levels of care in one location; for example, people living in the community can elect to live in total independence in their own apartment-like units, in congregate housing, or, if they have a serious and immediately health problem, in the nursing home. Arranged like a campus, facilities include independent living units, a health care center, and a nursing home.
The general purpose of these extensive facilities are to meet residents changing health care needs. Ms. Rose has recently experienced a change in her health care needs. One month ago, she had been living in the congregate housing area of the campus, a part of the facility that provides those living there with organized social and recreational activities, assistance with housekeeping, meal service, medical assistance, transportation, home health care, and custodial care. However, when she fell and broke her hip, she was moved to the nursing care facility following a stay in the hospital.
Ms. Rose is a difficult patient in that she is very distressed about finding herself in the nursing care facility. She insists that she is not "frail and enfeebled like these old folks." Every day she asks staff when she will be able to go back to the congregate housing facility. And, when she is told th
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