Taking a Closer Look at Nursing Homes

Editor’s note: This is eighth in a series of posts by guest blogger Michelle Seitzer.  For a series recap, please see links below.

In the past, when all else failed (or when individuals outlived family and friends who could provide support), people turned to nursing homes.

Our guest blogger Michelle Seitzer

Not anymore, as this series has indicated. Thanks to assisted living, independent living, home care, urban villages, active adult communities and more, caregivers and seniors have an array of choices — and just in time, since 2010 Census data pins the 65 and older population as the largest in size and percentage, adding to their numbers daily.

Nursing homes are still around though… and still needed. Because when all else fails, people need services at the other end of the spectrum as well. Also known as SNFs (skilled nursing facilities), nursing homes generally provide these services and amenities:

  1. on-site physical therapy and rehabilitation services
  2. activity programming
  3. transportation to medical appointments
  4. all meals and snacks
  5. medical care (i.e. IV therapy, wound care, end-of-life care)
  6. medication management and administration
  7. personal care (dressing, bathing, transferring, toileting)

Rooms are private and semi-private (up to three people may share a room) and simply furnished with a hospital bed, small nightstand, and dresser. Most rooms have one shared bathroom with a toilet and sink only; direct care workers assist with showers and baths in a larger space located elsewhere (at the end/in the middle of a hall of rooms, depending on the facility’s layout).

Who Qualifies?

A physician or hospital discharge planner generally makes the call for placement in a nursing home after a prolonged illness or medical event has limited a person’s ability to manage self-care. In some cases, a senior who has spent down assets and outlived relatives becomes a “ward of the state” and qualifies for nursing home care.

Who Pays?

Paying for nursing home care is quite complex. An elder law attorney or care/case manager can help clarify options and eligibility via Medicare, Medicaid, personal assets, long-term care insurance, managed care plans, and Medicare supplemental insurance. (Note: Medicare does not pay for nursing home care indefinitely. Also, in order to use Medicare funds, you must choose a Medicare-certified facility.)

Who Provides Services?

Direct care services are overseen by the director of nursing and administered by nurses, nurses’ aides and therapists (physical, occupational, etc.). Also on board: an administrator, receptionist, certified recreation therapist/activities director, transportation staff, and members of the housekeeping and maintenance departments. Many skilled nursing facilities require a registered dietitian to run the dietary department. Certification requirements for personnel are determined by the state department who licenses the facility.

Who Licenses Nursing Homes?

Nursing homes are typically licensed by a state’s department of aging, health or human services. Regular inspections are required, and the facility must post documentation of licensure, the state ombudsman’s phone number (an ombudsman handles quality care issues and reports of abuse or neglect), and any notifications of regulatory violations/subsequent resolutions towards compliance in a conspicuous location.

Where to Find Nursing Homes? 

Begin the search at Eldercare.gov or Medicare.gov.

In the next and final post, we’ll take a closer look at ancillary services (adult day care, hospice care, therapy and home care).

Editor’s Notes: Michelle Seitzer has blogged for the senior living search site SeniorsforLiving.com since 2008, and is the co-moderator of #ElderCareChat, a bi-monthly Twitter-facilitated discussion group for family and professional caregivers passionate about quality senior care.