1. Nursing Home Industry The nursing home industry is dominated by the for-profit sector. Nationally, the average nursing home had 107.6 beds with an occupancy rate of 86%. Most nursing homes operate in chains, the 10 largest chains have at least 90 homes.

2. Nursing Homes Stats 90% of all residents that live in nursing homes are 65 years of age or older. 80% of residents are dependent for their mobility, 66% are incontinent, 47% require assistance when eating and 37% are dependent in all three areas.

3. Nursing Home Services Nursing homes provide a variety of services such as: Restorative care. Treatment of skin wounds. Dementia care. These are the most commonly available services offered at nursing homes.

4. Patient Conditions The three most common conditions nursing home patients suffer from are: Bladder incontinence 54%. Alzheimer’s disease 46%. Bowel incontinence 43%. Also weight variation, pressure sores and skin rashes.

5. Nursing Home Finances National expenditures for nursing home care have been much lower than those in other sectors of health care delivery. Most of the expenses are financed through Medicaid, but private sources like private insurance and out of pocket cover a sizeable portion.

6. Medicare Medicare is known for being the primary payer for elderly medical services. In 2004, Medicare only covered 13.9% of the costs of nursing homes. Medicare only covers limited benefits for nursing home care.

7. Medicaid Of the 52 million Medicaid beneficiaries, only 3.3% received services in nursing home facilities. These facilities consumed 22% of total Medicaid expenditures, which is far more than what it spent for any other service.

8. Private Pay Private pay is out of pocket financing for LTC (long-term care insurance). Many patients are initially admitted to a facility through private funds. Once the funds are exhausted, then the patient may qualify for Medicaid. The term step down refers to exhausting ones assets and income to the medically needy levels to qualify for Medicaid.

9. Prospective Payment In 1998, Medicare implemented the PPS program to replace cost based reimbursement for SNFs. Prospective payment is based on case mix. Patients who are more seriously ill incur more costs so depending on the case mix will determine how much the SNF is reimbursed.

10. Prospective Payment Patient assessment plays a big role in prospective reimbursement because it is used to determine the case mix. A trained RN oversees the assessment process using a minimum data sheet (MDS) which contains over 100 assessment items that provide extensive information about the patient.

11. Federal Certification In order for SNFs and NFs to qualify for federal certification which allows them to admit Medicare and Medicaid patients they must meet 17 major categories. 1. Residents Rights. Choose a physician. 2. Admission, transfer, and discharge rights. 3. Resident behavior and facility practices.

12. Federal Certification 4. Quality of Life. 5. Resident assessment. 6. Quality of care. 7. Nursing services. 8. Dietary services. 9. Physician services. 10. Rehabilitation services.

13. Federal Certification 11. Dental services. 12. Pharmacy services. 13. Infection control. 14. Physical environment. 15. Administration. 16. Laboratory services. 17. Other services. Maintenance of clinical records.

14. Conclusion Nursing facilities play a very key role in our society. They offer families and people who are unable to care for themselves or loved ones an opportunity of assisted living.