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The situation you describe makes sense to the REST of us, that the elderly or disabled could be better taken care of in the comfort of their own homes, & it would be less costly to the govt agency assigned to their health care. (& to the patient).
BUT try to look at it from the perspective of a money-worshipping, inhumane group like the GOP, who think of the elderly or sick as a bunch of lazy loafers, who are just looking for a dole from the govt. THEIR (GOP) ideal of healthcare is to take advantage of the system as much as possible for the sake of wealthy doctors, or the wealthy owners & investors in our hospitals & healthcare facilities. THEY do not make as much Profit, if the elderly are allowed to be taken care of at Home. NO, they MUST be put into a hospital where they can be charged indecent amounts of money just to lay in a bed all day & be spoon-fed multiple RX of unnecessary (but very costly) PILLS. In THAT scenario, the GOP wins BIG. First of all, it is not uncommon for elderly people to be charged $7,000 per MONTH to be in a nursing home. That is for the BARE essentials. You get the room, period. You have to provide your own furniture. Then you have to pay extra for your laundry. If you have special needs, like some therapy for a knee, or you need help getting to the bathroom, that costs EXTRA. (All of this far exceeds $300 per DAY) = ($109,500 per Year).
Then there is the cost of all the pills & breathing therapy. They had my aunt on 12 different meds every day. (It is well known that they often over-medicate their patients to keep them quiet, so they don't make too many demands on the nursing staff, such as liking their meals on time). In nursing homes you will often see the patients sitting in a wheelchair, nodding off into slumberland due to all the medications given them. (I talked my aunt's doctor into taking her off some of the meds to get rid of some of her bad side effects, & surprising to me, he DID. He immediately took her off of 11 out of the 12 meds she was taking, & then she IMPROVED. It was really a miracle, she began to feel better, her swollen legs went down, she had a better appetite, & was moving around much better. Her whole attitude was better. So we wonder WHY they keep on over-medicating the old people, if it makes them WORSE? Perhaps it is the exorbitant amount of MONEY they are charging the patient & their family for all those (unnecessary) drugs. Do you suppose? (Oh NO, it couldn't just be for GREED, could it?)
Then I remembered: Hubert Humphrey (Democrat) tried to introduce Medicare way back, & the Republicans fought it tooth & nail for over 20 years. They finally decided to allow it, once they had figured out how to "pad the bills" & "game the system." So once they could milk every possible dollar in PROFIT from it, all of a sudden, taking care of America's elderly became an OK deal for them. (So true to their ideals).