Types of Long Term Care Services

What is a Nursing Facility?

The major providers of long-term care services are nursing facilities. These facilities are designed for those persons unable to care for themselves, who may require special nursing or rehabilitative care and other supervised needs.

Nursing facilities provide skilled nursing care services on a 24-hour basis, seven days a week. These are procedures requiring the professional skills of a registered or a licensed practical nurse, including administering and monitoring medications, injections, catheterizations, and similar procedures ordered by the attending physician. Post-hospital stroke, heart or orthopedic care is available, with related services such as physical, occupational and speech therapy, dental services, dietary consultation, laboratory and x-ray services available. The emphasis in a nursing facility is on rehabilitative nursing care, with restorative, physical, occupational and other therapies also provided.

Personal care services such as help in walking, getting in and out of bed, bathing, dressing and eating, and the preparation of special diets as prescribed by a physician are also in the scope of nursing facility services.
Many nursing facilities serve special populations, including patients with Alzheimer's disease, AIDS, stroke victims, accident or surgical rehabilitation, or others requiring specialized services.

All nursing facilities in Ohio must be licensed by the state. Participation in the Medicaid and Medicare programs (or Certification) is voluntary. Not all homes that are licensed are certified for Medicaid or Medicare.
Nursing facility care can be paid by the individual, may be funded by the Medicaid or Medicare programs, or through private long-term care insurance.

What is Subacute Care? 

Many nursing facilities are now expanding into the field of subacute care, which serves patients needing complex care or rehabilitation.

Subacute care is defined as comprehensive inpatient care designed for someone who has an acute illness, injury or exacerbation of a disease process. It is goal oriented treatment rendered immediately after, or instead of, acute hospitalization to treat one or more specific active complex medical conditions or to administer one or more technically complex treatments, in the context of a person's underlying long-term conditions and overall situation.

Generally, the individual's condition is such that the care does not depend heavily on high- technology monitoring or complex diagnostic procedures. Subacute care requires the coordinated services of an interdisciplinary team including physicians, nurses, and other relevant professional disciplines, who are trained and knowledgeable to assess and manage these specific conditions and perform the necessary procedures. Subacute care is given as part of a specifically defined program, regardless of the site.
Subacute care is generally more intensive than traditional nursing facility care and less than acute care. It requires frequent (daily to weekly) recurrent patient assessment and review of the clinical course and treatment plan for a limited (several days to several months) time period until the condition is stabilized or a predetermined treatment course is completed.

What is Assisted Living?

Assisted Living is one of the fastest growing segments of long-term care. The philosophy of assisted living is to provide maximum independence in a home-like setting, with individualized care and assistance when needed. Assisted living offers a unique mix of security and independent living, privacy and companionship and physical and social well-being. Assisted living communities in Ohio are required to be licensed by the State as residential care facilities if they provide any level of skilled nursing care. Administering medication, dressing wounds, providing services related to rehabilitation and supervising special diets are just some of the services that fall under skilled nursing care and therefore require an assisted living community to obtain a license. There are however, limitations to the amount of skilled care that a resident can received within a licensed residential care community. We encourage you to discuss those limitations with the community so there are no surprises down the road.

What is an Intermediate Care Facility for the Mentally Retarded (ICF/MR)?

Intermediate Care Facilities for the Mentally Retarded (ICFs/MR) are the piece of the long-term care continuum that provides care for individuals with mental retardation and/or developmental disabilities. The services provided are based on client needs, which vary according to age and level or mental retardation and developmental disabilities. Individuals can reside in facilities from youth until old age making these facilities a permanent home and staff a second family. A common goal of ICFs/MR is to assess what individuals are capable of doing and to help them achieve their potential by teaching and training these individuals.

ICFs/MR vary from facility to facility and from state to state. They are all bound by federal regulations.
In 1996, there were over 137,000 individuals receiving training and support in 7,191 facilities. Forty-five percent of clients resided in state-owned/operated facilities. Privately operated facilities, which accounted for 83 percent of total ICFs/MR, were home to 50 percent of clients. The remaining 5 percent resided in city, county, or town-based facilities.

The trend in recent years has been away from care provided in large state-run institutions to care provided in smaller, privately run facilities. These facilities have fewer than 15 beds. A new focus on the client and on outcomes determines services in ICFs/MR at this time. In order for a facility to participate in the program, it must meet standards in the areas of active treatment, client protection, client behavior, and health care services. The federal government is focusing on assessing the individuals who live in ICFs/MR rather that relying on reviewing written records.

What is Home Health Care?

Home health care includes the provision of routine nursing assistance in the home. An example would be a nurse or nurse aide visiting the home on a regular basis to assist an older person, to check blood pressure, assist in bathing, or to administer prescribed medication. Other specialists including occupational and physical therapists provide services in your home. Some services may be reimbursable by Medicare or Medicaid. Home health care can be delivered 24 hours if necessary.

What are Adult Care Facilities?

Adult care facilities are smaller board-and-care homes or group homes that provide housing, meals, personal care, and some nursing care to 3 - 16 adults. They are generally converted private residences, and are licensed by the state of Ohio.

What are Food and Nutrition Services?
(Meals on Wheels)

These programs provide noontime meals to people over 60 through either easy-to-reach community locations or by delivering a hot meal to the home.

What is Adult Day Care?

These programs generally have minimal medical and social supervision for the older person who has help at home during the evening, but whose family or spouse is employed or away during the day.

What are Hospice Services?

 Hospice care is is provided to enhance life for a dying person. A person with a terminal disease may choose to die at home, in a dedicated hospice environment or in a nursing home providing hospice services with the support of family, friends, and health care professionals. Hospice care emphasizes comfort measures and counseling to provide social, spiritual and physical support to the dying patient and his or her family. All hospice care is under professional medical supervision. Over 90% of hospice care is provided in the patient's home.
 

What is PASSPORT?

PASSPORT is a program operated by the Ohio Department of Aging and local area agencies on aging that pays for various types of home and community-based services.  PASSPORT includes pre-admission screening during which interested consumers are interviewed by telephone to determine preliminary Medicaid eligibility and care needs. They are also provided information about the variety of long-term care options available.  PASSPORT services includes personal care, homemaker services, transportation, home-delivered meals, adult day services, and other benefits.  The program is for Medicaid-eligible seniors who need the level of care provided in a nursing home, but who wish to and are able to receive care at home.