Nursing Home

In the Online Survey Certification and Reporting database, a nursing home is a facility that is certified and meets the Health Care Financing Administration’s long-term care requirements for Medicare and Medicaid eligibility. 

In the National Master Facility Inventory (NMFI), which provided the sampling frame for 1973-74, 1977, and 1985 National Nursing Home Surveys, a nursing home was an establishment with three or more beds that provided nursing or personal care services to the aged, infirm, or chronically ill. The following definitions of nursing home types applied to facilities listed in the NFMI. The 1977 National Nursing Home Survey included personal care homes and domiciliary care homes while the National Nursing Home Surveys of 1973-74, 1985, 1995, 1997, and 1999 excluded them.

Nursing care homes must employ one or more full-time registered or licensed practical nurses and must provide nursing care to at least one-half the residents.

Personal care homes with nursing have some but fewer than one-half the residents receiving nursing care. In addition, such homes must employ one or more registered or licensed practical nurses or must provide administration of medications and treatments in accordance with physicians’ orders, supervision of self-administered medications, or three or more personal services.

Personal care homes without nursing have no residents who are receiving nursing care. These homes provide administration of medications and treatments in accordance with physicians’ orders, supervision of self-administered medications, or three or more personal services.

Domiciliary care homes primarily provide supervisory care but also provide one or two personal services.

The following definitions of certification levels apply to data collected in National Nursing Home Surveys of 1973-74, 1977, and 1985.

Skilled nursing facilities provide the most intensive nursing care available outside of a hospital. Facilities certified by Medicare provide posthospital care to eligible Medicare enrollees. Facilities certified by Medicaid as skilled nursing facilities provide skilled nursing services on a daily basis to individuals eligible for Medicaid benefits.

Intermediate care facilities are certified by the Medicaid program to provide health-related services on a regular basis to Medicaid eligibles who do not require hospital or skilled nursing facility care but do require institutional care above the level of room and board.

Not certified facilities are not certified as providers of care by Medicare or Medicaid.

Beginning with the 1995 through the 1999 National Nursing Home Surveys, nursing homes are defined as facilities that routinely provide nursing care services and have three or more beds set up for residents. Facilities may be certified by Medicare or Medicaid or not certified but licensed by the state as a nursing home. The facilities may be freestanding or a distinct unit of a larger facility.

After October 1, 1990, long-term care facilities which met the Omnibus Budget Reconciliation Act of 1987 (OBRA 87) nursing home reform requirements that were formerly certified under the Medicaid program as skilled nursing, nursing home, or intermediate care facilities were reclassified as "nursing facilities." The Medicare program continues to certify skilled nursing facilities, but not intermediate care facilities. State Medicaid programs can certify intermediate care facilities for the mentally retarded or developmentally disabled. Nursing facilities must also be certified to participate in the Medicare program in order to be certified for participation in Medicaid, with the exception of those facilities that have obtained waivers. Thus most nursing home care is now provided in skilled care facilities.

SOURCE: Health, United States

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Nursing Care

This page last reviewed September 11, 2008