Make Nursing Homes More Like Home: Medicare

FRIDAY June 19, 2009 -- A warm, welcoming environment where residents are free to make choices regarding their care: That's the new vision of the ideal nursing home, according to a guidance issued Friday by the U.S. Centers for Medicare & Medicaid Services (CMS).

The directives in the CMS guidance aim to "transform nursing homes into environments that are more like [residents'] homes through both environmental changes and resident-centered caregiving," CMS Acting Administrator Charlene Frizzera said in an agency news release.

The guidance will serve as a kind of outline that CMS nursing home inspectors can use to make sure a particular facility is reaching federal regulations on good quality care, the agency said. The guidance went into effect June 12.

Included in the new proposals:

  • A call to "de-institutionalize" the nursing home's physical environment by doing away with things such as meals served on "institutional" trays, blaring noise from overhead paging speakers, and large nursing stations.
  • Efforts to individualize and personalize care, stressing the importance of personal one-on-one relationships between residents and staff, and a warm, welcoming environment.
  • Giving residents real choice over daily routines, including the scheduling of waking, bathing, mealtimes and bedtimes.

Almost 1.5 million Americans now live in an estimated 15,800 nursing homes spread throughout the country, CMS noted, and more than 3 million will spend at least some time in a nursing home this year.

"Many facilities cannot immediately make these types of changes, but it should be a goal for all facilities that have not yet made these types of changes to work toward them," the guidance reads.

More information

You can download the full guidance here.

Posted: June 2009


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