关于养老院的外文翻译22685.pdf

养 老 院 养老院分为疗养院，专业护理组（首尔大学），护理院或疗养院这是一个需要护理和日常活动有不便的人居住的地方居住在这里的居民包括身体或精神残疾的老人和成年人，住在疗养院的人如果发生意外或疾病也会被进行物理治疗居民的法律权利取决于机构的法律地位 美 国 在美国，一个“专业护理机构”或“民营护理机构”是指一个注册参加并可以医疗保险报销的机构联邦医疗保险方案主要是为那些在工作时为社会保障和医疗保险做出贡献的老年人而设的，护理基金是指给予那些得到认证并参与了医疗报销的养老院的资金联邦医疗补助计划是为每个国家提供医疗及相关服务，并为那些所谓的“穷人”实施的所谓的“穷人”是指每个国家确定的给予老人，残疾人或儿童医疗补助的资格（如儿童的健康保险计划 -芯片和母婴保健和食品方案） 每个国家开办的养老院，都受到国家法律和法规的保护护养院可以选择参加医疗保险或医疗补助如果他们通过一项调查（检查），他们得到许可，也受到联邦法律和法规的保护全部或部分护理之家可参加医疗保险或医疗补助 在美国，护理安老院参加医疗保险或医疗补助须有职业护士每天 24 小时值班至少每天 8 小时，每周 7 天，必须有一个注册护士值班。

护养院的管理由持牌护理之家管理员管理不像美国护理没有标准化的培训和管理人员发牌规定，但大多数州都要求有联邦许可证，许多州，如加利福尼亚州有他们自己的系统管理员执照到 2005 年 4 月 18 日，美国共有 16094 家有许可的养老院，低于 2002 年 12 月 12 日，德尔的 16516 家 有些国家已经给能够在社区生活但需要帮助的老人和其他成年人提供不同的照料例如，康涅狄格安老院或安老院是由公共卫生国务院授权这些安老院提供 24 小时监管，提供了更多的“如家“的环境许多人实际上已转化为住房，提供一个住宅社区，促进了独立的生活方式和给予他人需要的某种形式的援助，以促进更好的在社区生活 服 务 护理之家提供的服务包括护士，护理助手和助理服务，物理，职业及语言治疗师，社会工作者及康乐助理和食宿大多数护理机构提供的认证服务是护士助理，而不是由技术人员担任平均每 100 个居民拥有 40 张病床和 40 个认证的护士助理注册护士执照的护士和数量均明显低于每 100 个居民拥有和 7 张病床和每 100 个居民拥有 13 张病床 参加医疗保险和医疗补助的护养院都必须达到联邦工作人员和服务质量方面的要求才能为居民服务。

2004 年，16,100 家护理机构中，98.5％的护理机构被证实参与全国范围的医疗保险，医疗补助 医疗保险包含了在 20 到 100 天之内为那些需要熟练的护理或康复服务的护理受益人提供至少连续三天的贴身服务该保险不包括照顾只需要监护的人例如，当一个人需要帮助洗澡，散步，或从床上移到椅子上是不包括在里面的要获得医疗保险所指的专业护理，医生必须证明受益人需要熟练的日常护理康复技术或其他相关的住院服务，而且这些服务，作为一个实际问题，必须在提供住院的基础上例如，中风后住院和物理治疗，或在技术熟练的护理之下，受益人的伤口在手术后需要公布的受益者，可能是医疗保险包含的护理资格 民营护理之家是指提供一个独立的医院服务为基础的机构一个独立的机构是一般护理之家的一部分，涵盖了通过医疗补助，通过长期护理保险或医疗保险服务，以及民营护理之家长期护理服务的一部分一般来说，民营护理之家为患者所提供的医疗保险弥补的只是一个独立的护理之家常住人口总量的一小部分 医疗护理还包括那些需要监护，并按要求提供的相应等级的家庭护理如护理之家居民的身体障碍或认知障碍，需要 24 小时护理以满足一个国家的经济状况调查的入息及资产审查。

家庭护理费用可以达到每月数千元成本很高的护理往往都是一些消耗资源的护理如果符合资格，涵盖在医疗护理范围内的人可以继续保留这些权利然而，那些病人要求保护他们的毕生积蓄或资产 美国政府的管制和监督 在美国所有护理院接收医疗保险和医疗补助的资金是受联邦法规所规定的负责疗养院检测的被称为测量师，通常叫做情况检测师情况检测师可察看遵守执照（国家规定）认证（医疗保险和医疗补助的规定） “最小数据集”评估是美国联邦政府规定的部分，它是指对参与了医疗保险或医疗证明疗养院的所有居民进行全面评估的过程最小数据集的评估是一个筛选评估，在对每个居民的行为能力进行全面评估的基础上，帮助养老院工作人员识别并帮助居民达到健康的标准或应付其他需求 最小数据集会产生一种，用于偿还所有医疗保险，并在许多国家用来设置网络档案系统的报销的“资源利用组” 对于美国护养院和网络档案系统服务中心，医疗保险和医疗补助有一个网站，这个网站允许用户执行监督某些机构指标网站内容管理系统还出版了用于监督的设施清单用来衡量护养院的经营情况美国政府责任办公室已发现养老院视察的数目问题严重已经对目前的居民造成了危险美国政府责任办公室的结论是，虽然合作医疗监督有所改善，但在护理安老院的监督方面仍有薄弱环节。

2008 年 9 月发表的一份报告发现，2007 年，超过90％的家庭护理存在联邦卫生和安全的隐患，约有 17％的家庭护理有缺陷，这种缺陷造成了患者的实际损害或即时危害 养老行业被认为是国家两个最重要的行业之一，（另一个是核电工业） 医疗保险和医疗补助调查 适用护养院和网络档案系统的联邦监管和检查（测量）运用研究于1965 年创建的医疗服务质量模型该模型包含护理团队，护理程序和结果的概念 护理团队 调查发现，医疗结构是养老院的资源，这包括工作人员，他们的知识和技能，政策，程序，记录，设备等，护理团队是测量组织关怀的工具 护理程序 在实际中，护理程序是养老院的资本调查过程表明每个居民需要适当性，及时性的服务护理程序是由 5 种脑力和体力活动所组成的：测量，规划，执行（代），评估和传播 这些活动必须是完整的，并共同执行的遗憾的是这些过程都以任务而不是以居民为中心一个有责任的护士在发现伤口的时候可以有序的进行换药并就行伤口评估养老中心的护士早就知道治疗会导致居民的痛苦和术前的痛苦在治疗中，她（或他）将与居民交谈，并以此来分散他们的注意力从而达到减少居民痛苦的目的与那些处在特殊情况下的居民讨论各种问题，可以大大的提高他们的舒适感。

在这种特定的情况下，护士也能够做好纵向跟进，这保证了更持久的实施效果 结 果 在医疗服务质量模式中，结果被假定为医疗程序的结果，医疗程序被假定为需要的医疗团队一个结果可能是一个间接地支持照顾居民的结果一种间接治疗或设施治疗结果主要用于监督和纠正或培训员工，改变员工的知识和技能工作人员应用这些新技术的过程是一个产生更好居住效果的过程失败的结果可能被归类为物理结果（死亡，疾病，残疾或功能障碍）和心理结果（不适，不满） 结果通常是指居民的健康状况，福利，病人满意度等，这种结果通常是用来提高护理人员的护理经验 消费者选择 目前的趋势是向他们提供满足重要人士所需要的支持和长期的生活安排事实上，在美国，作为一个真正选择制度改革的研究结果显示很多人住在社区是都能够回自己的家 私人护理机构可以提供能够陪护的私人护士 在考虑为那些不能独立生活的人安排生活时，潜在客户认为多看看养老院和辅助生活设施记住每个人并能独立照顾自己是非常重要的许多家庭选择选择养老院都是选择那种充满爱心的，每天只要戴在养老院几个小时的养老院 从 2002 年开始，医疗补助就建立了一个比较网站，旨在促进养老院之间的良性竞争 趋 势 在美国，一些养老院已经开始改变他们的管理模式和组织结构，旨在创造一个更加以居民为中心的环境，所以他们更注重“家庭式”或“医院一样”的养老院，这些家庭共用一个厨房和客厅。

护理人员的任务是照顾好其中的一个“家庭”白天，当他们醒来时，当他们吃饭时，当他们想做什么时工作人员可以为他们服务他们也有机会获得更多的陪伴，如宠物的陪伴运用这种管理模式的机构将它称为“文化转向”或“文化变革”，例如长期照护，这种护理之家，被称为“温室” 面向任务的护理 任务导向的护理是指给护士分配具体的任务，一个护士负责一个特定的病房如果居民遇到特殊情况，那么，在一段时间内会有很多护士照顾她如果居民遇到问题，护理人员随机安排，护士被要求与居民建立密切的关系、美国的护士资格培训是任务导向在有营业资格的护士之家，它的主要从业者是有职业资格的护士经过认证的护理之家是病人的主要照顾者职业资格学院的培训要求培训时间和实际工作时间总共要达到 75 小时以上，并且必须通过口头或书面测试因此，美国的养老院，对护理者的培训是一项责任 居民护理 以居民为主的护理，是指护士被分配到特定的患者并有能力与病人建立良好的关系在一个机构中，就像大多数家庭一样，患者都被治疗了采用居民为主的护理，可以使护士与每个病人都更熟悉，照顾他们的特殊需求，无论是情绪上的还是医疗上的与此相反，以机构护理为中心的护理院其重点是工作人员的便利和效率。

在这里工作人员只是执行任务，而不是通过与居民互动而达到理想的居住成果凡驻地为中心的工作人员都知道你的名字，机构工作人员通过房间号码识别，诊断，例如帮助那些有需要的居民进食 科学发现 根据不同的调查结果显示，住在以居住为主的护理院，可以得到高质量的服务护理人员被要求要多关注一下病人，并与他们多相处大量的问题都是在初级护理检查之后才发现的在护理人员长时间的照顾病患之后，会慢慢的发现很多病患应注意的问题一旦体验过这种模式的护理，护士往往会更喜欢以居住中心这种模式虽然居民为导向的护理不能够延长生命，但是他们可以通过与人们交流来消除许多寂寞和不满的感受 轮流看护是指让所有人享受到同等的服务有了这个特定的系统，养老院会为居住在这里的人负责然而，这一系统的执行可能会引起问题，那些被分配照顾居民的护士和护理者会与居民们产生良好的感情当他们被调走或者离开时，他们会舍不得 各种研究结果表明，为了完成任务而去照顾居民会引起居民的不满在许多情况下，向居民透露信息会让他们变的慌乱，因此决定不透露所有信息 患者通常抱怨有寂寞和流离失所的感觉 “居民转让是指轮流着照顾居民，而不是一个护士照顾一个特定的居民 因为一个看护身上的负担可能很重，所以很多看护不能用一个居民的感情和物质方面的经验来定义居民的信息，这些信息可能是错误的或者是没有事实根据的，因为很多的看护轮流照顾一个居民。

应急处理 在看护病人的时候遇到紧急情况往往是令人生畏的任务，它包括着事件很容易失去控制和没有缓和的时间目前）只有一些可以运用的应急方案或操作标准程序幸好，还是有很多作家出版了关于这些话题的评论性文章 英 国 2002 年，英国的护理院因为有特定的居住环境和护理人员好和总所周知在英国护理院及护理安老院是由英格兰，苏格兰，威尔士和北爱尔兰的不同组织组成的 进入一家养老院，你需要当地市议会对您的财务状进行评估您可能还必须通过护士对你的评估，看你是否需要被护理 在英国，2009 年四月，资金下降底线是 13500 英镑，在这个水平上，所有的从退休金，补偿金，救济金和其他除了个人花费的津贴（当前是 21.9 英镑）以外的经济来源，都将用于支付房子看护当地的政务为提供被占据房间不比当地常态的房间贵这件事做出了持续的贡献目前，拿汉普夏郡打个比方，如果居民支出多于这个平均数字，政府就不会支付任何东西，一个三口之家必须做出贡献或者施舍，否则居民就搬到一个更便宜的房子里去在低收入居民和高收入居民之间的居民，领着带有很少的私人花费津贴的工资他们得到每周大约是 250 英镑的工资， 处在高收入和低收入居民之间。

政府会支付多余的部分，国民和原来的情况一样这是因为找到一个在政委会限定下能够使用政委会的资金而且避免日后搬走房子是很完美的超过医药费 23,000 英镑的病人们，在看护病房需要支付全额费用，直到他们的财产跌至最低限度那些需要额外看护的病人们估计这些费用（汉普夏郡看护在 2009 年是 483 英镑）并且通过国际健康服务接受另外的财政支持 (103.80 英镑)，这就是所谓的储备看护 作为卫生署网站上详细的多学科的评估过程国民保健服务的资金已全部用于保证给居民提供的护理符合医疗保健的标准并负全部责任是确定的 英国的成人护理安老院是受护理质量委员会所管的，这取代了社会的监管英国的成人护理安老院至少每 3 年要被检查一次在威尔士，威尔士照管标准监察局负有监督的责任，在苏格兰，苏格兰委员会的护理法规和北爱尔兰的法规质量促进了北爱尔兰委员会的法律监管力度 2010 年 5 月，联合政府宣布成立一个独立的委员会负责资助长期护理，这是由 12 个月份的人口老龄化医疗融资报告造成的护理质量委员会本身也重新实施了登记过程，2010 年十月竣工，这将导致 2011 年四月新的管理形式的产生 资料来源：Nursing home [EB/OL].http://en.wikipedia.org/wiki/Nursing_home，2010.6 外文原文： Nursing home From Wikipedia, the free encyclopedia A nursing home, convalescent home, Skilled Nursing Unit (SNU), care home or rest home provides a type of care of residents: it is a place of residence for people who require constant nursing care and have significant deficiencies with activities of daily living[citation needed]. Residents include the elderly and younger adults with physical or mental disabilities. Residents in a skilled nursing facility may also receive physical, occupational, and other rehabilitative therapies following an accident or illness. Residents may have certain legal rights depending on the location of the facility. United States In the United States, a "Skilled Nursing Facility" or "SNF" is a nursing home certified to participate in, and be reimbursed by Medicare. Medicare is the federal program primarily for the aged who contributed to Social Security and Medicare while they were employed. A "Nursing Facility" or "NF" is a nursing home certified to participate in, and be reimbursed by Medicaid. Medicaid is the federal program implemented with each State to provide health care and related services to those who are "poor." Each State defines poverty and; therefore, Medicaid eligibility. Those eligible for Medicaid may be aged, disabled or children (e.g. Children's Health Insurance Programs - CHIPs and Maternal-Child wellness and food programs). In the United States, each State "licenses" its nursing homes, making them subject to the State's laws and regulations. Nursing homes may choose to participate in Medicare and/or Medicaid. If they pass a survey (inspection), they are "certified" and are also subject to federal laws and regulations. All or part of a nursing home may participate in Medicare and/or Medicaid。

In the United States, nursing homes which participate in Medicare and/or Medicaid are required to have licensed practical nurses (LPNs) (in some States designated "vocational nurses" or "LVNs") on duty 24 hours a day. For at least 8 hours per day, 7 days per week, there must be a registered nurse on duty. Nursing homes are managed by a Licensed Nursing Home Administrator. Unlike U.S. nursing there are no standardized training and licensing requirements for administrators, though most states require a Federal License, and many states such as California have their own licensure for administrators. On April 18, 2005 there were a total of 16,094 nursing homes in the United States, down from 16,516 on December 12, 2002. There are states that have other levels of care offered to elderly and other adults who need assistance and are able to live in the community. For instance, Connecticut has Residential Care Homes or RCH that are licensed by the State Department of Public Health. These homes provide 24-hour supervision and typically offer a more "home-like" environment. Many are actually large homes that have been converted to dwellings that offer a residential community that promotes an independent lifestyle and fosters fellowship with others who need some form of assistance to live in the community.[1] Services Services provided in nursing homes include services of nurses, nursing aides and assistants; physical, occupational and speech therapists; social workers and recreational assistants; and room and board. Most care in nursing facilities is provided by certified nursing assistants, not by skilled personnel. In 2004, 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 2004, 98.5% 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 Medicare-covered skilled nursing facility (SNF) care, a physician must certify that the beneficiary needs daily skilled nursing care or other skilled rehabilitation services that are related to the hospitalization, and that these services, as a practical matter, can be provided only on an inpatient basis. For example, a beneficiary released from the hospital after a stroke and in need of physical therapy, or a beneficiary in need of skilled nursing care for wound treatment following a surgical procedure, might be eligible for Medicare-covered SNF care. SNF services may be offered in a free-standing or hospital-based facility. A freestanding facility is generally part of a nursing home that covers Medicare SNF services as well as long-term care services for people who pay out-of-pocket, through Medicaid, or through a long-term care insurance policy. Generally, Medicare SNF patients make up just a small portion of the total resident population of a free-standing nursing home. Medicare also covers nursing home care for certain persons who require custodial care, meet a state's means-tested income and asset tests, and require the level-of-care offered in a nursing home. Nursing home residents have physical or cognitive impairments and require 24-hour care. The cost of staying in a Nursing home can cost several thousand per month or more.[3] Some deplete their resources on the often high cost of care. If eligible, Medicaid will cover continued stays in nursing home for these individuals for life. However, they require that the patient be "spent down" to a low asset level first by either depleting their life savings or asset-protecting them, often using an elder law attorney. U.S. Government regulations and oversight All nursing homes in the United States that receive Medicare and/or Medicaid funding are subject to federal regulations. People who inspect nursing homes are called surveyors or, most commonly, state surveyors. State surveyors may inspect for compliance with licensure (State regulations) and/or certification (Medicare and Medicaid regulations). The "Mininimum Data Set" assessment (MDS) is part of the U.S. federally mandated process for comprehensive assessment of all residents in Medicare or Medicaid certified nursing homes. The MDS assessment is a screening assessment that forms the basis of a comprehensive assessment of each resident'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 2008 found that over 90% of nursing homes were cited for federal health or safety violations in 2007, 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 outcome. Structure For surveying, structure is the nursing home's resources. That includes staff, their knowledge and skills, policies, procedures, records, equipment, buildings, etc. Structure surveying looks at the instrumentalities of care and their organization. Process Process is the nursing home's resources in action. Process surveying looks at the appropriateness, timeliness and quality of care and services in relation to each resident's needs. Process can be organized into 5 kinds of intellectual and physical activities: assessing, planning, implementing (acting), evaluating, and communicating. These activities must be integrated and often occur together. Unfortunately these processes can be task or resident-centered. A task nurse implements a physician ordered-dressing change, perhaps assessing the wound while it is uncovered. A resident-centered nurse would already know if the treatment causes the resident pain and pre-medicated the resident. During the care, she (or he) will talk with the resident about topics they have both shared before, distracting the resident from discomfort and addressing social needs. Communication is heightened when residents feel comfortable discussing various issues with someone who is experienced with their particular case. In this particular situation nurses are also better able to do longitudinal follow up, which insures the implementation of more lasting results Outcome In Donabedian's model, outcome is assumed to result from processes and processes are assumed to require structures. An outcome may be a facility outcome which indirectly supports direct resident care. An example of an indirect or facility outcome 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 outcomes. Resident outcomes may be classified as physical (death, disease, disability or dysfunction) and psychosocial (discomfort, dissatisfaction). Resident outcomes are usually specified in terms of health, well-being, patient satisfaction, etc. Resident outcomes 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 U.S. as a result of the Real Choice Systems Change Grants, shows that many people are able to return to their own homes in the community. Private nursing agencies may be able to provide live-in 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 person's abilities to take care of themselves independently. While certainly not a residential option, many families choose to have their elderly loved one spend several hours per day at an adult daycare center. Beginning in 2002, Medicare began hosting an online comparison site intended to foster quality improving competition between nursing homes. Trend In the U.S. a few nursing homes are beginning to change the way they are managed and organized to create a more resident-centered environment, so they are more "home-like" and less institutional or "hospital-like." In these homes, units are replaced with a small set of rooms surrounding a common kitchen and living room. The staff giving care is assigned to one of these "households." Residents have far more choices about when they awake, when they eat and what they want to do during the day. They also have access to more companionship such as pets. Many of the facilities utilizing these models refer to such changes as the "Culture Shift" or "Culture Change" occurring in the Long Term Care, or LTC, industry. Sometimes this kind of nursing home is called a "greenhouse." Task-oriented care Task oriented care is where nurses are assigned specific tasks to perform for numerous residents on a specific ward. Residents in this particular situation are exposed to multiple nurses at any given time. Because of the random disbursement of tasks, nurses are declined the ability to develop more in depth relations with any particular resident. Licensed (vocational) nurse training in the United States is task oriented. The primary care giver in a certified nursing home is a "Certified Nurses Aide" (CNA). CNAs receive a minimum of 75 hours of didactic and practical task-oriented training and must pass an oral or written test. Thus, in U.S. nursing homes, the training of the majority of direct care-givers in nursing homes is task oriented. Resident-oriented care Resident oriented care is where nurses are assigned to particular patients and have the ability to develop relationships with individual patients. Patients are treated more as family, as opposed to random patients in an institution. Using resident-oriented care, nurses are able to become familiar with each patient and cater more to their specific needs, whether they be emotional or medical. In contrast, institutional care is institution-centered. The focus is staff convenience and efficiency. Staff perform tasks rather than interact with residents to achieve desirable resident outcomes. Where resident-centered staff know residents by name, institutional staff identify residents by room number, diagnosis, or a task like "feeders" for residents who need help to eat. Scientific findings According to various findings residents who receive resident-oriented care experience a higher quality of life, in respect to attention and time spent with patients and the number of fault reports after the introduction of Primary Nursing. Once they experience it, nurses often prefer resident-oriented settings, too. Although resident-oriented nursing does not lengthen life, nursing home residents are able to connect with someone, which allows them to dispel many feelings of loneliness and discontent. "Resident assignment" refers to the extent to which residents are allocated to the same nurse. With this particular system one person is responsible for the entire admission period of the resident. However, this system can cause difficulties for the nurse or care-giver should one of the residents they are assigned to pass away or move to a different facility, as the nurse/caregiver may become attached to the resident(s) they are caring for. Various findings suggest that task-oriented care produces less satisfied residents. In many cases, residents are disoriented and unsure of who to disclose information to and as a result decide not to share information at all. Patients usually complain of loneliness and feelings of displacement. "Resident assignment" is allocated to numerous nurses as opposed to one person carrying the responsibility of one resident. Because the load on one nurse can become so great, various nurses are unable to identify with gradual emotional and physical changes experienced by one particular resident. Resident information has the ability to get misplaced or undocumented because of the numerous amounts of nurses that deal with one resident.[citation needed]. Emergency management Dealing with an emergency in nursing home is always a formidable task which involves the damage control and mitigation of the event. Not many written plans or standard operating procedures are available publicly, except for a few [9]. However, there are published academic reviews about the topic written by many authors [10], [11], [12]. United Kingdom In 2002 nursing homes became known as care homes with nursing and residential homes became known as care homes [13]. In the United Kingdom care homes and care homes with nursing are regulated by different organisations in England, Scotland, Wales and Northern Ireland. To enter a care home, you need an assessment of needs and of your financial condition from your local council. You may also have an assessment by a nurse, should you require nursing care. The cost of a care home is means tested in England. As of April 2009 in England, the lower capital limit is £13,500. At this level, all income from pensions, savings, benefits and other sources, except a "personal expenses allowance" (currently £21.90), will go to paying the care home fees. The local council pays the remaining contribution provided the room occupied is not more expensive than the local council's normal rate, currently £364.48 for Hampshire for example. If the resident is paying more than this the council will not pay anything and contributions from a third party or charity must be found or the resident move to a cheaper care home. Between the lower and the upper capital limits, the resident pays their income less personal expenses allowancek for every £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 council's limit if council funding is likely to be required to avoid a forced move later. Patients with capital over more than £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 2009 £483pw) and receive additional financial support (£103.80pw) through the National Health Service (NHS); this is known as [[Funded Nursing Care}}. The NHS has full responsibility for funding the whole placement if the resident in a care home with nursing meets the criteria for NHS continuing Health Care. This is identified by a multi-disciplinary assessment process as detailed on the DOH website. Care homes for adults in England are regulated by Care Quality Commission, which replaced the Commission for Social Care Inspection, and each care home is inspected at least every three years. In Wales the Care Standards Inspectorate for Wales has responsibility for oversight, In Scotland the Scottish Commission for the Regulation of Care and in Northern Ireland the Regulation and Quality Improvement Authority in Northern Ireland. In May 2010, the Coalition Government announced the formation of an independent commission on the funding of long-term care, which is due to report within a 12-month timeframe on the financing of care for an Ageing population. The Care Quality Commission have themselves implemented a re-registration process, completed in October 2010, which will result in a new form of regulation being outlined in April 2011[citation needed] 。