Nursing care facilities have evolved from being considered hospitals for the poor to become one of the primary care facilities for individuals suffering from the debilitating effects of age or other medical conditions. The concept of the nursing ‘home’ evolved from the establishment of special care facilities by Christian missionaries in England and the United States. Historical records from around the world document the existence of similar care facilities in India and the Far East where traditional and herbal medicine was practiced. In the West, the documented history of the concept of a nursing home can be traced to the mid-19th Century.
Today, nursing homes in New York City offer care that is distinct from that of a traditional medical care facility. A modern nursing home offers round-the-clock nursing care for individuals who need constant care on account of physical or mental disabilities. These facilities offer several levels of care depending on patient demographic they cater to, combining multidisciplinary care with critical services such as emergency care. Nursing homes in NY City are classified as:
• Intermediate Care Facilities
• Assisted Living Facilities
• Skilled Nursing Facilities
The primary differentiator between these three types of facilities is the degree of care given to patients and the nature of their functioning.
Intermediate Care Facilities
An intermediate care facility is a first-level care facility that typically offers daytime assistance to the aged, disabled or patients suffering from non-critical medical conditions but need limited assistance with daily activities. Intermediate care is often considered the ideal for individuals who prefer the atmosphere of a home rather than the impersonal atmosphere of a medical facility. Typically, an intermediate care facility offers board and lodging facilities with daytime or 24-hour assistance. Such a facility may have scheduled visits by certified medical professionals such as doctors, nurses and therapists depending on the age and general health of its inmates. The construction and interior décor of such a facility is usually designed to recreate the atmosphere of a home while ensuring ease of access to all areas.
A typical intermediate care nursing home may have several individual rooms or cottages and a common area for socialization or organized activities. Some nursing homes may run an in-house pharmacy for over-the-counter and basic prescription drugs. Such facilities are funded by a regular maintenance fee paid by the patient’s or inmate’s family or by a hospice. These facilities make basic care far more affordable than a hospital or skilled nursing home.
The focus of an intermediate care nursing home is to improve an inmate’s quality of life without compromising their mobility and access to the outside world. Patients who live in these facilities do not generally require constant supervision.
Assisted Living Facilities
As the name suggests, assisted living facilities offer a significantly higher degree of care as compared to intermediate care nursing homes. Such facilities cater to individuals who are in need of assistance to perform some or all of their daily activities. An assisted living nursing home offers 24-hour care and monitoring of an individual’s health and daily activities by a trained and certified caregiver, usually an assisted living professional who is trained in several disciplines of caregiving including bathing, dressing, feeding and the administration of prescription medication as well as emergency procedures such as CPR. An assisted living facility often employs dedicated caregivers in a 1:1 ratio to patients. Assisted living nursing homes are often similar to residential facilities that house small groups of 15 to 30 people.
Assisted living facilities differ from intermediate facilities by offering specialized care services for patients suffering from senile dementia or progressive conditions such as Alzheimer’s disease and Parkinson’s disease. Such facilities also offer transportation facilities, housekeeping, laundry, dining and cafeteria services in addition to a fully stocked pharmacy and regular visits by doctors, specialists, therapists and nursing care staff. Despite the increased level of care, assisted living facilities seek to provide an assisted yet fairly independent living experience to people with medical or psychological conditions who do not qualify for retirement care or community care facilities. Such facilities may offer rehabilitation services such as physical therapy, occupational therapy and speech therapy in addition to daily assistance and observation by a trained nurse.
A typical assisted living nursing home is often a bridge between a hospital and the home, allowing an individual to be cared for in a homely environment but with the care and occasional oversight of medical staff. The focus of an assisted living nursing home is to improve the quality of life for those individuals who need assistance to take care of their own needs while providing them with opportunities to live a full, socially involved life.
Skilled Nursing Facilities
A skilled nursing facility offers the finest nursing care aside from a hospital and is designed for rehabilitation after a hospital stay or highly specialized healthcare services. Skilled Nursing Facilities (SNFs) represent the highest level of nursing care here in the United States and around the world. Unlike intermediate nursing homes or assisted living nursing homes, SNFs cater to specialized needs of post-operative and post-hospitalization patients who need constant monitoring, medication and palliative care. Skilled nursing facilities provide medical support that is comparable to most major hospitals including emergency services, 24-hour patient monitoring, support and rehabilitation. These nursing homes also cater to patients in advanced stages of progressive diseases and the terminally ill. Long-term care is one of the important functions of a skilled nursing home. While assisted living homes may offer short-term and medium-term admission, skilled nursing homes are designed to serve a patient’s needs till the end of their natural life. Such complex and detailed long-term care requires a larger administrative and care staff who will plan and implement every aspect of an individual’s time spent in the nursing facility. SNFs also take care of diet management, medication management and the management of high-risk medical conditions that require constant monitoring.
A typical skilled nursing facility has a wide range of employees or consultants drawn from medical and non-medical professions including doctors, nurses, therapists and caregivers. Nurses who work at SNFs are typically Registered Nurses or Licensed Practical Nurses. They may be supported by Certified Nursing Assistants. Nursing staff at SNFs are trained to handle a variety of medical procedures including the administration of intravenous lines and medication. The facility itself may feature a functional Critical Care Unit (CCU).
SNFs are funded by Medicare, the federal social insurance program that provides all citizens of the United States who are over 65 years of age and younger people with specific disabilities assurance of health insurance coverage. Since these nursing facilities are covered by a federally funded program, they are bound to follow a strict code of certification and eligibility in order to be licensed as Skilled Nursing Facilities.
Improving the Quality of Life
As worldwide life expectancy rates improve, NYC nursing homes gain relevance as affordable, high-quality care facilities that allow the aged, chronically infirm and even the terminally ill to enjoy the highest possible quality of life. Understanding the difference between these facilities and how they are funded can help retirees, parents and children plan for the care that their loved ones need. It is important that citizens choose the nursing homes that will provide a secure, comfortable and healthy environment that is designed to encourage, heal and revitalize — the essential components of true nursing care.