Nursing Care Facilities

Retirement Community and Facility Types

There are two types of nursing facilities associated with residential facilities. Intermediate care facilities which provide custodial and intermediate care, and skilled nursing facilities, which provide custodial, intermediate, and skilled care. Defining some terms, custodial care is nonmedical care that includes around-the-clock supervision, as well as assistance with personal needs such as eating, bathing, dressing, grooming, toileting, and mobility. Intermediate care provides basic medical care. Skilled care provides more intensive medical care.

Individuals are attended by professional nurses operating under the direction of physicians. They may be freestanding or part of a senior community, and are licensed by state and local health agencies.

An intermediate care facility is licensed by the state to provide 24-hour basic medical care under the supervision of a registered nurse who may be on call and not necessarily on duty. Basic medical care includes rehabilitative and recuperative care, but not more intensive medical procedures such as intravenous therapy and feeding tubes. The staff-to-patient ratio is lower than in a skilled nursing facility.

A skilled nursing facility is also licensed by the state and provides 24-hour nursing care with at least one registered nurse on duty during the day. Care is provided under the supervision of a licensed physician who is on call. The facility is equipped to provide more intensive medical procedures such as intravenous therapy and feeding tubes. This is subacute care, which is the highest degree of nursing care outside of a hospital.

A senior residential community, such as an assisted living facility or a continuing care retirement community, may provide nursing care on site or may contract with a nearby facility to provide care to its residents

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