Nursing home

A nursing home or skilled nursing facility (SNF) is a place of residence for people who require constant nursing care and have significant Activity of Daily Living (ADL) deficiencies. 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. 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.

A nursing home is one specific type of care, but other forms of care are covered under Care of residents in Wikipedia

Similar facilities
What is a nursing home not? A hospital is not a residence, but is a place where people require constant nursing care. A retirement home is a residence, but requires non-constant nursing care. An assisted living facility does have some similarities to a nursing home; however, a nursing home's patients need more intensive care than residents in an assisted living facility. A long term care facility (LTCF) is a generic term for long-term residents requiring some form of assistance. LTCF is commonly used within a medical context.

People in nursing homes generally, but not always, live in double occupancy rooms. There is usually a nursing station in each hallway of a nursing home for the nurses (Licensed Practical Nurses, with a minority of Registered Nurses, generally in a supervisory role) who monitor resident health and administer medications. Nursing assistants (Health Care Assistants in the UK) play a key role maintaining residents' hygiene, assiting residents with activities of daily living, and performing other basic nursing skills. A housekeeping staff in a nursing home is responsible for ensuring that the rooms, beds, towels, bathrooms, and other facilities are kept sanitary. Physical therapists and occupational therapists attempt to help the residence regain certain abilities. Assistive technology such as wheelchairs, standing frames, and pateint lifts are often used. Social workers help with personal issues such as billing and transitions back to the home environment.

In the US, Medicare reimburses an elderly person for nursing home stays for skilled nursing care and rehabilitation purposes after the elderly person has been in the hospital for three or more days (technically 3 midnight stays). Medicare pays 100 percent of the cost for the first 20 days of stay. From day 21 through day 100 there is a copayment for each day. Medicare does not pay after the 100th day. Also, if during the 100 days the person has gotten as well as the nursing home staff believes she will get, Medicare no longer reimburses. Medicare never reimburses for purely custodial care. Medicaid does reimburse for custodial care but a person may only qualify for Medicaid if she has extremely limited income and assets.

In the US, nursing home costs can run to $350 and up daily. Charges are usually determined by how much assistance the nursing home resident needs with the activities of daily living (ADLs).

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). Homes in England are regulated by the Commission for Social Care Inspection.

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.

New 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 sets 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.