Nursing Homes are an evident requirement of time dedicated to serve the elderly the patients of around 65 years of age. In the US, there are more or less 16,000 of which around 67% of the nursing homes functions privately and serve around 1.5 million people. The cost of a nursing home is primarily reimbursed by Medicare. However, if the stay exceeds from 100 days in a period of a year than the reimbursement is supported by Medicaid. There is also the option of paying the cost of nursing homes privately.Keeping in view the importance of the service, its structure is organized and determined strictly through regulations.
In particular, the nursing houses of a place are developed keeping in view the requirements and demands of the residents and populace around the vicinity. The core general causes of admission in nursing homes include medical condition that requires observance and regular assistance (on grounds of psychological and physical state reasoning), diagnostic services, physician preferences and family preferences. Hence, the sensitive nature of the service demands utmost vigilance to secure the operational management from unwanted incidence. The legal bindings are provided by the state to determine quality standards of services and govern the system cautiously. The scope and regulation of the system at the primary level is covered in The Nursing Home Reform Act 1987 (NHRA [OBRA’87]) (PL 100-203). The Act provides guideline in reference to the standard of service and quality of performance. The components demand the certification from the federal government CMS (Centers for Medicare and Medicaid). The clauses determine that people treated in nursing homes to be referred as residents rather than patients and gives an elaboration of the reimbursement conditions. The quality of services and care of the residents is the prime objective of the utterance as determined by the law and it further emphasize to develop and maintain an environment that is notorious for the health and the emotional / psychological health of the residents.
Hence, it is the strict observance of law that have aggravated the standards of staffing in Medicare and Medicaid Skilled Nursing Homes to match the demands of the law. The supervision of an on site licensed nurse is the essential requirement of the operations and so is the obligation for the allocation of a physician for every resident. The other mandated requirement includes the establishment of the services and committed encompassing the scope of special care units. The service department includes Podiatric, orthopedic and dental services, Rehab therapy services depending upon the intensity (PT, OT, ST), Medicine, Pathological laboratory, X ray and radiology, services for End of Life (EOL) Care, psychotherapists consultation, Consultation council for Family and acquaintance of resident for support and information and Committees: security and Risk management, Quality Management, Medicine and Rehab, Contamination Control, Utility management. The physician is the monitor and supervision of the team who design interdisciplinary according to the needs and demands of the resident.
Even though the quality standards of the services are well defined through legislations and guidelines of services, the delivery is further assured of quality through an organized system. The CMS 5 Star Quality Rating System is a standard recognized structure at the national level that is used to compare and contrast the services of nursing homes. It is conducted randomly through the State Health Department on behalf of CMS. The quality and consistency of services are gauged through survey that determine the performance quality through five star rating system (the higher the star better is the quality). The performance is measured over the domains of staffing (nursing), quality measures and health inspection. The rating is based on the evaluation of the range and limitations of health care services.
Medicare.gov. (2014, Jan 22). Nursing Home Compare. Retrieved Nov 4, 2014
NIH. (2014, Jan 30). Nursing Homes. Retrieved Nov 4, 2014