Trend Change in the Intellectual Disability Nursing Home Census From 1977 to 2004.

Wormald et al. (2019) looked at national nursing-home records from 1977 to 2004. They counted how many people with intellectual disability lived in these homes each year.

The team wanted to see if a 1987 federal law, OBRA-87, really moved people out of nursing homes that were not right for them.

After OBRA-87, both the number and the share of people with ID in nursing homes fell sharply. The drop shows the law met its goal.

Scott et al. (2009) extends these numbers to 2007 and finds the same downward slope. Together, the two papers trace a 30-year exit from nursing homes.

Kozma et al. (2009) reviewed 68 studies and found community homes beat congregate care in most life areas. Their work explains why the census drop is good news.

Matson et al. (2009) sounds a caution: after people move to the community, their social networks and jobs still lag far behind peers. The policy won the placement battle, not the participation war.

You can tell funders and families that federal policy really did empty inappropriate nursing-home beds. Yet when you write transition plans, add goals for jobs, friends, and community outings. Placement is only step one.