters, Gallup senior researcher. "This signals that these institutions do not have the benefit of the doubt. Nursing homes have a need to better demonstrate that they are safe places for older adults and provide a high quality of care."

The survey was conducted from July 5–24, 2023, with data collected from 2,145 American adults ages 18 and older. The topic of the study, which was fielded by Gallup via the Gallup Panel, is Americans' Perceptions of Nursing Homes in the U.S.