However, some of the conditions present in the populations that would normally be cared for in a nursing home require staff preparedness.  This includes managing pulmonary issues, skin integrity issues and appropriate human transfer and lifting techniques that assure the safety of the resident and the health of the direct care worker.  This makes training to serve the medically fragile really important.  In addition training in how to develop such a residential program that makes it marketable, stable and protected from certain liability is equally important for owners and administrators.  Read more about how to develop this kind of a program in future issues of American Care News.  Have you subscribed?  To learn more about live training and training on DVD about the development of programs for the medically fragile contact our Deputy Editor, Mr. Marty Hill at 248.987.6844 or send him an e-mail to:  mhill@americancarenews.com.