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    Comparing a Nursing Home and an Acute Care Hospital

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    How does the nursing structure of a nursing home facility differ from that of a general acute care hospital? Why? Are these differences necessary? Please cite all references. Please try to use and cite USA illustration and examples if possible. Thank you.

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    This has been an interesting question. Please see response attached, which are also presented below. I have provided examples of United States, Canada, and other countries as well. I located an excellent article on safety issues to consider in nursing homes in the U.S. (see http://www.whscc.nf.ca/resource/NIOSH/nursinghome.htm), which is attached. Another online article you may want to check out is http://www.agingandhealth.org/primarycare.htm.


    I will answer your questions in the order that you presented them.

    Q1: How does the nursing structure of a nursing home facility differ from that of a general acute care hospital?

    The differences between nursing home facility and a general acute care hospital are a function of definition, type and level of care required by the patient, and financial funding available to the client, to name a few.

    Before we discuss more fully the specific characteristics of these two health settings, it is important to think of acute care facilities and nursing homes within a broader context. Although based on a Canadian article, the below figure does this very nicely (note: there is some overlap as some nursing homes also provide acute short time care): (see in attached response)

    Similarly, in the United States (in addition to the acute care hospitals) four types of patient care are available: CCRC, Independent Living, Assisted Living and Nursing Homes (Source: Available [On-line} http://www.myguideinc.com/LrnAnswerGuide.asp Retrieved June 23, 2004). These settings are similar to the Canadian group homes, homemaker services and home nursing care services listed in the above diagram. For more details refer to the article (http://www.myguideinc.com/LrnAnswerGuide.asp).

    Now, we will look a little closer at the Nursing Home structure, followed by the structure of the general acute hospital setting.

    1. Nursing and Rehabilitation Center/Nursing Homes (US source: http://www.myguideinc.com/LrnAnswerGuide.asp):

    a. Definition and structure:

    A Nursing and Rehabilitation Center, also known as a Nursing Home, is a facility that provides 24-hour nursing care, rehabilitative services and assistance with daily tasks to individuals who are unable to safely reside at home or in any other living alternative. Nursing and Rehabilitation Centers provide medically supervised care to the elderly, disabled and chronically ill.

    Some individuals require only a short stay for rehabilitation and strengthening after hospitalization, before returning home. Other residents require long-term medical, social and personal care along with supportive services that cannot be adequately provided in any other setting. A great number of Nursing and Rehabilitation Centers offer short-term respite care for caregivers needing temporary relief from their caregiving responsibilities.

    Nursing and Rehabilitation Centers, also referred to as Skilled Nursing Facilities, Nursing Facilities, Health Care Centers, Convalescent Centers, Extended Care Centers or Long Term Care Facilities, can be freestanding or part of a continuum of care that typically includes Independent Living and Assisted Living.

    Many facilities specialize in certain types of care. For example, a Nursing and Rehabilitation Center may offer complex medical and rehabilitation services called sub acute care. Others may have a separate dementia care "neighborhood" for individuals with Alzheimer's disease and related dementias. Medicare, Medicaid, private payment and long term care insurance are all methods of payment for nursing and rehabilitative care provided to seniors, although Medicare currently covers only short-term care.

    b. Safety and Quality

    A Caring structure that is client-centered, limited personal freedom depending on individual needs, individualized assessment, privacy (to visit with friends and family), and rehabilitation focus for some clients. For other long-term clients, and with more serious debilitating ailments, their treatment and care plan is designed to meet their needs (i.e., a person with dementia may not be able to walk freely around outside as would a person with a good mental capacity, etc.)
    Final Comments: By definition and supported through various researchers (see http://www.gnb.ca/0062/regs/85-187.htm) the clients needs ideally determine the type of care and, thus, the setting in which they will be place. For example, if a person needs a short time in the hospital for a surgery, they will be placed according to their need (i.e., acute care hospital). On the other hand, if a person requires long-term medical, social and personal care along with supportive services that cannot be adequately provided in any other setting, a nursing home setting will be ...

    Solution Summary

    This solution explains the similarities and differences between the nursing structure of a nursing home and that of a general acute care hospital. It also discusses why these differences exist and whether or not these differences are necessary. Supplemented with two informative and supportive articles.