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Information about Nursing Home

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A nursing home or skilled nursing facility (SNF), also known as a rest home, is a type of care of residents: it is a place of residence for people who require constant nursing care and have significant deficiencies with activities of daily living. Residents include the elderly and younger adults with physical disabilities. Adults 18 or older can stay in a skilled nursing facility to receive physical, occupational, and other rehabilitative therapies following an accident or illness.

United States

In the US, nursing homes are required to have a licensed nurse on duty 24 hours a day, and during at least one shift each day, one of those nurses must be a Registered Nurse. In April, 2005 there were a total of 16,094 nursing homes in the United States, down from 16,516 in December, 2002. Some states have nursing homes that are called nursing facilities (NF), which do not have beds certified for Medicare patients, but can only treat patients whose payments source is Private Payment, Private Insurance or Medicaid.

Services

Services provided in nursing homes include services of nurses, nursing aides and assistants; physical, occupational and speech therapists; social workers and recreational assistants; and room and board. Most care in nursing facilities is provided by certified nursing assistants, not by skilled personnel. In 2004, there were, on average, 40 certified nursing assistants per 100 resident beds. The number of registered nurses and licensed practical nurses were significantly lower at 7 per 100 resident beds and 13 per 100 resident beds, respectively.(38)

Nursing facilities that participate in the Medicare and Medicaid programs are subject to federal requirements regarding staffing and quality of care for residents (42 CFR Part 483). In 2004, 98.5% of the 16,100 nursing facilities nationwide were certified to participate in Medicare, Medicaid, or both.

Medicare covers nursing home services for beneficiaries who require skilled nursing care and/or rehabilitation services following a hospitalization of at least three consecutive days. The program does not cover nursing care if only custodial care is needed -- for example, when a person needs assistance with bathing, walking, or transferring from a bed to a chair. To be eligible for Medicare-covered skilled nursing facility (SNF) care, a physician must certify that the beneficiary needs daily skilled nursing care or other skilled rehabilitation services that are related to the hospitalization,(1) and that these services, as a practical matter, can be provided only on an inpatient basis. For example, a beneficiary released from the hospital after a stroke and in need of physical therapy, or a beneficiary in need of skilled nursing care for wound treatment following a surgical procedure, might be eligible for Medicare-covered SNF care.

SNF services may be offered in a free-standing or hospital-based facility. A freestanding facility is generally part of a nursing home that covers Medicare SNF services as well as long-term care(2) services for people who pay out-of-pocket, through Medicaid, and/or through a long-term care insurance policy. Generally, Medicare SNF patients make up just a small portion of the total resident population of a free-standing nursing home.

Medicaid also covers nursing home care for certain persons who require custodial care, meet a state's means-tested income and asset tests, and require the level-of-care offered in a nursing home. Nursing home residents have physical or cognitive impairments and require 24-hour care.

Many patients who live in nursing homes often begin paying out-of-pocket. Some deplete their resources on the often high cost of care. If eligible, Medicaid will cover continued stays in nursing home for these individuals.

Government regulations and oversight

All nursing homes in the United States that receive Medicare and/or Medicaid funding are subject to federal regulations. People who inspect nursing homes are called surveyors or, most commonly, state surveyors.

The Minimum Data Set (MDS) is part of the U.S. federally mandated process for clinical assessment of all residents in Medicare or Medicaid certified nursing homes. This process provides a comprehensive assessment of each resident's functional capabilities and helps nursing home staff identify health problems.

For United States homes, the Centers for Medicare and Medicaid Services has a website which allows users to see how well facilities perform in certain metrics (see Nursing Home Compare in the link below).

Care homes for adults in England are regulated by the Commission for Social Care Inspection.

Nursing homes are subject to federal regulations and also strict state regulations. The nursing home industry is considered one of the two most heavily regulated industries in the United States (the other being the nuclear power industry). {source: [1]

Consumer choices

Current trends are to provide people with significant needs for long term supports and services with a variety of living arrangements. Indeed, research in the U.S as a result of the Real Choice Systems Change Grants, shows that many people are able to return to their own homes in the community. Private nursing agencies may be able to provide live-in nurses to stay and work with patients in their own homes.

When considering living arrangements for those who are unable to live by themselves, it is important to carefully look at many nursing homes and assisted living facilities as well as retirement homes, keeping in mind the person's abilities to take care of themselves independently. While certainly not a residential option, many families choose to have their elderly loved one spend several hours per day at an adult daycare center.

Beginning in 2002, Medicare began hosting an online resource known as Nursing Home Compare (see the "External Links" section at the bottom of the page). The program is intended to foster quality improving competition between nursing homes. Informed consumer choice has long been missing from decisions regarding the placement of the elderly in need.

Trends

Nursing homes are beginning to change the way they are managed and organized to create a more resident-centered environment, so they are more "home-like" and less "hospital-like." In these homes, nursing home units are replaced with a small set of rooms surrounding a common kitchen and living room. The staff giving care is assigned to one of these "households." Residents have far more choices about when they awake, when they eat and what they want to do during the day. They also have access to more companionship such as pets. Some organizations working toward these goals are the Pioneer Network, the Eden Alternative, and the Green House Project. Many of the facilities utilizing these models refer to such changes as the "Culture Shift" or "Culture Change" occurring in the LTC industry.

Quality of life

Resident-oriented care

Resident oriented care is where nurses are assigned to particular patients and have the ability to develop relationships with individual patients. Patients are treated more as family, as opposed to random patients. Using resident-oriented care, nurses are able to become familiar with each patient and cater more to their specific needs, whether they be emotional or medical.
Scientific findings
According to various findings residents who receive resident-oriented care experience a higher quality of life, in respect to attention and time spent with patients and the number of fault reports after the introduction of Primary Nursing. Although resident-oriented nursing does not lengthen life, nursing home residents are able to connect with someone, which allows them to dispel many feelings of loneliness and discontent.

"Resident assignment" refers to the extent to which residents are allocated to the same nurse. With this particular system one person is responsible for the entire admission period of the resident. However, this system can cause difficulties for the nurse or care-giver should one of the residents they are assigned to pass away or move to a different facility, as the nurse/caregiver may become attached to the resident(s) they are caring for.

In coming to this conclusion three guidelines must be assessed: structure, process and outcome. Structure is the assessment of the instrumentalities of care and their organization; Process being the quality of the way in which care is given; Outcome being usually specified in terms of health, well being, patient satisfaction, etc. Using these three criteria find that are strengthened when residents experience resident oriented care.

Communication is also heightened when residents feel comfortable discussing various issues with someone who is experienced with their particular case. In this particular situation nurses are also better able to do longitudinal follow up, which insures the implementation of more lasting results.

Various findings suggest that task-oriented care produces less satisfied residents. In many cases, residents are disoriented and unsure of who to disclose information to and as a result decide not to share information at all.

Patients usually complain of loneliness and feelings of displacement.

"Resident assignment" is allocated to numerous nurses as opposed to one person carrying the responsibility of one resident. Because the load on one nurse can become so great, various nurses are unable to identify with gradual emotional and physical changes experienced by one particular resident. Resident information has the ability to get misplaced or undocumented because of the numerous amounts of nurses that deal with one resident.

Task-oriented care

Task oriented care is where nurses are assigned specific tasks to perform for numerous residents on a specific ward. Residents in this particular situation are exposed to multiple nurses at any given time. Because of the random disbursement of tasks, nurses are declined the ability to develop more in depth relations with any particular resident.

See also

External links

Motto
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"E Pluribus Unum"   ("From Many, One"; Latin, traditional)
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NBC Sunday Night Football is a weekly television broadcast of Sunday evening National Football League games on NBC that began airing on Sunday, August 6, 2006 with the pre-season opening Hall of Fame Game.
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Care of residents refers to care given to adults or children outside of the patient's home. Care can be 24 hour care or partial care depending on the person's needs. Residential care services take into account the needs and wishes of the individual, weighed against the resources
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The term residence may refer to:
  • House
  • Nursing home.
  • Residence in English family law, pertaining to where children should live in the case of disputes
  • Habitual residence, a civil law term dealing with the status of refugees, and child abduction

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Nursing is a profession focused on assisting individuals, families, and communities in attaining, maintaining, and recovering optimal health and functioning. Modern definitions of nursing define it as a science and an art that focuses on promoting quality of life as defined by
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Activities of daily living (ADLs),are "the things we normally do in daily living including any daily activity we perform for self-care (such as feeding ourselves, bathing, dressing, grooming), work, homemaking, and leisure.
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For the state of being elderly, see .
"Old Age" is a song recorded by the American rock bands Nirvana and Hole. For years, it was known only as a Hole song, first appearing as a B-side on their 1993 single "Beautiful Son," and again on their 1997
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disability is a condition or function judged to be significantly impaired relative to the usual standard of an individual or their group. The term is often used to refer to individual functioning, including physical impairment, sensory impairment, cognitive impairment, intellectual
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Licensure refers to the granting of a license (in the US and Canada, whilst, elsewhere the term registration is used), usually to work in a particular profession or to obtain a privilege such as to drive a car or truck.
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Nurses are responsible—along with other health care professionals—for the treatment, safety, and recovery of acutely or chronically ill or injured people, health maintenance of the healthy, and treatment of life-threatening emergencies in a wide range of health
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A registered nurse ("RN"), is a health care professional responsible for implementing the practice of nursing through the use of the nursing process (in concert with other health care professionals).
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This article refers to Medicare, a United States health insurance program. For similarly named programs in other countries, see Medicare.


Medicare
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Medicaid is the United States health program for individuals and families with low incomes and resources. It is jointly funded by the states and federal government, and is managed by the states.
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The Minimum Data Set (MDS) is part of the U.S. federally mandated process for clinical assessment of all residents in Medicare or Medicaid certified nursing homes. This process provides a comprehensive assessment of each resident's functional capabilities and helps nursing
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Centers for Medicare and Medicaid Services (CMS), previously known as the Health Care Financing Administration (HCFA), is a federal agency within the United States Department of Health and Human Services (DHHS) that administers the Medicare program and works in
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prevew not available
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A Nursing Agency (also known as Nurses Agency or Nurses Registry) is a business that provides nurses and usually health care assistants (such as Certified Nursing Assistants) to people who need the services of healthcare professionals.
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Assisted Living or Assisted Living Facilities (ALF) usually refers to a non-institutionalized facility that is used by people who are not able to live on their own, but do not yet need the level of continuous nursing care that a nursing home offers [1] .
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A retirement home is a multi-residence housing facility intended for the elderly. The usual pattern is that each person or couple in the home has an apartment-style room or suite of rooms. Additional facilities are provided within the building.
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An adult daycare center is a non-residential facility specializing in providing activities for elderly and/or handicapped individuals. Most centers operate 10 - 12 hours per day and provide meals, social/recreational outings, and general supervision.
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The American Health Care Association (AHCA) is non-profit federation of affiliated state health organizations, together representing more than 10,000 non-profit and for-profit assisted living, nursing facility, developmentally-disabled, and subacute care providers that care for
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The American Geriatrics Society (AGS): a professional society founded on June 11, 1942 for doctors practicing geriatric medicine. Among the founding physicians were Dr. Ignatz Leo Nascher, who coined the term "geriatrics," Dr. Malford W.
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The American Society of Consultant Pharmacists (ASCP) is the international professional association that provides leadership, education, advocacy, and resources to advance the practice of senior care pharmacy.
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Following is a list of companies operating nursing homes in the U.S.:
  • Benedictine Health System - based in Idaho, North Dakota, South Dakota, Kansas, Minnesota, Missouri, Wisconsin, and Illinois.

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IAHSA stands for The International Association for Homes and Services for the Aging.
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The National Association for the Support of Long Term Care (NASL) is a United States trade association of ancillary providers of products and services to the post acute care industry.
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Service Employees International Union

Founded 1921
Members 1.8 million (2005)
Country United States & Canada
Affiliation Change to Win Federation, CLC
Key people Andy Stern, International President
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University of Minnesota, Twin Cities is the oldest and largest part of the University of Minnesota system. It is located on two campuses in the cities of Minneapolis and St. Paul, Minnesota; the campuses are linked through a dedicated bus system.
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This article refers to Medicare, a United States health insurance program. For similarly named programs in other countries, see Medicare.


Medicare
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The American Society of Consultant Pharmacists (ASCP) is the international professional association that provides leadership, education, advocacy, and resources to advance the practice of senior care pharmacy.
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