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Encyclopedia > Nursing home
Rest home for seniors in Český Těšín, Czech Republic
Rest home for seniors in Český Těšín, Czech Republic
SNF redirects here. For the sports show, see NBC Sunday Night Football.

A nursing home, skilled nursing facility (SNF), or skilled nursing unit (SNU), 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. Image File history File links Gnome-globe. ... Image File history File linksMetadata Size of this preview: 800 × 600 pixelsFull resolution (2576 × 1932 pixel, file size: 680 KB, MIME type: image/jpeg) Description: Rest home for seniors in Český Těšín Date: 27 January, 2007 Camera: Kodak DX7590 Author: Darwinek File history Legend: (cur) = this is the current... Image File history File linksMetadata Size of this preview: 800 × 600 pixelsFull resolution (2576 × 1932 pixel, file size: 680 KB, MIME type: image/jpeg) Description: Rest home for seniors in Český Těšín Date: 27 January, 2007 Camera: Kodak DX7590 Author: Darwinek File history Legend: (cur) = this is the current... Český Těšín (Polish: ) is a town in the northeastern Czech Republic, on the Olza river, in Moravian-Silesian Region. ... 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. ... Care of residents refers to care given to adults or children outside of the patients home. ... Nursing is a profession focused on assisting individuals, families, and communities in attaining, re-attaining, and maintaining optimal health and functioning. ... Activities of daily living (ADLs), is a way to describe the functional status of a person. ... Old age consists of ages nearing the average lifespan of human beings, and thus the end of the human life cycle. ... Look up disability in Wiktionary, the free dictionary. ...


United States

In the United States, 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. Licensure refers to the granting of a license (in the US, whilst, elsewhere the term registration is used), usually to work in a particular profession. ... This article is about the occupation. ... 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). ... President Johnson signing the Medicare amendment. ... Medicaid is the US health insurance program for individuals and families with low incomes and resources. ...


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.

Nursing facilities that participate in the Medicare and Medicaid programs are subject to federal requirements regarding staffing and quality of care for residents.[1] 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 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, 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 services for people who pay out-of-pocket, through Medicaid, 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.

Almost no one can afford to pay for nursing home care "out of pocket." They cost $5,000 per month or more. Some deplete their resources on the often high cost of care. If eligible, Medicaid will cover continued stays in nursing home for these individuals. However, they require that the patient be "spent down" to poverty levels first, thus depleting their life savings.

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. 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. ...

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 Tool" in the external link section below). It has been suggested that Health Care Financing Administration be merged into this article or section. ...

Care homes for adults in England are regulated by the Commission for Social Care Inspection. The Commission for Social Care Inspection is the single, independent inspectorate for social care in England. ...

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).[2]

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. In the UK, a Nursing Agency (also known as Nurses Agency) is a business that provides nurses and usually health care assistants (or nursing assistants) to people who need the services of healthcare professionals. ...

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. It has been suggested that this article or section be merged with Retirement home. ... A retirement home is a place of residence intended for the elderly. ... This article or section does not cite its references or sources. ...

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.

The website My Patient Guide provides a directory of New Jersey nursing homes and assisted living communities, along with a question-and-answer section. This article is about the U.S. state. ...


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 Greenhouse nursing home, the Pioneer Network, and the Eden Alternative. 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

Image File history File links Question_book-3. ...

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.[citation needed]

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.

United Kingdom

In the United Kingdom, you have the right to choose your care home. Care homes and care homes with nursing are regulated by different organisations in England, Scotland, Wales and Northern Ireland.

To enter a care home, you need an assessment of needs and of your financial condition from your local council. You may also have an assessment by a nurse, should you require nursing care.

Costs in the UK

The cost of a care home is means tested in England.

As of February 2008 in England, the lower income limit is £13,000. At this income level, all your income from pensions, savings, benefits and other sources, except a "personal expenses allowance" (currently £20.45), will go to paying the care home fees. The local council pays the remaining contribution. Between the lower limit and the upper income limit, the personal expenses allowance is reduced by £1/week for every £250 higher income you have. If you earn more than the upper level, currently £21,500, you will have to pay the full cost of the care home yourself. If you require additional nursing care, you can get assessed for this and get additional financial support through the National Health Service (NHS).

UK Government regulations and oversight

English homes are regulated by the Commission for Social Care Inspection (CSCI), and they will inspect every home at least every three years. Their website can also help you find a home in the location you are looking for. Outside England, you may want to visit the Care Standards Inspectorate for Wales), the Scottish Commission for the Regulation of Care or the Regulation and Quality Improvement Authority in Northern Ireland.

For-Profit Institutions

Another growing trend in the Nursing Home Industry is the increasing number of for-profit institutions which are going into business in order to reap profits from the soon-to-retire "baby boomer" generation. These institutions can often provide adequate care, but the quality of care compared to that found at non-profit institutions has not yet been adequately studied.

See also

The American Health Care Association (AHCA) is an American organization for persons employed in the long-term care field. ... The American Geriatrics Society (AGS): a professional society founded on June 11, 1942 for doctors practicing geriatric medicine. ... 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. ... Following is a list of companies operating nursing homes in the U.S.: This list is incomplete; you can help by expanding it. ... 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. ... Service Employees International Union (SEIU) is a labor union representing 1. ... Chartered Scientist (CSci) is a professional qualification in the United Kingdom that is managed by the Science Council. ...


  1. ^ 42 CFR Part 483
  2. ^ NFPA Journal - Behind Closed Doors

The Code of Federal Regulations (CFR) is the codification of the general and permanent rules and regulations (sometimes called administrative law) published in the Federal Register by the executive departments and agencies of the Federal Government of the United States. ... The National Fire Protection Association (established 1896) is an independent, voluntary-membership, nonprofit (tax-exempt) organization. ...

External links

  • Nursing Home Compare Tool — Medicare's past performance results of every certified nursing home in the U.S.A.
  • [1] - Guide to choosing a UK care home
  • [2] - Age Concern UK guide to care homes
President Johnson signing the Medicare amendment. ...

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Directors of Nursing: The person responsible for overseeing all clinical procedures and operations may or may not be required to have a four-year college degree and generally is not required to be experienced in acute (hospital) care, even though today’s nursing home residents typically arrive with multiple diagnoses.
Staffing shortages are greater in the two-thirds of nursing homes that are operated for profit than among the 27 percent that are nonprofit and the 7 percent that are government-run.
Nursing facility needs were placed on the national policy agenda in the fall of 2000 when President Clinton proposed $1 billion in aid to help states address nursing home staffing shortages.
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