'Nursing home' has new meaning - The Explorer: Health

'Nursing home' has new meaning

Facilities evolve

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Posted: Monday, May 31, 2010 11:00 pm | Updated: 8:16 am, Thu Mar 24, 2011.

The term "nursing home" has taken on a new meaning over the past 10 to 15 years.

Before the evolution of insurance coverage, which is now generally more restrictive, a person could go to a nursing home for a long-term stay for many reasons, whether they were really in need of medical care or not.

According to the Centers for Disease Control, there were 16,100 nursing homes providing 1.7 million beds across the country in 2004. Of those residents, 88.3 percent were aged 65 years and older and 45.2 percent were aged 85 years and older. The average length of stay for these patients was 835 days. (http://www.cdc.gov/nchs/data/series/sr_13/)

There are two main types of inpatient care available at nursing homes. The more familiar type of care is called "long-term care." Long-term care refers to care that requires significant medical service which cannot be provided in the home or on an outpatient basis — usually for a chronic condition. According to CDC statistics, diseases of the circulatory system were the leading primary diagnoses among nursing home residents at admission (23.7 percent), and mental disorders were the second leading primary diagnoses among residents at admission (16.4 percent). Fourteen percent of residents had a primary admission diagnosis for diseases of the nervous system and sense organs. More than one-half of all residents were either totally dependent or required extensive assistance in bathing, dressing, toileting, and transferring.

In addition to medical needs, patients in long-term care receive meals, activities and other daily interactions that can enhance their quality of life. In order to qualify for Medicare, Medicaid and other insurance coverage of long-term care, a patient has to meet certain medical requirements as determined by that particular insurance carrier. Long-term care insurance coverage can come in handy when needing any type of nursing home care. Most nursing homes that provide any type of long-term care service will also accept long-term care insurance as a payment source.

The other main service found in nursing homes is called "skilled nursing," and facilities which offer this service are commonly referred to as SNFs. These can exist by themselves or as a part of a larger nursing home with both long-term care and SNF.

A skilled nursing facility usually handles short-term rehab needs that cannot be met in the home. Examples of skilled care include intravenous injections and physical therapy. Care that can be given by non-professional staff isn't considered skilled care. Skilled nursing and rehabilitation staff includes registered nurses, licensed practical and vocational nurses, physical and occupational therapists, speech-language pathologists, and audiologists. Medicare covers certain skilled care services that are needed daily on a short-term basis (up to 100 days). (source: www.medicare.gov)

Nursing homes are expanding services to include special long-term care programs for mental health, including Alzheimer's disease and other forms of dementia. Most of these specialized programs have a secured, locked program that provides the safety and security paired with medical needs which many dementia patients require.

Being faced with long-term care can be an emotional issue, and knowing the facts prior to making a decision is crucial. Each nursing home has an admissions department that is well-versed in insurance coverage for their particular facility. In addition, the facility will have a social service and/or discharge planning department who work to ensure all services are provided within the length of stay that matches the patients' needs as well as the insurance requirements. Although your insurance might dictate the nursing homes that are available to you or your loved one, take time to tour the facilities and ask questions about licensing and services.

One source for good information is www.medicare.gov.

Brooke Martin of Healthcare Communications can be reached at brooke@hcc123.com; www.hcc123.com.

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