You’ll never be completely prepared to place your parents or a disabled loved one in a nursing home, but it’s best to be ready if and when that moment comes. It is estimated that 50% of the older adults in the U.S. will spend at least some time in a nursing home during their lifetime.
Most families only check out a nursing home when forced to by a medical emergency. As a result, they are often unprepared to make an informed decision regarding which facility would be the best fit.
Watch the full episode or listen to the podcast of Episode 106: What is a Nursing Home? Five Things to Know. Take note of the essential things you need to know about Nursing Homes and correct some misconceptions as you stay tuned.
Key points covered in this episode:
✔️What Is A Nursing Home?
A nursing home is where you go when you need care but you don’t need to be at a hospital, but you also can’t be cared for at home. It’s a middle ground between the hospital and home care.
Nursing homes play an essential role in our society, yet many people still negatively think about them.
Why is that so? The negative impression can be attributed to the history of poor care, abuse or neglect that follows this industry after 35 years of regulation by the Federal Government.
On the bright side, many good people are working in this industry, and they’re working to improve the quality of care until it gets where it needs to be for older adults and people living with disabilities.
#1. Who Pays For Nursing Home Care?
When you turn 65, you are eligible for Medicare. Medicare Part A is primarily hospital insurance, but will cover skilled nursing care for a limited time after a qualifying inpatient hospital stay.
For adults aged 65 and older, nursing home care is paid for in 3 ways, that are progressive.
- Federal Dollars: Nursing homes take federal dollars in the form of Medicare for up to 100 days, but not 100% of the bill. On Day 101, you pay for your care out-of-pocket (and if you have supplemental insurance, it may cover some of your stay – check with your individual insurance carrier for more details).
- Private Pay: After the 100 days of Medicare coverage, if you don’t have supplemental insurance, you have to pay out-of-pocket for care until you qualify for Medicaid. This process is known as “spending down”.
- State Dollars: Nursing homes also take state dollars, which is Medicaid. Only people who have “spent down” their own money quality for Medicaid to cover them long-term in a skilled nursing home.
#2. What Type Of Care Is Provided In Nursing Homes?
Skilled care! It is at the heart of distinguishing a skilled nursing home from assisted living. “Skilled care” means that a licensed nurse provides some of the needed care each day. Some examples of skilled nursing care include managing sliding scale insulin, wound care, and intravenous (IV) antibiotics.
#3. Who Provides Skilled Care In A Nursing Home?
Licensed nurses provide skilled care in nursing homes. Licensed nurses include baccalaureate-prepared registered nurses (RN), associate degree RNs, or Licensed Practical Nurse (LPN).
A nursing home must have a licensed nurse in the building 24 hours a day, which could be an RN or an LPN. The facility also needs to have a RN (either the baccalaureate or the associate degree level) in the building eight hours a day, seven days a week and on-call 24 hours.
Many assisted living advertised providing “nursing” care, but they’re not talking about licensed nursing care.
#4. Who Provides Most Of The Care In Nursing Homes?
Certified Nursing Assistants or CNAs provide the bulk of the care that’s provided to nursing home residents – and they are an INTEGRAL part of the nursing staff/ team. And while all nursing staff in nursing homes are underpaid, CNAs bear the worst of it. These direct care workers aren’t even paid a livable wage, which has to change.
#5. What Other Things Could Be Considered Skilled Care?
Rehabilitation is another skilled care provided by nursing homes. This is done by our Physical Therapist (PT), Occupational Therapist (OT), or Speech-Language Pathologist (SLP), who are also essential team members who are usually in the building Monday through Friday during regular business hours. They help our residents get stronger, help them re-learn to do things, help them be independent or they can re-learn communication skills, even help with swallowing and cognition.
If you have questions, comments, or need help, please feel free to drop a one-minute audio or video clip and email it to me at melissabphd@gmail.com, and I will get back to you by recording an answer to your question.
About Melissa:
I earned my Bachelor of Science in Nursing (‘96) and Master of Science in Nursing (‘00) as a Family Nurse Practitioner (FNP) from the University of North Carolina Wilmington (UNCW) School of Nursing (SON). I truly enjoy working with the complex medical needs of older adults. I worked full-time for five years as FNP in geriatric primary care across many long-term care settings (skilled nursing homes, assisted living, home and office visits) then transitioned into academic nursing in 2005, joining the faculty at UNCW SON as a lecturer.
I obtained my PhD in Nursing and a post-Master’s Certificate in Nursing Education from the Medical University of South Carolina College of Nursing (2011) ) and then joined the faculty at Duke University School of Nursing as an Assistant Professor. My family moved to northern Virginia in 2015 and led to me joining the faculty at George Washington University (GW) School of Nursing in 2018 as a (tenured) Associate Professor where I am also the Director of the GW Center for Aging, Health and Humanities.
Find out more about her work HERE.
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