geriatrics
Skilled Nursing Facilities
Selection of nursing home
Nursing homes vary in the types of medical, nursing, and social services provided. Some states set minimum nurse-to-patient ratios that are more stringent than federal requirements; the ratio of other staff members to patients varies considerably. Physicians, nurse practitioners, and physician assistants should help families select a nursing home that matches the needs of the patient with the services of a nursing home. Practitioners should consider the following: Which clinical care practice model the nursing home uses (eg, private single-physician practices, large networks of primary care practitioners who routinely visit a certain set of nursing homes) Which hospitals have transfer agreements with the nursing home Which special therapeutic services, palliative care, hospice, acute rehabilitation, and other services are available Whether staff members are employed full-time or part-time What the patient’s medical coverage is, particularly if it is a Medicare capitated program, which covers certain aspects of ongoing medical care but does not cover long-term custodial care What services are available at the nursing home (eg, physical, occupational, and speech therapy) What appropriate recreational activities are available 