Nursing Homes

Nursing Homes Overview

Nursing homes, also called skilled nursing facilities, are places that provide 24-hour services and supervision to people who need assistance because of physical or mental conditions.

Nursing homes are operated by for-profit and non-profit organizations. They are found in different states, vary in size and offer different programs. All nursing homes provide long term care services to chronically ill persons, including those with chronic mental illness. Many nursing homes also offer short term or extended care rehabilitative services, and special units for people with Alzheimer's Disease or other types of dementia.

Nursing homes are also certified to provide services to eligible Medicare and Medicaid beneficiaries and are expected to meet federal regulations. Both federal and state regulations define Resident Rights (a Bill of Rights for nursing home residents.) 

Every nursing home has an assigned ombudsman who visits the facility regularly and helps residents with any problems they encounter, including quality of care, residents' rights and problems with transfer and discharge. 

In the USA, nursing homes have been paid by the states under the Medicaid system on a flat rate per patient. Federal government contributes 50%. Medicaid covers all those unable to pay - the majority of nursing home residents. Government's idea of increasing efficiency is to reduce the amount of money available. The care of these nursing home residents has consequently been poorly funded and the only way for profit-oriented groups to increase profits has been to reduce care.

Under market pressures, nursing homes became a vehicle for generating profit rather than for care.
Nursing homes provide care for the frail elderly - those who can no longer look after themselves. This is their core function. This is not very profitable.

Many people think of nursing homes as grim places where residents often seem bored, lonely and sad. But now some reformers are experimenting with new kinds of nursing homes. Instead of an institutional setting, they want to provide a homelike atmosphere for residents.

Among the leading proponents of this kind of nursing home reform is Dr. William Thomas, who calls his vision the Green House Project. It's based on a simple idea: older people will thrive in a nursing home if it's built to resemble living in one's own house. Others have tried to make existing nursing homes more homelike. The Green House Project makes the nursing home over from scratch, the goal being to give residents more privacy and more control over their lives.

Alternatives to a Nursing Home: In-home aide services, home health care, shared housing, group homes, assisted living, continuing care retirement communities, hospice care. Nursing homes though are not hospitals; they are places where rehabilitative and nursing care is provided as needed by qualified staff.