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Both the Ohio Medical Association and the Ohio Hospital Association are giving us support in relation to this program.

As the philosophy and concepts of care of the sick and aged progress, administrators are becoming increasingly aware of the need for new modern facilities that are in keeping with these revolutionary concepts-allow me to illustrate. (a) In respect to the individuals privacy which is necessary for his well being, we need

1. More private and semiprivate rooms.

2. Bathing and toilet facilities in the rooms or connecting rooms.

(b) In order to motivate patient in relation to rehabilitation we need1. Dining rooms.

2. Lounges.

3. Rehabilitation areas.

4. More space in rooms so wheel chairs and hydraulic lifts can be utilized without disturbing furniture.

5. Wide corridors so wheel chairs can pass.

6. Homes of one-story construction with ramp approaches for wheel chairs and those who cannot ambulate well.

(c) In relation to safety of patient we need-

1. New homes of fire-resistant construction.

2. Automatic sprinkling systems in old facilities.

(d) These new facilities would produce the following results:

1. Motivate the patient to help himself and thereby increase the likelihood of his rehabilitation.

2. Improve working conditions for the staff.

3. Increase the confidence of the public in the nursing home.

4. Increase the number of long term convalescents transferred to nursing homes from hospitals-a more expensive facility and thus relieve shortage of hospital beds.

The past years have produced dozens, if not hundreds, excellent administrators in Ohio. Their competence has been enhanced by the educational atmosphere provided by the Ohio Association of Nursing Homes. At the present time there are 800 homes in Ohio caring for over 15,000 patients. This is a sizable industry especially when compared to the hospital industry which has 25,000 beds.

A most significant point and one that is having quite an impact on our profession, is the second generation administrators, the sons and daughters of existing administrators who are coming into the field. These people are well educated, progressive and quick to grasp new principles in relation to care of the aged and sick.

The main point of this letter is to acquaint you with our main "stumbling block” in relation to progressing at a much faster rate; it is adequate financing for new facilities. Dozens of administrators have talked to me concerning this problem. I have seen dozens of architects drawings and plans which are now gathering dust in drawers or on shelves for lack of adequate financing. The background of these people is excellent, their businesses are successful; however, lending institutions will not advance adequate financing. The main reason, of course, is that nursing homes are of one purpose construction.

It is absolutely imperative that this problem be resolved not only for the benefit of the individual administrator but also for the good of the country as a whole. Adequate financing will release the aspirations of these individual administrators to build new modern facilities which will gve us thousands of new beds in the next few years throughout the country.

I am confident that the American association with its excellent executive guidance will do much to see this problem suitably resolved.

Sincerely,

Mr. FRANK BATEMAN,
Executive Diretcor,

LEO GLASS, President.

OKLAHOMA NURSING HOME ASSOCIATION,
Oklahoma City, Okla., May 8, 1958.

American Nursing Home Association,

Washington, D. C.

DEAR MR. BATEMAN: The Oklahoma Nursing Home Association requests that you, as executive director of the American Nursing Home Association, make every possible effort through the association's office in Washington, D. C., to see that no possible method is left untried which would encourage an amendment

modifying the present Federal Housing Administration Act and providing loans for construction of new, modern and efficient convalescent and nursing homes and homes for the aged, and for their expansion and renovation.

The nursing home profession of Oklahoma is continually confronted with public demands to increase and raise the standards and facilities of nursing homes. Through local and State legislation, we find ourselves confronted with the problem of meeting local ordinances and State legislation requiring the expenditure of funds to make our facilities more desirable and safe. Yet, at the same time, we are confronted with the impossible situation of procuring loans from private lending agencies or through the usual lending channels. Lending institutions such as banks, building and loan companies, insurance companies, etc., have continued to demonstrate an almost complete reluctance to give us the type of credit we need.

Again, we urge that every possible action be taken to help with the passage of this amendment.

Sincerely yours,

JACK R. PROPPS, President, Oklahoma Nursing Home Association,

RHODE ISLAND ASSOCIATION OF NURSING HOMES,
East Greenwich, R. I., May 9, 1958.

FRANK C. BATEMAN,

Executive Director,

American Nursing Home Association,

Washington, D. C.

DEAR MR. BATEMAN: Rhode Island nursing homes recently were under public scrutiny. The picture of our nursing homes as developed by our local papers bears out the need for improved and more modern facilities. However, at present, the opportunity for financial assistance needed to create new and better facilities are not now available. Local lending houses and banks are not adequately versed on the need nor the potential of this growing profession. As a consequence, we cannot depend on any assistance from these institutions to help alleviate a serious problem.

Any help that will elevate our building program and our standards will do much to assure the aged and chronically ill of our country a safer, healthier, and happier place to live.

Feeling assured that our country will take the proper measures to correct this present situation, I remain,

Sincerely yours,

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DEAR Mr. BATEMAN: Loans for construction, expansion, and improvement of nursing home facilities in the State of South Carolina are not readily available on terms suitable to the financial capabilities of existing nursing home businesses.

Several new facilities have been constructed in this State during the past 4 years with the assistance of local financing firms; however, said local financing has been on a matching dollar basis or on other terms relatively difficult for the homes to meet.

Approximately 65 percent of the homes in South Carolina operate within buildings rated as unsuitable by the licensing agency, the South Carolina State Board of Health. "Unsuitable" is defined as "A nursing home is declared unsuitable if it is (a) housed in a structure which does not meet the appropriate rating for fire safety and (b) not designed for use as a nursing home." The majority of these unsuitable facilities referred to would be immediately replaced with new, modern, and suitable facilities were construction loans more

readily available on terms inducive to sound business operation and practices designed to meet the financial ability of the borrower.

This information is submitted to you in support of the efforts on the part of the American Nursing Home Association to encourage consideration of a loan program of the FHA-type for nursing homes.

Respectfully submitted.

Mr. FRANK BATEMAN,

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TENNESSEE STATE ASSOCIATION OF NURSING HOMES,
Knoxville, Tenn., May 8, 1958.

Executive Secretary,

American Nursing Home Association,

Washington, D. C.

DEAR Mr. BATEMAN: This is to inform you that there are not funds available through private or routine lending channels on the local level for construction of new modern nursing homes and homes for the aged, nor are there such funds for expansion or remodeling of present facilities.

I have personally investigated through banks and other lending agencies here in Knoxville and throughout the State, since I have plans to build a 25-bed facility. Others have had a similar experience throughout the State of Ten

nessee.

I trust the near future will change this picture and the proprietary nursing home can continue to grow, thus filling an increasing need for nursing-home beds, affording the patient and the public a much needed service at a reasonable rate. Respectfully yours,

CATHERINE T. ANDERSON,

President.

VIRGINIA NURSING HOME ASSOCIATION, INC.,
Winchester, Va., May 10, 1958.

Mr. FRANK BATEMAN,
Executive Director, American Nursing Home Association.

DEAR MR. BATEMAN: I understand the American Nursing Home Association is to appear before a congressional committee to present a proposal of Government-guaranteed loans to nursing homes and convalescent homes for construction and renovating acceptable licensed homes.

The experience of borrowing through routine lending institutions has been undesirable and almost an impossibility. I tried borrowing through the regular lending institutes but could not, and I am sure my financial statement looked better than the average nursing home.

I was able to get a loan approved through the SBA. My experience has been shared by many others in Virginia trying to get a loan for construction of larger and better facilities, but the happy ending I experienced has not been shared by many others.

The Virginia association is pleased to hear about the action taken by the American association in trying to get the Federal Government to include licensed nursing homes in the FHA program on such a sound businesslike manner. We in the Virginia association want to give you our full support in anything that might help.

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Recent survey State of Washington reveals normal lending agencies still not making loans, new constructions nursing homes or additions, improvements thereto. Bankers say officially not opening new lines credit. Admit privately

reluctant to finance because single purpose. Many operators have plans various stages but insufficient money. Some could let contracts start constructions 60 to 90 days if financing assured. Appreciate your efforts to help.

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DEAR SIR: Our West Virginia Nursing Home Association has asked that I express to you, as the Washington representative, the total lack of opportunity for nursing homes in West Virginia to obtain financial backing.

The Hill-Burton Act is of no value to us; there is only one nonprofit home in this entire State. Banks seem to operate upon the same basis as they did at the time nursing homes were in their dark days, many years ago.

Nonprofit homes in our State were never successful and have now virtually disappeared. In spite of this we see legislation continually directed for the encourage of this type of business.

Anything which you can do to encourage a fair, businesslike approach to this problem will be greatly appreciated.

Sincerely,

DANIEL F. BERLIN, President.

MAY 12, 1958.

Mr. FRANK C. BATEMAN,

Executive Director American Nursing Home Association,

Washington, D. C.

DEAR MR. BATEMAN: Although it is of vital importance that nursing homes have financial assistance for construction, expansion, and renovation, due to the increasing need of such homes for the aged and the sick, there is no possibility of obtaining loans for this work through any type of program in this area. Financial aid is needed now and the future will bring an even greater need for same.

Very truly yours,

BEATRICE M. FOUCHA,

President, Vermont Association of Licensed Nursing Homes.

TEXAS NURSING HOME OPERATORS ASSOCIATION, AUSTIN, TEX., May 8, 1958. Mr. FRANK C. BATEMAN, Executive Director, American Nursing Home Association,

Washington, D. C.

DEAR MR. BATEMAN: I should like to call to your attention a serious situation which is very definitely hindering the progress and development of the services and care that our nursing homes in Texas would so very much like to improve, namely, the lack of availability of loans for the construction, expansion, and/or renovation of new and modern, as well as existing, nursing and convalescent homes.

We can state that in Texas there is not available through the regular existing loan channels opportunities from which to borrow for nursing homes. This situation is dramatically illustrated by hundreds of our people who have attempted to borrow for new construction and for improvement.

If you can find sources for relief, we in Texas would be so very grateful.
Yours very truly,

Senator SPARK MAN. Mr. Ryan is next.

ELDRED THOMAS, President.

I understand you are with the First State Mortgage Co. of Miami, Fla. Is that right?

STATEMENT OF WILLIAM RYAN, VICE PRESIDENT; ACCOMPANIED BY LEONARD BURSTEN, COUNSEL, FIRST STATE MORTGAGE CO., MIAMI, FLA.

Mr. RYAN. That is correct, Senator.

Senator SPARKMAN. We are very glad to have you, Mr. Ryan. You may proceed in your own way.

Mr. RYAN. Thank you. I am very happy to be here.

Senator SPARKMAN. For the benefit of the record, will you introduce your associate?

Mr. RYAN. Yes, sir. This is Mr. Leonard Bursten, associating attorney retained by our firm in Miami.

Senator SPARKMAN. In Miami?

Mr. RYAN. Yes, sir. I am not an attorney.

Our First State Mortgage Co. has been for the past 22 years developing a retired village on the northwest gulf coast of Florida. It is approximately 51 miles from the city of Tallahassee. In developing this program, Senator, we have run into a lot of the problems, intangible problems, which you confront in providing housing for the elderly.

When we started this program I doubt any legislation with regard to providing housing for the elderly had been promulgated by Congress, but since getting into it we have at present a village there consisting of approximately 400 homes, and the average age of our people is about 68 years. They are definitely those persons whom I believe you mentioned in your brochure which I had the pleasure of reading. They are of the lower income group of the 12 million retirees of this country. They are the people that I think it was the intent of Congress to take care of in passing their legislation last year and the year previous to that.

The people we have at our particular village, and of which there are millions more in this country, are those people who are subsisting almost entirely upon their retired pensions, which are either under social security, union pensions, or former company employment pensions. I would say on the average their income runs approximately $150 a month.

The problem we have run into is that in furnishing long-term financing for these types of people, the average institutional mortgage company considers it a poor risk, and it is very difficult to get any long-term financing, particularly with the income gradient they have, and the age of the people themselves.

The average institutional mortgage company, or a banker, will tell you in their opinion a person 60 years old or older ought not to have any long-term financial obligations. In attempting to sell mortgages to persons that age you have the factor which is almost impossible to surmount in private financing. Under your Housing for the Elderly Act, which was just discussed here, title 207, you have primarily institutional housing much the same as Mr. Mustin here just got through explaining. It is for people who have reached the point of feebleness where they have to be cared for, and they have to live in a village where there will be communal dining facilities, and nursing, and immediate medical care. But I think that is a very small portion of the retired group which you spoke of in the brochure that I was happy to have

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