LONG-TERM CARE, SKILLED NURSING, AND ASSISTED LIVING FACILITIES

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Policy:

It has been predicted that the increasing elderly population combined with a breakdown of the extended family in America will continue create additional expansion of the adult care industry. EMS needs a policy that explains the structure and role of licensed adult care facilities in North Carolina in order to understand where we fit in with this industry.

 

Purpose:

·         Educate EMS personnel about the licensing, services, and limitations of the adult care industry in North Carolina.

·         Emphasize the importance of teamwork between EMS personnel and adult care staff.

 

Procedure:

·         Adult care facilities are licensed by the State of North Carolina, Division of Facility Services. Each county has an Adult Care Specialist that works out of the local Department of Social Services.

·         Adult care facilities are classified as either skilled nursing facilities or assisted living facilities. Assisted living facilities are markedly different from skilled nursing facilities and are not to be confused with “nursing homes.” The level of care provided and the medical knowledge of the staff at an assisted living facility varies greatly from that of a skilled nursing facility.

·         Staff Medical Skills and Training: Skilled nursing facilities may have RN’s, LPN’s, CNA’s, and Medical Technicians on staff. Assisted Living Centers may be supervised by an RN but typically are staffed with Medical Technicians and workers with limited medical skills and/or knowledge. Staffs with lower levels of certification do not have a broad understanding of medical conditions, emergencies, or patient care.

·         Many times, staff at an adult care facility will consult with a physician, physician’s assistant, or nurse practitioner regarding a resident’s care in both emergency and non-emergency situations. Staff has no choice but to follow the direction of licensed medical professionals contracted to their facility when directed to obtain transport to a doctor’s office or emergency department for further evaluation.

·         It is important for EMS personnel to remain non-judgmental about the staffs working at any adult care facility.

·         Every effort must be made to maintain a professional demeanor when dealing with the patients, staffs, and families of adult care facilities.

Our ultimate goal is to ensure that each patient receives an appropriate assessment, appropriate treatment, and appropriate transport for their condition. This can be done in an effective and efficient manner when EMS and adult care staffs work cooperatively and professionally to meet the needs of each patient.