February 16, 1970

NY Times survey of US nursing home indus and complaints about homes, including low quality of care, inflated costs and callous attitudes of some drs; illus; 9 Cong probes have begun in recent months and some Reprs are conducting ind probes; reasons for growth of indus outlined; last yr home stocks were considered by investors as glamour issues because Fed funds were guaranteed under Medicare and Medicaid, making profits almost certain; number of homes has doubled to 24,000 since '66 and new ones examples of how home chains operate; discussion of concern of elderly and their families with quality of care, often felt inadequate despite relatively high costs and modern accommodations; middle class is being shut out of homes because wealthy pay for their own care while poor get pub assistance; Amer Assn of Homes for Aged ex-pres H Shore views older person as victim in battle between Govt, concerned with lowest possible cost, and home operators, who seek maximum profits; homes are unhappy with welfare programs and what they feel is unjust and arbitrary treatment by Govt; in most states Medicaid pays low benefits for home care, which results in shunting of Medicaid patients to worst homes that provide cheapest care; conditions in 'bad' homes described; even if physical surroundings in homes are adequate, care is sometimes fragmented; Amer Assn of Homes for Aged exec dir L Davis holds 'whole' human being is sometimes forgotten; homes are also selective in choosing least sick and troublesome patients; discussion of conflict of interest, in which some drs own, operate and sometimes even evaluate their homes; AMA holds it proper for drs to own or have financial interest in home or similar facility providing patient has free choice of dr; quality of admr seen as key to quality of home; only 10% of admrs currently have any sort of training and 1/3 do not hold coll degrees; lower-echelon staff are rarely paid more than minimum wage, have high turnover rate and are rarely trained except for on-the-job experience; suggestions for improving homes detailed; include; greater Govt financing of more insts with many levels of care in 1 bldg; training of admrs and staff to meet minimum requirements; establishment of uniform terminology and standards; overhaul of Fed programs to provide single audits and eliminate red tape; increase in Govt loans to nonprofit homes; exploration of alternatives to nursing home care such as day-care centers, foster homes, visiting services, sheltered workshops and sheltered housing

Israeli jets resume attacks on UAR positions in Suez Canal northern and southern secs after relative lull of 3 days; Israeli Cabinet hears rept by Dayan on gen security situation; scattered incidents in Gaza Strip and occupied Golan Hts noted

NYS Ins Dept proposes complete overhaul of auto ins coverage in state to do away with need to find who is at fault in an accident before payments are made; plan, contained in 164-page rept prepared in large part by Supt R E Stewart, is promptly endorsed by Gov Rockefeller; rept says new system could cut ins costs by as much as 56% and end much of courtroom litigation that now occurs in damage suits; seen arousing strong opposition from segments of ins indus and from negligence attys; recommended changes are designed to provide all accident victims with full compensation promptly for all their med costs and all net-income losses; neither car owner would be allowed to sue other for negligence, except where death occurred or drunken driving was involved; relationship between co and insured will be similar to one that exists between most med plans and subscribers; rept finds that 1 out of every 4 people injured in accidents receives nothing whatsoever; says 53c of every $1 paid in premiums goes for overhead rather than compensation of victims; other findings detailed; Allstate Ins Co opposes plan; says it will result in higher accident rate

US Sec of State Rogers in Zambia, 5th stop of 10 nation tour; to conf with Kaunda

Article on urban crisis posed by refugees in Saigon; 1.3-million refugees from countryside have poured into city in last decade of war in search of security and chance to make living; plight of 1 family detailed; illus