Three levels of care in nursing homes include skilled care, intermediate care and custodial care. Skilled care is the highest level of care, while custodial care is the minimal level of care in nursing homes. Knowing the type of care you or your loved one requires is the first step in locating a nursing facility to fit your needs.
Skilled Care
Skilled nursing home care is the highest level of care provided in nursing homes. Skilled care is provided under physician supervision by licensed practical nurses, registered nurses and other licensed professionals such as physical therapists.The U.S. Department of Health and Human Services defines skilled nursing facility care as "a level of care that requires the daily involvement of skilled nursing or rehabilitation staff and that, as a practical matter, can't be provided on an outpatient basis. For example, physical therapy and intravenous injections are skilled level nursing care.
Intermediate Care
Intermediate care is a step down from skilled care. As the skilled level of nursing home care, intermediate care is provided under physician supervision by licensed practical nurses or registered nurses. But unlike skilled care, intermediate care does not include daily therapy services such as physical therapy. Intermediate care includes assistance cooking meals, provision of housekeeping and laundry services and delivery of medication.
Custodial Care
Custodial care is the next step down from intermediate care. The U.S. Department of Health and Human Resources defines custodial care as "non-skilled, personal care." Custodial care includes assistance with "activities of daily living" such as bathing, dressing, eating, going to the bathroom, using eye drops, moving around and getting into and out of bed.
Selecting a Nursing Home
Selecting a nursing home is one of the most important life decisions you'll make---whether it is for yourself or a loved one. Your physician, hospital social workers, local agency on aging or other local social-services organization can provide referrals for nursing homes. The internet also offers reliable tools such as Nursing Home Compare from Medicare.gov. This site allows comparison of nursing homes by amount of staffing, fire-safety-inspection results, health-inspection results and the federal Five-Star Quality Rating given to every nursing home. Although much information is available online, visiting a potential nursing home may provide additional information to assist your decision-making process.
Nursing Home Resident Rights
Section 483.10 of Title 42 of the Code of Federal Regulations sets forth the rights of all nursing home residents. Generally, each "resident has a right to a dignified existence, self-determination, and communication with and access to persons and services inside and outside the facility." Several specific rights include the right to exercise resident rights, receive notice of rights and services, choose a physician, maintain privacy and confidentiality, receive visitors, use the telephone, retain personal property and self-administer medications if deemed safe.
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