In the United States Nursing or long term care facilities provide different levels of care depending upon a person’s needs. Generally, people who live in skilled nursing homes need a lot of care while those in residential care facilities do not. Compliance to local, state and federal regulations cost facilities thousands of dollars due to the fact that at risk populations have been compromised by poor health conditions or risky behavior of healthcare workers within a facility. Noncompliance also cost facilities in law suits for wrongful death, settlements, corrective actions, re-inspections, fines and specialist required to correct cited deficiencies.
In 2009 there were approximately 15,658 nursing homes with 1.66 million beds, 1.4 million residents.
Across the United States of the 15,658 nursing homes, about 156,000 deficiencies were issued for violations of federal regulations, indicating violation of quality of life issues. Violations of food sanitation regulations were found in 35% percent of the 15,658, with a larger percentage receiving deficiencies for failure to meet quality standards in food Sanitation. Such problems also account for more than an estimated 125,000 Americans deaths annually (342 people every day) due to poor medication adherence and 10% - 25% of hospital and nursing home admissions, of people's inability to take their medications as prescribed ( Compliance Packaging Council). Healthbeat (Health Human Service Publication HHS) reports noncompliance raises healthcare costs by about $100 billion due to increased hospital and nursing home admissions. It may also be one of the reasons when medical treatment fails.
Center for Medicare Service establishes requirements for nursing home participation in the Medicate/Medicare Program. Skilled nursing facilities must meet over 400 requirements, broken down into three levels. The first level consists