A Nursing Home, also known as a Skilled Nursing Facility or SNF, has Registered Nurses who help provide 24-hour care to people who can no longer care for themselves due to physical, emotional, or mental conditions. A licensed physician supervises each patient’s care and a nurse or other medical professional is almost always on the premises. Most nursing homes have two basic types of services: skilled medical care and custodial care.
Skilled medical care includes services of trained professionals that are needed for a limited period of time following an injury or illness:
- An R.N. doing wound care and changing dressings after a major surgery, or administering and monitoring I.V. antibiotics for a severe infection.
- A physical therapist helping to correct strength and balance problems that have made it difficult for a patient to walk or get on and off the bed, toilet or furniture.
- A speech therapist helping a person regain the ability to communicate after a stroke.
- An occupational therapist helping a person relearn independent self-care in areas such as dressing, grooming and eating.
Skilled care may also be needed on a long term basis if a resident requires injections, ventilation or other treatment of that nature.
Custodial or personal care includes assistance with what are known as the activities of daily living, such as:
- getting in and out of bed, or walking around
- toileting (incontinence care)
People who are able to recover from a disabling injury or illness, may temporarily need the custodial care as they are getting back the strength and balance to be independent again. For people who are losing their ability to function independently due to chronic disease and increasing frailty, custodial care may be a long-term need. In the most severe cases where a person is bed-bound, ongoing supervision by an RN is necessary along with the custodial care, to ensure proper hydration and nutrition and to prevent skin breakdown. If a custodial care resident becomes ill or injured, they may spend a period of time in skilled care, and then return to custodial care. Whether a resident is under skilled or custodial care is important in terms of who provides the care and who pays for the services provided.