19- Jul2016
Posted By: Tony Fischer
75 Views

Finding A Nursing Home: Four Insider Tips

Finding a nursing home can be one of the most stressful tasks a caregiver can take on.  The negative stigma attached to nursing homes creates fear among seniors and the family caring for them.  Adding to this fear that the cost of care will consume the nest egg that has taken a lifetime to save.

These factors prevent seniors and their families from discussing the scenarios in which care in a nursing home is necessary. It also prevents seniors from developing a plan to search and pay for this level of the senior healthcare continuum.

This post highlights four insider tips a family member can use before touring the nursing home to narrow down the large list of choices in the area.

Tip #1. Call First

Communication is key component of good customer service.  Nursing Homes that fail to communicate have significantly more complaints than others.  There is no better way to evaluate a nursing homes communication than giving them a call.

When you called:

  • Did a real person answer the phone instead of a recording?
  • Was the receptionist polite and professional when she answered?
  • Did they connect you to the person you needed to talk to?
  • Did the nursing home call you back within a reasonable time?

Tour Tip: If the answers to these questions is no then the nursing home may have an issue with communication. Look for common communication tools like newsletters and postings about resident and family council meetings.

Tip #2: Check the Want Ads

Before you decide to tour the nursing home you should check the want ads. It may sound strange but nursing homes with a lot of turnover may be in crisis.  This is especially true if the job ads are for key positions like Director of Nursing or Administrator. It is very difficult for a nursing center to provide good service during a transition in leadership.

Tour Tip: Ask the manager giving you the tour about staff turnover and staffing ratios.  Also ask about the facilities use of staffing agencies.  If a nursing home uses a staffing agencies to fill gaps in their schedule they may have issues with customer service.

Tip #3: Ask At Area Churches

Every church has an outreach program that visits area nursing homes. Volunteers from these programs are in these facilities weekly and often witness the good, bad and ugly.  If you church visits a nursing home you are considering seek out and ask the outreach coordinator. They may have valuable insight into your choice.

Tour Tip: Look at the nursing homes activity calendar for groups run by area churches and community groups.  Nursing Homes that open themselves up to community involvement are typically more accountable and transparent.  That accountability usually translates into better patient care.

Tip #4 Look for Credentialing and Insurance Coverage

Before touring the nursing home you want to ask about insurance coverage.  As a general rule facilities that accept many different types have more accountability than others.  This is because each insurance has its own credentialing process the nursing home must comply with in before they are allowed to accept payment.  Nursing homes that accept multiple insurances usually have an enhanced quality improvement process to handle resident and family concerns.

You may also want to check credentialing. Nursing centers are only required to be licensed by Medicare.  Nursing homes may seek an additional level of credentialing to enhance customer service and patient care.

Tour Tip:  Facilities who have additional credentialing will have it posted within the facility, on their marketing material and on their website.

18- Jul2016
Posted By: Tony Fischer
98 Views

Answers to Common Questions About Medicare In The Nursing Home

The most common questions seniors have about paying for long term care involves Medicare.  Most people assume Medicare covers long-term care in the nursing home.  Others confuse it with its state-funded cousin Medicaid.

The confusion is caused by Medicare’s coverage of sub-acute services or short-term rehab.  This service is often provided in a nursing home and can last up to 100 days if the patient is able to show progress toward therapy goals. Unfortunately most patients admitted under Medicare coverage for nursing home rehab will stay between only 14 and 21 days depending on their condition.  In order for someone to be covered for 100 days of sub-acute care they would have to be either very sick or have used their coverage over the course of several admissions.

Here are some common questions about using Medicare while in a nursing home.

WHEN DOES MEDICARE KICK IN?

A patient becomes eligible for sub-acute care after a qualifying three-day hospital stay.  In order to have a qualifying stay a patient must be ADMITTED to the hospital. Observation stays don’t count.  They must be admitted.  This has become an important distinction in recent years as hospitals will sometimes avoid admitting patients because of new rules meant to reduce readmission.

If you are not sure if the senior you care for has been admitted to the hospital ask the nurse in charge. It may not only affect your eligibility for nursing home coverage but you may find yourself looking at a big bill.

WHO DECIDES HOW LONG COVERAGE LASTS?

Each nursing home patient is assigned members of the Interdisciplinary Team (or IDT for short.)  The IDT meets on a regular basis and develops a care plan for each sub-acute patient based on diagnosis, current condition and projected discharge plan.

They work together to develop goals that the patient must achieve in order to become discharged.  These goals and the progress made toward them determine the amount of time a patient is covered.  Coverage ends when a patient reaches those goals or has reached their maximum rehab potential.

Medicare coverage can renew if a person goes for 60 days without using their Medicare for admission to the hospital or sub-acute care.

SO WHAT ABOUT AFTER REHAB WHAT THEN?

Medicare is only designed to cover patients for the short term. Medicare coverage alone is not enough to cover long-term care services whether in a nursing center or at home.  Medicaid, long-term care insurance or Veterans Aid and Attendance are benefits that can cover long-term care.  Otherwise patients will have to pay out-of-pocket.

Read Related: Paying For Long Term Care

Editors Note:  The nursing home industry uses the term Resident to refer to people who have been admitted for either short-term or long-term care. To avoid confusing the reader we have used the more universal term patient to refer to those admitted to nursing homes.

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