Types of Services

Six basic types of services are offered by nursing facilities.

Nursing Care . Nursing procedures require the professional skills of a registered or licensed practical nurse. These include administering medications, injections, catheterizations, and similar procedures ordered by the attending physician. Post-hospital stroke, heart, or orthopedic care is available with related services such as physical therapy, occupational therapy, dental services, dietary consultation, laboratory and X-ray services, and a pharmaceutical dispensary.

Personal Care . These services include help in walking, getting in and out of bed, bathing, dressing, eating, and preparing special diets as prescribed by a physician.

Residential Services . These include general supervision and protective environment, such as room and board and a planned program for the social and spiritual needs of the resident.

Medical Care . Each patient in a nursing home is under the care of a physician who visits periodically, and who is responsible for the patient's overall plan of care. In most cases, the patient's personal physician refers the patient to the facility and certifies the need for admission. Once the patient is admitted, the physician writes orders for medication and develops the patient care plan, including restorative and rehabilitative procedures, special diets, and other treatments. Every nursing facility usually has at least one physician on staff or on call to handle emergencies.

Subacute Care . Skilled nursing facility subacute care units offer a wide variety of medical, rehabilitative, and therapeutic services once provided only by hospitals. Common conditions treated in subacute units include brain and spinal cord injuries, neurological and respiratory problems, cancer, stroke, AIDS, and head trauma. Because nursing facility subacute care costs are 40 percent to 60 percent less than hospital costs, HMOs and other managed care entities have begun moving hospital patients to nursing facilities for subacute care.

Rehabilitation . All nursing facilities are required to provide services to enable the resident to meet the highest practicable level of functioning. Nursing care facilities provide intensive rehabilitative services. These services are designed to enhance the resident's highest functional abilities and encourage discharge to the community at a lower level of care. Nursing facilities are demonstrating enormous success at providing these services at a lower cost to the consumer.