From the start, American hospitals focused on caring for acutely ill persons and assumed that families would care for chronically ill persons. During the course of the 20th century, however, average life expectancy increased; families grew smaller, more geographically dispersed, and less stable; and women less often worked at home. As a result, more and more Americans needed to seek long-term care from strangers, and nursing homes—facilities that primarily provide nursing and cus- todial care to groups of individuals over a long period of time—became part of the American landscape.
The number of nursing homes has more than tripled since 1980. Currently, there are around 16,000 skilled nursing homes in the United States. Two-thirds of homes are run for profit, a sharp rise from earlier years.
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