What is a Nursing Home?
Nursing Homes are places for people who don't need to be in a hospital but can't be cared for at home, more commonly referred to as skilled nursing and rehab centers. Nursing care is typically provided for people who need long-term care or rehabilitation after surgery or are recovering from a more severe medical condition like a stroke. These communities provide all of the personal care and services of an assisted living with the addition of 24-hour nursing care.
Regent Care Center Facts
Funded 35 yrs ago
A modern facility with 180 beds
Joint commission accredited facility
A for profit-non-sectarian, and private funded organization
Client Population: mostly 65 and over
Catchment area: Includes many residents of Bergen-Hudson-Passaic County. Also patients from Hackensack Medical Center
Regent Care Mission Statement
Regent Care Center’s mission is to provide the best possible quality of care and quality of life for our long-term residents and sub acute patients. We are also committed to improving quality of life for our staff and family members of our residents. All staff, through team work and the interdisciplinary process, will provide the highest quality service compassion and respect to residents and their family members.
The staff of Regent Care Center fulfills its mission and produces a first-class facility by practicing the key concepts on a daily basis:
C= Commitment to residents, families, self, and career
L= Leadership – setting a good example
A= Attitude – positive at all times
S= Service – only the best
S= Support through team work
Regent Care Center is a team of health care professionals committed to quality.

Types of Care Offered:
Sub acute Care (On the Road to Recovery)
Offers short-term rehabilitation and complex medical care…treating a wide range of patients recovering from accidents, injury, surgery or illness following hospitalization. The rehabilitation includes therapies, along with medical, nursing and social programs, and enables patients to recover and return home as quickly as possible. Long Term Care (Maintaining a Vital and Stimulating Quality Of Life)
Long-term care is for older adults who need around the clock nursing care. These residents need help not only with basic ADLs (activities of daily living) but need the supervision of staff to maintain their safety.

Respite Care (Providing a Secure, Short Term Break for Caregivers)
Is the provision of short-term, temporary relief to those who are caring for family members who might otherwise require permanent placement in a facility outside the home. Rehabilitation Services (Working to Assist in the Recovery Process with Inpatient or Outpatient)
RS is typically for patients who have had an injury, acute illness or a surgery. This level of care requires the services of a licensed nurse and often times physical, occupational or speech therapy. These patients usually require more frequent, intensive treatment and/or therapy services.
Social Service Function and Responsibilities
To provide appropriate and sufficient social services to meet the social and emotional needs of residents in accordance with written policies and procedures. 1. Identifying and meeting resident’s needs
(assessment, care plan, helping adjustment and orientation of new resident, reviews resident’s rights, therapeutic interventions, visiting resident to find out needs, coordinates room changes, help with practical problems such as phoning, letter writing, encourages resident to maintain cultural, spiritual, and religious traditions, and serves as a resident advocate and liaison between residents, families, regent care, center staff, and outside agencies)

2. Working with the Family
(Initiates timely contact with the family to secure data for the initial social history & Assessment, helps the family to understand and deal with adjustment issues, discusses mutual expectations of residents and RCC, Encourages family to visit frequently, importance of care plan, conducts family meetings, new admissions group, spousal support group, family council, etc)

3. Discharge Planning
(Discusses discharge potential plan at time of admission with resident and family physician, nursing staff, and physical therapy staff, documents initial discharge plan, updates in medical record, coordinates discharge planning regarding needed community resources, completes discharge summary form and documentation upon resident’s discharge back to the community to assure continuity of care.

4. Education
(Participates in the provision of in-service sessions to staff including sensitivity training, residents rights, legal decision making, mandated reporting, etc., participates in staff orientation, educates the staff of role, function of social services., Serves as a member of the management team serving in committees, family council, ethics, etc)

5. Documentation
(complete Within first 14 days initial evaluation and assessment form on the basis of interviews and review with resident, family, friends, medical records., sub-acute assessment by disciplines specific to the admitting diagnosis is initiated in 24-48 hrs including medical., completes periodic MDS updates, within 7 days of the completion of the initial MDS, but no later than 21 days after admission, records social service problems, goals and approaches in the overall resident care plan. Writes Social services progress notes as necessary and quarterly notes as required by regulatory agencies. Documents initial discharge plan and periodically updates discharge status as mandated by regulatory agencies.

6. Admissions/Community Relations
(Coordinates with staff to assure effective and smooth entry for residents and their families, and to ease residents’ and families’ adjustment during the weeks following admission. Backs up director of admissions with inquiries, admission paperwork, tours, surveys, etc. Serves as a role model and maintains contact with community agencies, hospital social workers and professional organizations through public speaking, visitation, telephone calls, etc.

7. Professional Development
(Participates in workshops, meeting, committees to enhance professional self, participates in facility staff meeting, and resident care policy committee meetings as schedule, maintains membership in professional organizations like NASW.

Social Worker Role
With Administration: The relationship between the Social Service Dept. and Administration includes the S.W. in the planning and budgeting for the Social Service Dept. Assist with problems and issues related to the psychosocial aspects of aging and coping with illness and disability.
With Nursing: The S.W. collaborates with the nursing dept. on the development of a psychosocial evaluation, goals, plans, and discharge planning. The nursing staff will assist the S.W. in understanding the resident’s medical diagnosis and the S.W. will assist the nursing staff in understanding the resident’s psychosocial functioning related to the aging process and coping with illness.
With Rehabilitation Therapy: The S.W. collaborates with the rehabilitation therapy dept. on the development of a psychosocial evaluation, goals, plans, and discharge planning. The rehabilitation therapist will assist the S.W. in understanding the resident’s physical abilities and limitations and the S.W. will assist the therapy in understanding the resident’s psychosocial functioning related to the aging process and coping with illness.

Environment of Care: Social Services Space
Adequate, private space will be provides for the social work staff to communicate with residents, families, and professionals. The space will be private, large enough to accommodate a family, be wheelchair accessible, be free from distraction, and avoiding telephone conversations to ensure confidentiality at all times.

HOW ARE THEY PAID
Because of the high cost, many patients utilized Medicare or Medicaid to get reimbursed for stays in a Nursing Home. If the condition or financial situation does not permit the use of these programs, the patient will pay via private funds or private insurance (if available). Reimbursement for nursing care community patients and residents is a bit complex.

HOW ARE THEY REGULATED
Nursing Homes are regulated at both the state and the federal level. They are licensed and regulated by the Department of Public Health for the state, and are certified by both Medicaid and Medicare. In addition, there are licensing standards for the administrators and the clinical staff.

U.S. Government regulations and oversight
All nursing homes in the United States that receive Medicare and/or Medicaid funding are subject to federal regulations. People who inspect nursing homes are called surveyors or, most commonly, state surveyors. State surveyors may inspect for compliance with licensure (State regulations) and/or certification (Medicare and Medicaid regulations).
The "Minimum Data Set" assessment (MDS) is part of the U.S. federally mandated process for comprehensive assessment of all residents in Medicare or Medicaid certified nursing homes. The MDS assessment is a screening assessment that forms the basis of a comprehensive assessment of each resident's functional capabilities and helps nursing home staff identifies and help residents meet or cope with health and other needs
The nursing home industry is considered one of the two most heavily regulated industries in the United States (the other being the nuclear power industry)

Ombudsman
The Governor of NJ has appointed an official, known as the Ombudsman for the Institutionalized Elderly, to investigate complains of abuse or exploitation of persons over the age of 60, residing in long term care facilities within this state.

My Job so Far * Follow up meeting (Every morning) * IDCP (inter disciplinary care plan meeting) Done quarterly to go over progress of patient, moods, quality of life, behavior, and medicine * Fall off meeting (if a patient falls off, a family need to be contacted for a meeting) * Family meeting if requested by resident or family member (done with LPN, S.W, Unit manager, MDS coordinator, dietician, dir. Of recreation and administrator) * Filing face sheets to all floors * Visiting patients with Social Worker * Data Entry * Locating Patients folder chart in medical record department * Accompany S.W. to do new assessments * Translator between Spanish speaking residents and family and S.W.

NURSING HOME STATISTICS (AHCA)
Nursing facility providers in the United 1,813,665 total nursing facility beds;
16,995 total nursing facilities;
13 percent of facilities are hospital-based;
52 percent of facilities are part of a chain ("Chain" facilities are owned or leased by a multifacility organization. The remaining facilities are individually owned and operated);
107 facility bed size (average);
83 percent nursing facility occupancy rate.States
Nursing facility ownership in the United States
66 percent for profit;
27 percent not-for-profit;
7 percent government.
Nursing facility direct care staff in the United States
53 total direct care staff (average);
35 certified nurse assistants (average);
11 licensed practical nurses (average);
6 registered nurses (average).
Nursing facility reimbursement in the United States
8 percent Medicare;
68 percent Medicaid;
23 percent private pay.
Nursing facility special care beds in the United States (1)
105,066 total special care beds; including
65,304 Alzheimer beds;
3,013 AIDS beds;
4,304 hospice beds;
5,699 ventilator beds;
26,746 other special care beds.
Elderly Population in the United States
The elderly population, ages 65-74 is 7 percent (18,759,000 people) of the total population;
The elderly population, ages 75-84 is 4 percent (11,145,000 people) of the total population;
The elderly 85 and older are 1 percent (3,625,000 people) of the total population; and
The total elderly population, aged 65 and older is 13 percent of the total population.
Medicaid in the United States
1,031,364 Medicaid only beds;
400,122,716 Medicaid nursing facility days;
1,667,319 total Medicaid nursing facility residents;
$85.05 per diem Medicaid nursing facility rate.
Ancillary services -- included in the per diem Medicaid rate.

Medicare in the United States
53,138 Medicare only beds;
608,070 Dual certification beds;
1,113,237 total Medicare stays;
$234 average per diem Medicare rate;
27 days covered by Medicare (average);
$1,092 total copayment for a Medicare stay (average).
1. HCFA's Online Survey, Certification and Reporting Date
2. HCFA's Medicaid Statistical Information System (MSIS)
3. HCFA's Medicaid Data System
4. US Bureau of the Centus, Statistical Abstract of the United States