【正文】 ) through the National Health Service (NHS)。23,000 pay the full cost of the care home, until the total value of their assets fall below the threshold[14]. Patients who require additional nursing care are assessed for this (Hampshire nursing limit 2022 163。250 capital between lower and higher limit. The council pays the rest, subject to the same conditions as before. It is therefore preferable to find a home within the council39。s normal rate, currently 163。13,500. At this level, all ine from pensions, savings, benefits and other sources, except a personal expenses allowance (currently 163。s model, oute is assumed to result from processes and processes are assumed to require structures. An oute may be a facility oute which indirectly supports direct resident care. An example of an indirect or facility oute would be supervising and correcting or training staff That changes staff knowledge and skills. Staff applying those new skills is a process which should yield better resident outes. Resident outes may be classified as physical (death, disease, disability or dysfunction) and psychosocial (disfort, dissatisfaction). Resident outes are usually specified in terms of health, wellbeing, patient satisfaction, etc. Resident outes are usually improved when staff provide and residents experience resident oriented care Consumer choices Current trends are to provide people with significant needs for long term supports and services with a variety of living arrangements. Indeed, research in the . as a result of the Real Choice Systems Change Grants, shows that many people are able to return to their own homes in the munity. Private nursing agencies may be able to provide livein nurses to stay and work with patients in their own homes. When considering living arrangements for those who are unable to live by themselves, potential customers consider it to be important to carefully look at many nursing homes and assisted living facilities as well as retirement homes, keeping in mind the person39。s resources in action. Process surveying looks at the appropriateness, timeliness and quality of care and services in relation to each resident39。s functional capabilities and helps nursing home staffs identify and help residents meet or cope with health and other needs. The MDS also yields Resource Utilization Groups (RUGS) which are used for all Medicare reimbursement to SNFs, and is used in many States to set reimbursement for NFs. For United States SNFs and NFs, the Centers for Medicare and Medicaid Services has a website which allows users to see how well facilities perform in certain metrics (see Nursing Home Compare Tool in the external link section below). CMS also publishes a list of Special Focus Facilities nursing homes with a history of serious quality issues.[4][5] The US Government Accountability Office (GAO), however, has found that state nursing home inspections understate the number of serious nursing home problems that present a danger to residents. The GAO concluded that while CMS oversight has improved, there are still weaknesses in its oversight of nursing homes.[6][7] A report issued in September 2022 found that over 90% of nursing homes were cited for federal health or safety violations in 2022, with about 17% of nursing homes having deficiencies causing actual harm or immediate jeopardy to patients.[8] SNFs and NFs are subject to federal regulations and also strict state regulations. The nursing home industry is considered one of the two most heavily regulated industries in the United States (the other being the nuclear power industry).[9] Medicare and Medicaid surveys Federal regulation and inspection (surveying) of SNFs and NFs applies a model of health care quality created for research by Avedis Donabedian in 1965. The model uses the concepts of structure, process and oute. Structure For surveying, structure is the nursing home39。 and room and board. Most care in nursing facilities is provided by certified nursing assistants, not by skilled personnel. In 2022, there were, on average, 40 certified nursing assistants per 100 resident beds. The number of registered nurses and licensed practical nurses were significantly lower at 7 per 100 resident beds and 13 per 100 resident beds, respectively. Nursing homes that participate in the Medicare and Medicaid programs are subject to federal requirements regarding staffing and quality of care for residents.[2] In 2022, % of the 16,100 nursing facilities nationwide were certified to participate in Medicare, Medicaid, or both. Medicare covers nursing home services for 20 to 100 days for beneficiaries who require skilled nursing care or rehabilitation services following a hospitalization of at least three consecutive days. The program does not cover nursing care if only custodial care is needed — for example, when a person needs assistance with bathing, walking, or transferring from a bed to a chair. To be eligible for Medicarecovered skilled nursing facility (SNF) care, a physic