What Services Does a Nursing Home Provide?

The basic function of any long-term care setting is to provide for your loved one the things they can no longer do for themselves. This will protect their health and safety as well as enhancing their quality of life. An important part of choosing a nursing home is being able to compare the services offered at each candidate facility.

A skilled nursing facility will provide nursing care from registered nurses (RNs) and licensed practical or vocational nurses (LPNs or LVNs) who are on staff 24 hours a day. It will also provide assistance with daily living (the basics such as bathing, dressing, toileting, personal hygiene, and the like), and meals. Generally speaking, you can also expect the facility to provide

• Housekeeping
• Laundry service, to include providing linens and towels
• Basic hygiene items
• Recreational activities
• Therapy (physical, speech, or occupational) as required
• Dental services
• Mental health services
• Special dietary needs as required.

It's important to understand that because they provide a higher level of medical care, not every skilled nursing facility will have specialized staff or equipment for dealing with every specific medical condition. You should ensure that any facility you are considering can meet your loved one's particular medical needs. Here are some common examples of specialized care requirements:

• Intravenous (IV) drug therapy
• Respiratory therapy
• Rehabilitative therapy
• Pain management
• Dialysis
• Alzheimer's and dementia patients

A skilled nursing facility that handles a large number of patients with a particular need is going to have staff members who are specialized and experienced in that specific type of care and a wider range of resources for providing it. For example, while any facility can transport a patient to a dialysis clinic, one that has dialysis equipment on-site is going to be the preferred choice if your loved one requires this treatment. A facility that employs several experienced physical therapists on its staff is likely to provide a better outcome for a patient requiring rehabilitation.

Since medical care is obviously the most crucial aspect of a skilled nursing facility, and the reason the patient is there in the first place, you'll want to pay particular attention to this issue. Your loved one's physician should provide information on his or her diagnosis, treatment history, prognosis, and requirements for further care. In addition, federal law requires a nursing home to evaluate a new patient within two weeks of admission, after which the staff will then develop a care plan. The law also requires follow-up assessments of the patient's condition, which should indicate the effectiveness of the care plan, at least every three months. (For further information on this subject, see "What Kind of Medical Care Will the Nursing Home Provide?”)

Finally, in addition to the basic services we've noted, a nursing home should offer a range of recreational, social, religious, and cultural activities. Normally there is a scheduled set of events and activities, with opportunities for residents to participate as they choose. In many cases, volunteers from the community such as church or service club members may offer programs at the facility. Some facilities will also offer transportation to outside events in the community. Another important consideration is the ability to leave the facility to spend time with family for part of a day or even a few days. (See "What Are Quality-of-Life Considerations in Choosing a Nursing Home?" for more information.)