Who operates nursing homes and how do they work?

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The term “Nursing Home” (NH) encompasses residential care facilities, convalescent homes, care homes, old folks homes, rest homes, and skilled nursing facilities and the like.  Their purpose is the care of patients who are mentally or physically unable to fully care for themselves.

They provide room and board and varying levels of medical and custodial care, depending on the patient’s needs.

Because there is wide variation in level of impairment, there are corresponding differences in types of NH facilities, some examples of which follow:

Residential Care Facility:  Provides room and board and residential activities. Residents might receive minor assistance in taking their medications at the proper time, but generally are expected to care for themselves.

Nursing Home, Unskilled:  Here the patients receive medical care, usually administered by Licensed Vocational Nurses (LVN’s) instead of RN’s.   Care may involve bathing, personal hygiene and administration of medications including injections, but no Intravenous (IV) treatments.

Skilled Nursing Facility:  Here the patients receive skilled care, usually by or supervised by a registered nurse (RN).  It may involve IV therapy, wound care, tube feedings and the like.  Some SNF's are capable of advanced medical care such as that required for brain-damaged, comatose patients.

Most nursing homes have a Medical Director (on or off site), Nursing Director and Administrator.  Patients in SNF’s have an attending physician who visits the patient periodically and is available by telephone if problems arise.

Most nursing homes offer ancillary services such as Physical Therapy and Occupational Therapy.

Many residential care facilities have on site beauty parlors, barbershops, libraries and chapels.  The offer organized social activities, on site, and field trips for shopping.

Nursing Homes operate under varying auspices, some being small and privately owned, others part of nationwide corporations.  Some nursing homes are associated with HMO’s and other large medical care systems.

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