They are going to pick up the phone book and thumb through to the N section, straight to Nursing Homes. What they are going to find - this first wave of baby boomers in search of senior care - might be a pretty scary picture. 

During the last two years, one in 10 nursing homes across the country has gone bankrupt. Although most have not closed, experts predict that many will be defunct in the next few years. By the time the huge wave of baby boomers needs extra care, there will be fewer facilities for them; and other options, such as independent living, assisted care and home care, probably won't be covered by Medicare or Medicaid. 

In short: You'd better start saving your pennies, because more of you are going to be paying for it yourself. 

"This is a huge issue, and it's going to get worse before it gets better," said Robert H. Moran, the executive vice president of the Pennsylvania Health Care Association, an alliance of 300 nursing homes across the state. "It is a system that must be sustained, but it is a politically dangerous question because it involves staggering amounts of money." 

Nursing homes receive 77 percent of their income from Medicare and Medicaid, two programs which have undergone enormous cuts because of the 1997 Balanced Budget Act. The cuts took $16.6 billion from homes over 10 years by changing the formulas by which certain procedures (e.g. lab tests, blood screenings) are reimbursed.

As those cuts have hit the homes, the financial pressure has been transferred to those who can pay out of their own pocket, driving up the average cost of one year of nursing home care to $41,000. 

This then becomes a Catch-22: Because of the high cost of care, a huge number of individual patients or their families run out of money in a few years. Then they go on Medicaid, making the problem worse. 

The bankruptcy plague has hit homes in the southern and western United States the hardest, where large chains own hundreds of facilities each. Pennsylvania nursing home chains tend to be smaller, so they have fared better. Only two facilities in Bucks County are affected; the Genesis Eldercare homes in Langhorne and Bristol Township are part of a larger chain that has stayed out of bankruptcy by debt restructuring. 

Local support groups say that the impact is most obvious in the smaller numbers of nurses roaming the halls. 

"There have been a lot of staff cuts, and when there are staff cuts, you can't provide as much personal service as you'd like," said Lorraine Sailor; the operations coordinator for Children of Aging Parents. "We have gotten a lot of calls from people saying their parent is no longer getting their twice-a-week baths or things like that." 

The law prevents nursing home patients from being thrown out. If a home closes or if a patient happens to be at a private-pay-only facility, home officials must find the person a new bed. 

To take some of the pressure off nursing homes, Charles Kane is spending lottery money. 

Kane directs the Bucks County Area Agency on Aging, which provides the only government support for home care. It comes from the sales of Pennsylvania lottery tickets - not exactly a guaranteed income. 

"We say that every nursing home admission is the result of a caregiver who burned out," said Kane. "Everyone wants to keep their family at home, and we have to come up with increasing dollars to help them." 

With its lottery money, the county aging office is able to help about 1,000 patients who are convalescing at home. They usually have a waiting list of 100 more, said Kane, and statewide the waiting list is 5,000 names long. 

Home care providers and many assisted living and independent living facilities cost thousands of dollars less per month than nursing homes, but few are covered.

The fees for independent or assisted living facilities are well beyond the means of the middle class. Entry fees for these facilities range from $38,000 to $360,000, plus another $500 to $6,000 per month. Far example, Fran McElroy had to sell the family home to raise the $82.000 deposit to get her mom into a one-bedroom apartment in Twining Village. She said that her mom loves Twin ining Village, the continuing care facility in Holland, but that if it weren't for a combination of Social Security and two pensions, she doesn't know how the family would pull it off. 

"The thing we are wondering is what happens when the money runs out?" said McElroy. 

Many aging experts are hopeful that Congress, once its members realize the depth of the cuts in Medicare and Medicaid, can restore some of the money to the system. Last year Congress eased some of the pain by changing some minor regulations, according to officials with the American Health Care Association. 

But there's a long way to go, say nursing home officials. 

"America wants to provide for its elderly, but there isn't really a well-coordinated plan to deal with this," said Joe Cox, administrator of the Attleboro Nursing and Rehabilitation facility in Langhorne. "We say we want this, but I don't think there's a really strong commitment. If we focus, we can do it. But it's going to be very slow."