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Senior Care – SNFs and Beyond
Health visitor and a senior woman during home visit. A nurse talking to an elderly woman.

Senior Care – SNFs and Beyond

It’s January of the year 2020. Woo boy! Just the sound of 2020 seems the future have arrived (at least for me, a child of the 60’s). As a long time RN and active healthcare team member, felt it was time to share some senior care information which I have been mulling over. There are differences, variables, many actions, and much specialized care necessary in the process of providing healthy living for seniors. My goal here is to provide a worthy review for my fellow RNs, Healthcare Employers and each and every Healthcare Worker.

Non-healthcare folks, too, need awareness in order to be better prepared to discuss their senior healthcare options, as well as options for their loved ones’. Healthcare professionals unlock many mysteries, which can be overwhelming to their patients and their families, Knowledge about care options is powerful and what seems so basic to a healthcare professional might be nerve racking to those not in this career. Below I’ve highlighted facility and care options, beginning with institutions providing the most care and concluding with minimal care.

Acute Care can be divided into three (3) levels. Primary is usually the general physician/family doctor. Commonly the first point of care. This is usually enough for minor health issues. Secondary is generally a hospital level of care or advanced diagnostic clinic. Tertiary Care provides specialized consultative care, usually on referral from primary or secondary medical care personnel, by specialists working in a center that has personnel and facilities for special investigation and treatment.

Long Term Acute Care Hospitals(LTAC)-Long-term care hospitals (LTCHs) is A facility which provides rehabilitative, restorative, and/or ongoing skilled nursing care to patients or residents in need of assistance with activities of daily living, breathing, mobility, and recuperation.


Sub-Acute Care/Transitional Care is for patients’ whose condition is stabilized and may no longer need aggressive medical care as provided in a hospital, but still need complex care or inpatient rehabilitation.

Skilled Nursing Facility (SNF)/Nursing Home does have a subtle difference but the Skilled Nursing Facility more typically provides temporary care for rehabilitation patients that do not require long-term care services or to solve a specific medical need or to allow recovery outside a hospital. Nursing Home Facilities/Homes provide permanent custodial assistance.

Intermediate Care Facility/ICF is a long term care facility that provides nursing and supportive care to residents on a non-continuous skilled nursing care basis, under a physician’s direction. Clients usually require less assistance with day-to-day living.

Home Health Care medical care provided in a patient’s home. It can include broad care given by skilled medical professionals, including Licensed and/or skilled nursing care, physical therapy, occupational therapy and speech therapy.

Hospice Care/Palliative Care is designed to give supportive care to people in the final phase of a terminal illness and focus on comfort and quality of life, rather than cure. Both palliative and hospice care provide comfort. But palliative care can begin at diagnosis, and at the same time as treatment. Hospice care begins after treatment of the disease is stopped and when it is clear that the person is not going to survive the illness.

Assisted Living Care is part of a continuum of long term care services that provides a combination of housing, personal care services, and health care designed to respond to individuals who need assistance with normal daily activities in a way that promotes maximum independence.


I’ve decided to focus on the Personalized, Senior Living Facility or its more common reference term, Assisted Living Facility. Eligibility for admission to an Assisted Living Facility is primarily based on an individual’s care level requirements. Individuals will often need assistance with ADLs (activities of daily living) such as personal care, hygiene/bathing assistance, mobility, meal preparation, medication management and more. The individual and their family may consider this type of living arrangement, because they have noticed themselves not able to keep pace with their previous physical, mental and psychosocial activities. Some seniors may find that the passion they once had for golfing or hiking has diminished, the paying of bills causes increased frustration, and/or skipping a meal prevails over preparing a meal. Who cares for seniors in this setting and what will it take for it to be a healthy place for them? Good question. The answer and first variable is that it widely differs in our 50 United States. Our Occupational Health and Safety Administration (OSHA) of the federal government operates the primary job safety and health program in twenty-nine (29) of our fifty (50) states. This includes conducting inspections and enforcing its standards. Twenty-one states (21) operate their own job safety and health programs. In most cases, states adopt standards identical to federal ones and compliance grows from here, including Environmental Topic Summaries, Buildings & Grounds, Construction Activities, Utilities and Wastes. Rather than get bogged down with tons of specifics, which vary even further, based on whether there is a gym, a pool, a salon, gardens, and lesser or greater than 100 residents. Suffice it to say, a Senior Living Facility will minimally require a Healthcare Director, Facilities and Maintenance Director, and a number of other dedicated licensed, skilled, and non-skilled staff members. Family members living both near and far rely on the facilities staff members to provide a safe and happy home for their family member(s). Consider that parents can plan for constant child care in the early years and less as children grow more independent. With the elderly, it’s the opposite. The elderly’s needs tend to be intermittent, changing and increasing. That unpredictability can put a big strain on employees and employers. Consider also that the word CARE has been used no less than 53 times in this writing. CARE is IT. It is the truest bottom line for exemplary healthcare, in my not so humble opinion. Fellow healthcare professionals, Employees and Employers, consider CARE as your top and bottom line, then release your inner Caesar. “Veni, Vidi, Vici” or in other words, “I came. I saw. I conquered.”

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