In addition, a good nursing home should help residents maintain self-esteem, build strength, continue social relationships and interests formed over a lifetime, and even assist in developing new ones. Nursing homes are licensed by the Texas Department of Human Services and must meet state and federal government licensing standards. They are monitored by the Texas Department of Human Services, the U.S. Department of Health and Human Services, the U.S. Occupational Safety and Health Administration, state and local fire safety agencies, and a variety of other government agencies. In all, there are about two dozen agencies monitoring licensed facilities on a regular basis. A board of trustees determines the general policies of the home and implements its mission of care and service to the total person.
Trustees are volunteers who often are leaders of the local community.
Personnel usually include an administrator or executive director, and admissions, personnel, and financial officers. A director of nursing is usually a registered nurse who manages the daily activities of other registered nurses, licensed vocational nurses, and nursing assistants. Other health care professionals, such as therapists, social services staff, nutritionists, and pastoral care staff provide a variety of services. Each nursing home has a designated medical director who coordinates with other staff to ensure the adequacy and appropriateness of the medical services provided to the residents. Nursing home care, like all good health care, is costly.