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Proposed edits to Wikipedia's Nursing home care in the United States article for ENG1100

 * 1) Types
 * 2) typical resident
 * 3) special need
 * 4) Controversy
 * 5) References

Reading List

 * 1) Joan Lunder. (2015). A Place for Mum.
 * 2) H Eskildsen, M. and Price, T. (2009), Nursing home care in the USA.
 * 3) Medicare.gov. (n.d.). How can I pay for nursing home care?
 * 4) Medicaid Coverage of Nursing Home Care.
 * 5) Sylvia Engdahl.(2011)
 * 6) Rice Robyn.(2006) (

Original
Nursing home care in the USA is part of the costliest health-care system in the world, and is a heavily regulated industry still struggling to maintain quality care across the country. The modern nursing home dates back to the 1930s and the passage of the Social Security Act, with continued growth of the industry after the 1960s, when the Medicare and Medicaid programs were created. As in other industrialized countries, the elderly population in the USA is growing, and the highest growth is occurring among those older than 85. This is the group with the highest health-care costs and rates of nursing home utilization. There are two major types of care provided in US nursing homes: long-term and subacute care. In the 1980s, quality of care became an important concern, which led to major reform and passage of new regulations under the law known as OBRA-87. During this time, the Minimum Data Set (MDS), which is a comprehensive assessment tool, was introduced. It continues to be a vital tool for both payment and research. Reform also ushered in the state survey process, which scrutinizes nursing homes yearly and assesses financial penalties for substandard care. The aging of the American population will provide challenges for financing nursing home care in the future. The use of private long-term care insurance is growing, and may be an important source of payment for this type of care in the decades to come.

Revised
Nursing home care in the USA is part of the costliest health-care system in the world, and is a heavily regulated industry still struggling to maintain quality care across the country because of its sensitive nature. The modern nursing home dates back to the 1930s and the passage of the Social Security Act, with continued growth of the industry after the 1960s, when the Medicare and Medicaid programs were created. As in other industrialized countries, the elderly population in the USA is growing, and the highest growth is occurring among those older than 85. This is the group with the highest health-care costs and rates of nursing home utilization. There are two major types of care provided in US nursing homes: long-term and subacute care. In the 1980s, quality of care became an important concern, which led to major reform and passage of new regulations under the law known as OBRA-87. During this time, the Minimum Data Set (MDS), which is a comprehensive assessment tool, was introduced. It continues to be a vital tool for both payment and research. Reform also ushered in the state survey process, which scrutinizes nursing homes yearly and assesses financial penalties for substandard care. The aging of the American population will provide challenges for financing nursing home care in the future. The use of private long-term care insurance is growing, and may be an important source of payment for this type of care in the decades to come.

Original Contribution
They reported that 13 large institutions were certified as SNFs (skilled nursing facilities), that all were "absolutely inappropriate" placements for the developmental disabilities' clients (the federal Government Accounting Office (GAO) then reported a need to upgrade services in the homes, including day services), and the facilities resembled the institutions that resulted in the national exposés of institutions such as Willowbrook in other fields. Government are better in management of safety and protection of its citizenry, in fact number basic duty of any government is protection of life and it is believed that it is always best managed by the government than leaving it to the private sectors who try to make huge profit by exploiting their potential customers. Government should provide this service in the same way it provides other services, like police and fire protection or other community services. Arguably, it is the responsibility of a state to concern itself for all its citizens/residents. An important part of such a responsibility is to protect the innocent and the helpless. The "helpless" includes those who do not possess the means to take care of themselves, which clearly includes those who are too poor or whose treatment is too expensive for them to afford on their own.

Original: Typical resident[edit] An assisted living resident is defined as a resident who needs assistance with at least one of the activities of daily living. A typical assisted living facility resident would usually be a senior citizen who does not need the level of care offered by a nursing home but prefers more companionship and needs some assistance in day-to-day living. Age groups will vary with every facility. There is currently a transformation occurring in long-term care. Assisted living communities are accepting higher and higher levels of care and nursing homes are becoming a place for those undergoing rehabilitation after a hospital stay or are individuals who need extensive assistance. Many assisted living communities now accept individuals who need assistance with all activities of daily living. The "Overview of Assisted Living Report" from 2010 stated, 54 percent of assisted living residents are 85 years or older; 27 percent are 75–84 years old; 9 percent of residents are between 65 and 74 years; and 11 percent are younger than 65 years old. 74% assisted living residents are female; 26 percent are male.[3] Special needs[edit] The residence may assist in arranging the appropriate medical, health, and dental care services for each resident. The resident generally chooses his or her medical doctor and dental services. Residents who have periods of temporary incapacity due to illness, injury, or recuperation from surgery often are allowed to remain in the residence or to return from a rehabilitation center, skilled nursing facility or hospital if appropriate services can be provided by the assisted living residence. It is important to remember that assisted living residences are a bridge between living at home and living in a nursing home. Assisted living residences do not typically provide the level of continuous skilled nursing care found in nursing homes and hospitals. More recently built facilities are designed with an emphasis on ease of use for disabled people. Bathrooms and kitchens are designed with wheelchairs and walkers in mind. Hallways and doors are extra-wide to accommodate wheelchairs. These facilities are by necessity fully compliant with the Americans with Disabilities Act of 1990 (ADA) or similar legislation elsewhere. The socialization aspects of ALFs are very beneficial to the occupants. Normally the facility has many activities scheduled for the occupants, keeping in mind different disabilities and needs. There are many ways you can pay for nursing home care. Most people who enter nursing homes begin by paying for their care out-of-pocket. As you use your resources (like bank accounts and stocks) over a period of time, you may eventually become eligible for Medicaid.

CONTROVERSY:
Medicare generally doesn't cover long-term care stays (room and board) in a nursing home. Also, nursing home care isn't covered by many types of health insurance. However, don't drop your health care coverage (including Medicare) if you're in a nursing home. Even if it doesn't cover nursing home care, you'll need health coverage for hospital care, doctor services, and medical supplies while you're in the nursing home.

Medicaid is the only government program that is available to most people to cover long-term care costs and it does not cover everything. If you spend all of your money and then go on Medicaid, which is the case for most Medicaid recipients, you will have nothing left to pay for all of the services not covered by Medicaid. Medicaid will cover the cost of long-term care but it sure helps to have money set aside to cover important extras.

Medicaid is the only government program that is available to most people to cover long-term care costs and it does not cover everything. If you spend all of your money and then go on Medicaid, which is the case for most Medicaid recipients, you will have nothing left to pay for all of the services not covered by Medicaid. Medicaid will cover the cost of long-term care but it sure helps to have money set aside to cover important extras.