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Nursing Home Reform


Senior Living

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In a large many-windowed dining room, seniors eat together at round wooden tables, men and women talking, their plates rest on red trays.
The dining room at Homestead, an
independent living rental retirement
community in Alva, Oklahoma

An elderly Caucasian man in a shirt, tie and khaki pants, sits in a wheelchair in the center of a long hallway, resting his head on his hand.
Lloyd Herrold at Saint John's On The Lake Nursing Home

Nursing homes provide comprehensive nursing, medical, social and rehabilitative care and room and board to individuals of all ages on a short-term or long-term basis. The federal government regulates nursing homes that receive federal money. Most states have additional regulations and licensing requirements.

Also known as
Skilled nursing facilities, extended care services or health care centers. In most nursing homes, living spaces consist of a single room for one or two residents.

Who it serves
Those in need of around-the-clock custodial or medical care, patients recovering from an illness or surgery.

A licensed nursing staff to provide medication administration, care coordination and all treatment regimens; assistance with personal care, such as bathing, meals, dressing and toileting; physician on-call for acute needs, prescriptions; a registered dietician; physical, occupational, recreational and speech therapies; social activities and recreation.

In March 2005, cost of services could exceed $50,000 annually, or more than $4,000 per month. By 2030, when baby boomers will need nursing homes, experts estimate the annual cost will be $97,000.

A green marble plaque with a Celtic cross reads, Saint John’s On The Lake, 1840, in gold letters.

Continuing Care Retirement Communities (CCRC)

Continuing Care Retirement Communities are housing communities with different levels of care based on a senior’s needs. Saint John’s On The Lake, featured in ALMOST HOME, is an example of a CCRC. The community may have individual homes or apartments for residents who still live on their own, an assisted living facility for people who need some help with daily care and a nursing home for those who require more care. Residents move from one level of care to another based on their needs, but still stay in the CCRC.

Who it serves
Seniors who want to take care of all of their care needs throughout the aging process within one community.

Those typically available in communities from independent living to nursing homes are part of CCRC.

The most expensive long-term-care option, in 2004 CCRC entrance fees ranged from $38,000 to $400,000. Monthly payments ranged from $650 to $3,500 per month. Fees vary according to whether a resident owns or rents the living space; the size and location of the residence; amenities; service plan and the current risk for needing intensive long-term care.

Naturally Occurring Retirement Communities (NORCs)

Naturally Occurring Retirement Communities are communities, neighborhoods or one or more buildings in which residents band together to develop access to services in order to “age in place.”

Who it serves
Seniors who wish to live in a non-healthcare environment and use products, services and conveniences that allow them to remain at home as circumstances change.

Social and recreational programs, continuing education, indoor and outdoor home maintenance, emergency and preventative healthcare, transportation and meal programs such as Meals on Wheels.

In 2005, the average hourly rate for homemakers/companions was $17; the average hourly rate for Home Health Aides was $19.

Get information on nursing home reform >>

Meet the seniors featured in ALMOST HOME >>

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