Nursing Home

A nursing home is a long term care facility that functions primarily for elderly persons who are sick, for those who are too feeble to care for themselves and have no alternative source of care, and often for those who are too poor to provide for their own maintenance.

About 23,000 long term care institutions function within the United States, housing more than 1.3 million persons. These institutions are classified by physicians, intermediate care facilities, which accept patients who are not so sick as to require a highly skilled staff, and extended care facilities, which provide custodial care and do not employ skilled personnel.

Since the 1960s the number of residents in nursing homes in the United States has more than double. Several factors have contributed to this growth; an increase in the proportion of the population age 65 or older; changes in living styles that now often separate the elderly from their families; and since 1965; the payment of over half the cost of nursing home care through federal programs, primarily Medicaid. Almost no private insurance plans pay for nursing home bills of $ 50,000 or more. In the mid 1980s, private pay patients were contributing half of total nursing home expenditures.

Both federal and state agencies set standards regulating levels of care and minimum staff in nursing homes. Nevertheless, the nursing home industry has been the subject of periodic scandals involving inadequate patient care, fraudulent billing and other illegalities.

In recent years, the structure of the industry has changed radically, as more and more homes are operated by large nursing home chains that seek primarily to house the more profitable private pay patients. Regulation issue by the US Department of Health and Human Services require that nursing homes assure their patients all possible privacy and allow them to receive visitors. Patients must also recieve a regular physician's examination and be given routine dental care. Procedures to eliminate the misuse of psychoactive drugs are also outlined.

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