In the past, nursing homes took care of patients in a custodial way, and they really didn’t need a doctor to accomplish this level of care. In those earlier years, the type of patient that went to live in a nursing home was similar to the patient that today goes to an independent or assisted living facility. These were people that needed a certain level of help to handle their day-to-day lives, but not necessarily very much.
What that longstanding manner of nursing home needed most was, like the name implies, nurses. Even today, the most important factor in taking care of patients in a nursing home is the number of nurses on staff and the competency of those nurses. However, there is widespread variation state-by-state when it comes to minimum staffing requirements. While some states require a minimum number of staff hours per resident per day, other states mandate nursing homes provide direct care staff 24/7, without a set number of hours per resident. Eleven states introduced changes to minimum staffing requirements since the onset of COVID-19.
When Medicare set up a payment system to help cover the costs of caring for these individuals, the reimbursement was based, essentially, on a modified room-and-board scenario. That payment system, although modified, remains largely in effect today. Thus, just as renters pay rent once a month, so do patients (or their families or insurance) to keep their loved ones in a nursing home.
- Dr. Kenneth L Scott Jr DO
