Who Needs Nursing Home Care?

Nursing home care is one of the most intensive placements seniors can receive, often requiring certain conditions or diagnoses to become eligible for a bed. Many seniors are better suited for less-extensive care provided by in-home services, assisted living or memory care.

Nursing home services are typically reserved for seniors with debilitating health issues or conditions that mean they require 24/7 supervision and care. Each state has its own criteria regarding who qualifies for nursing home care, often requiring diagnosis and documentation from a physician confirming that nursing home placement is required. This includes a physician order stating that a patient requires nursing home levels of care, as well as a list of medications, treatment plans and a medical history for the senior being placed. Each state also requires a form for admittance stating that the senior meets the state’s standard for nursing home qualification and that the nursing home can meet the individual’s medical needs.

Commonly, states require individuals to need a nursing home level of care to qualify for admission to a nursing home, especially if the stay is funded by Medicaid. A nursing home level of care isn’t federally defined, and each state determines what qualifies. Generally, however, this includes an analysis of the person’s physical functional ability to complete activities of daily living and instrumental activities of daily living, health issues or medical needs, cognitive impairment and behavioral problems. The last two criteria are often used when considering care for individuals with dementia, Alzheimer’s disease or related conditions. This is often assessed through interviews and physician reports.

Nursing homes provide comprehensive medical care and assistance with activities of daily living to support residents. Residents often have a team of nurses and physicians managing their conditions and medications. Staff is also available to assist with personal care, such as dressing, grooming and toileting. Therapies and rehabilitation services are regularly provided, including physical, occupational and speech therapies. Nursing homes also tend to provide life enrichment activities to those who can participate, including music, entertainment and classes, to help residents socialize and stay active.

Before admission, many residents, such as those recovering after a stroke or a severe injury, have conditions or needs that require extensive support. They may already be diagnosed with a chronic disabling disease or face severe cognitive decline. Others require extensive support with activities of daily living due to being bedridden or in need of mobility assistance.