Though the term "nursing home" is used rather generically by many people, it actually refers to a facility that provides 24-hour-a-day care to its patients. Not every patient will require the level of services offered by a true nursing home, making less-expensive options (such as an assisted living community or at-home care, to name only two of many different ones) viable alternatives. (See our guide "What Are Alternative Long-Term Care Choices?" for more information.)
- Skilled Nursing Facility Evaluation Visit ChecklistA checklist for making evaluation visits to skilled nursing facilities you are considering.
- How Nursing Home Quality is DeterminedA summary of the different measures used to determine a quality rating of a nursing home.
- What Are Quality-of-Life Considerations in Choosing a Nursing Home?A guide to quality-of-life issues that should be considered when selecting a skilled nursing facility.
Today the term "nursing home" is often replaced with a name that's descriptive of specific types of care offered, such as "convalescent care center" or "rehabilitation center." This reflects the fact that it's no longer just assumed that a patient will remain in a nursing home for the rest of their life. Instead, these facilities address medical care needs that are often specific and temporary-something we'll talk more about in a moment.
Whatever the name used, true nursing homes fall into two groups. Intermediate care facilities have certified nursing assistants (CNAs) on staff 24 hours a day rather than nurses and provide primarily assistance with the "activities of daily living," a common term that covers routine needs such as bathing, dressing, personal hygiene, toileting, and so forth. Skilled nursing facilities, which have either registered nurses (RNs) or licensed nurses (LPNs or LVNs-the specific title varies from state to state) on staff 24 hours a day and are intended for those patients who require ongoing medical care, such as physical therapy, wound care, respiratory therapy, pain management, a feeding tube, or dialysis in addition to assistance with activities of daily living.
In many cases, patients may transition from a hospital stay to a skilled nursing facility and then eventually to an intermediate care facility as their medical care needs diminish. An example would be a person who is hospitalized for a stroke, undergoes rehabilitation at a skilled nursing facility, and then resides long-term at an intermediate care facility because of diminished capacity to live independently. A stay at a skilled nursing facility can also be a temporary measure before the patient is able to return home or move to a less-intensive type of care such as assisted living or in-home care.
Data from the Centers for Disease Control shows that overall (that is, looking at all patients 45 years of age or older), 40% of males and 37% of females stayed less than one month in a nursing home, and another 20% of males and 19% of females stayed more than a month but less than three months. Only 4% of males and 7% of females had stays longer than five years.
Many facilities offers both skilled nursing and intermediate care under the same roof, so if your loved one is nearing discharge from the hospital and will require step-down care like this, finding such a facility will be a huge plus. It will provide continuity of care with many of the same staff members, and the patient will not have to adjust to a new setting yet again after the previous dislocations of hospitalization and then the transition to a skilled nursing facility. It will also eliminate the need to work through the nursing home selection process again, once skilled nursing care is no longer necessary.