Until I went into the healthcare field, I assumed that a nursing home was just a nursing home. I never really paid that much attention to the term. If I heard of a family member moving into a “home” I deduced they were moving to what I considered you standard nursing home. As far as I know everyone else around me presumed the same. Little did I imagine that there are at least five different types of senior living facilities, excluding the standard nursing home!
- Skilled Nursing Home – provide 24-hour skilled nursing care.
- Independent Living Facility – resident lives in an apartment in a senior community, usually a two or three story building.
- Assisted Living Facility – same as Independent Living, except services such as meals (usually in a dining room), housekeeping and laundry are included.
- Hospice Care Facility – end of life care by skilled health professionals
- Adult Day Care Facility – geared toward loved ones with Alzheimer’s or other types of dementia. Your loved one is taken care of while you are at work or shopping, or just need a day off. It’s “adult babysitting” – activities, meals and snacks are provided.
If you find yourself in need of searching for a living facility for your loved one, the terms skilled nursing home and nursing home can be very confusing at first. More confusing still is the fact that government entities use both terms interchangeably, so looking them up on the web could actually confuse you even more. Additionally, Medicare only regulates and covers skilled nursing homes. The criteria used to regulate a nursing home versus a skilled nursing home are different, and that criterion is something you should study when searching for a nursing home for your loved one.
Pros and Cons of Nursing Homes
PROS: If you are apprehensive about your loved one living alone because of a chronic illness, history of falls, or other persistent detrimental behaviors, a nursing home may be the right choice. Nursing homes will provide your loved one with assistance in their ADL’s (Activities of Daily Living). ADL’s consist of assistance with meals (a staff member will make sure your loved one is eating properly and often); dressing and undressing, bathing, using the restroom – everything your loved one would do at home, but in a nursing home he will have the assistance to accomplish all those daily tasks, and ensure his safety. All nursing homes should be staffed with at least an LPN (Licensed Practical Nurse) at all times, a Facility Manager (usually a Registered Nurse), Certified Nursing Assistants (CNA), and doctors on staff that can be called upon should an emergency arise. Consider a nursing home as a 24-hour professional assistant
CONS: They are not certified and therefore not covered by Medicare or Medicaid. Additionally, they are not government regulated. However, they do have to be regularly inspected and licensed by the Department of Health, so it’s not like they are free to do as they wish, and some of those inspections can be pretty rigorous.
Pros and Cons of Skilled Nursing Homes
PROS: A skilled nursing home provides the same care as a standard nursing home, but with additional professional and highly skilled staff, and the criteria they must meet for State certification is even more rigorous. The same goes for their State inspection. Typically, they are inspected more often than a standard nursing home. A skilled nursing home many times has the words “health and rehabilitation” as part of their company’s name. That’s because they also provide occupational and physical therapy as part of their rehabilitation program.
A standard nursing home is not required to have the same staff as a skilled nursing home. A skilled nursing home must have available staff to provide intravenous injections (an LPN is not licensed to provide this service), speech therapist, physical therapist, occupational therapist, registered nurses, licensed practical nurses, audiologists, to name just a few. Additionally, they are run by a Medical Director, not a Manager, as is the case in a standard nursing home. The criteria above are the minimum that has to be met by a skilled nursing facility in order to be certified by Medicare or Medicaid.
CONS: The only con I can visualize is the difference in cost between a standard nursing home and a skilled nursing home. You can expect to pay a bit more for a skilled nursing home. But keep in mind that your loved one is also receiving more skilled care for the money.
Last but not least, whether you and/or a loved one decide upon a nursing home or a skilled nursing home, be sure to ask for their inspection records and a copy of their licensure. By law, they have to make those documents available to you any time you request them. You can also go to the Department of Health for each state online, type the name of the nursing home, and look up any violations or citations the nursing home has received, if at all.