Inpatient Facilities
Inpatient health care facilities include hospitals, skilled nursing and long-term care facilities, and residential care facilities. Each of these has many different specialties ranging from generic to highly specialized levels of care.
Hospitals
The majority of health care workers are employed by hospitals. Hospitals fit into two categories: They are dedicated to either acute care or long-term rehabilitative care. Acute care facilities treat sudden and acute illness or injuries, and patients typically stay less than ten days unless their care involves more intense treatment (such as that which requires being admitted to an intensive care unit).
Long-term hospitals treat illnesses such as psychiatric issues; chronic illness, like respiratory issues; and rehabilitative issues. The rehab can be for substance abuse. Other rehabilitation is for post-acute illness or severe injury such as massive strokes, spinal cord injuries, and major or multiple orthopedic injuries. The long-term stays in these facilities can range from a few weeks to several months. The key element is progress and the potential to continue progressing.
Hospitals are generally owned and operated by three different groups:
For-Profit: These are proprietary facilities usually owned by individuals or companies. Sometimes groups of physicians own the hospital.
Nonprofit: These are usually local, private hospitals most often run by religious organizations. Other nonprofit organizations, such as the Shriners, operate specialty hospitals in some areas of the country.
Government owned and operated: These are run by the local, state, or federal government. The Veterans Administration is an example. State hospitals are usually psychiatric hospitals, and local governments have community or county hospitals.
Specialty hospitals, such as children's hospitals, are usually run by local city and county governments. There are also hospitals designed to treat specific illnesses, such as respiratory disease, orthopedic and neuromuscular conditions, and cancer. These are usually either run by local governments or are privately owned, and often are nonprofit.
On the other hand, for-profit organizations are in the business of making money and paying large dividends to the owners and shareholders. The philosophical approach to
Some nonprofit hospitals provide free care to all who seek it and cannot afford to pay. They depend heavily on donations and endowments to provide this level of care. For-profit institutions are less likely to offer free care, but may allow for sliding-scale payments based on the ability to pay.
Question
What are nonprofit organizations?
They are organizations that have been granted tax-exempt status. They usually depend on donations from the private sector or from government agencies. Nonprofit organizations can engage in moneymaking operations; however, they cannot distribute the profits to owners and shareholders as a for-profit company would. How they earn and spend money is restricted by their tax-exempt status.
Skilled-Nursing and Long-Term Care Facilities
A skilled-nursing facility, also known as a
Patients at a SNF are usually recovering from an acute illness and are not yet able to return home. They may have had a stroke, major illness, or surgery, or may be recovering from an orthopedic injury such as a fractured hip or a joint replacement, and require continued nursing care and/or physical, occupational, or speech therapy. The rehabilitative nature of a SNF is far less intense than that of a long-term rehab hospital.
A long-term care facility is one in which the residents require twenty-four-hour care or supervision, but it is custodial in nature rather than skilled. That is, they require supervision and varying levels of assistance with activities of daily living (ADLs), like bathing, grooming, feeding, mobility, and toileting. This can also include those patients who are in vegetative states and require total care, as long as they don't require any
These two types of facilities are often lumped together and referred to as
Fact
Most insurance will reimburse for either a finite period of time, or as long as there is a need for skilled care and the potential to improve. However, once there is no further requirement for skilled care or there is no potential to improve, the reimbursement will usually end. The patient's only option may be to move to a long-term care facility, where his out-of-pocket expense will be lower.
Residential Care
The most common residential care facilities are senior residences, whether they are small board-and-care homes or large assisted-living facilities. There are a variety of senior residences offering several levels of care, from independent living to moderate levels of assistance. (Those who require maximum assistance should be placed in a long-term care facility.)
In independent living, seniors require little to no assistance, but have the advantage that someone will check to be sure they are okay each day, and an option of community dining. In assisted-living facilities, residents can require minimal assistance (such as help with medications), more moderate assistance with activities of daily living (such as bathing and dressing), or may even require twenty-four-hour supervision. The higher the level of care, the higher the cost for the care. Residents do, however, have to be able to ambulate (walk). They can require the use of a cane or walker, but if they are wheelchair bound, even though they transfer independently, they should be living in a facility with a higher level of care.
In board-and-care homes, residents can be wheelchair bound, depending on the home's licensing and staffing ratios. A board-and-care home is a private home that is licensed by the state to house one or more residents who can require varying levels of care, from only supervision to a moderate level of assistance with activities of daily living (ADLs), depending on the skill and number of staff available twenty-four hours a day to care for the residents.
Other residential care facilities serve special needs. These include, but are not limited to, homes for those with autism or severe birth defects; the mentally challenged and retarded; and emotionally disturbed individuals. There are also facilities such as halfway houses for substance abuse and alcohol rehabilitation.
