18- Dec2016
Posted By: Tony Fischer
170 Views

Understanding Nursing Home Rehab

Most seniors and their families spend a lot of time planning how to stay out of the nursing home.  Those perceptions of nursing homes are often tainted by old stereotypes. Although Nursing Homes still provide long-term care, they also provide effective short term rehabilitation services for seniors recovering from extended illness or injury. Nursing Home rehab can actually be a short stop on the road back home after illness.

100 days of coverage? Not necessarily

Nursing Home used to be known for a slower pace of therapy, which was helpful for seniors recovering from illness.  In recent years therapy in the nursing home has become more aggressive measuring progress on a daily basis rather than the weekly measure they used before.  This change in approach has dramtically reduced the length of stay for those receiving therapy in the nursing home.

The common misunderstanding among seniors and families is that they get 100 days of Medicare coverage as long as they are receiving therapy.  While Medicare does provide for 100 days of coverage it does not mean that the patient will actually receive that amount.  The patient will only be covered as long as they are showing “progress” toward therapy goals.

Who determines progress?

Nursing Home therapists will tell you that it is Medicare that determines whether a patient is making progress. While this is true, much of how that decision is made depends on how the therapist documents therapy treatments.

Medicare determines progress through regulation and precedent with the facility they are dealing with. There is not some room where someone from Medicare waits to review daily therapy notes.  Instead a therapist estimates coverages based on how Medicare has approved billing in the past. The notes are only reviewed during random audit or if the patient appeals the coverage decision.

Directed Therapy Goals

Because the process for determining progress is highly subjective, it is vital to make sure the therapist understands your personal goals.  If the senior is returning home, the therapist should understand what abilities and skill the senior will need in order to remain safe. For example, if the senior has limited support at home they may need to be strong while standing in order to use the bathroom safely.  If responsible for preparing their own meals, they may need to work on adaptations to make that task easier.

By directing the therapist to focus on practical outcomes, rather than a focus on general goals like walking distance, a patient can help define progress as it relates their patient-centered treatment plan. This will improve your therapy outcome and get the most coverage out of your nursing home rehab stay.

Categories:
27- Aug2016
Posted By: Tony Fischer
167 Views

Senior Care Planning: Avoid Over-Paying For Long Term Care

There is a common theme among seniors and their families who are using the long term care system.  Most of them are overpaying.

Seniors are paying too much for long-term care because they lack understanding of how the senior healthcare system works. There are multiple levels of the senior healthcare continuum and although they vary slightly from state to state they still offer plenty of options for seniors; many of which provide better outcomes at a lower cost.

NURSING HOMES ARE THE DEFAULT LONG TERM CARE PLAN!

Patients who are 65+ and need some extended rehabilitation after a hospital stay will probably be encouraged to discharge to the local nursing home. In some circumstances this is the right plan. Nursing Homes are a vital part of the healthcare continuum but seniors only need nursing home level of care if they are have a condition that requires constant monitoring by a doctor or nurse.

Nursing Centers also provide excellent therapy programs for patients needing a more intense therapy intervention than they can get at an outpatient clinic. However unless you a senior needs extensive assistance to attend and complete therapy, there are other options that could be more effective.

OUTPATIENT THERAPY

If a senior has the support of family or friends to help them get to their therapy appointments, outpatient therapy may be the best option. Therapists at this level are focused on a patient’s mobility in the community instead of mobility in a facility.  The therapy sessions are more intense and usually involve more up-to-date equipment than that of the nursing home.

ASSISTED AND INDEPENDENT LIVING

These facilities offer a variety of services for seniors at the fraction of the cost.  Services are often provided onsite, eliminating the need for transportation, and usually include therapy, nursing, incontinence care, medication pass, housekeeping, light meal prep and more. These services can also be increased or scaled back depending on the senior’s health condition. This enables them to manage their precious financial resources.

HOME CARE SERVICES

For those seniors who need assistance without the constant monitoring from a doctor or nurse. Home Care might be the best way to go. Home care is perfect for those who need therapy and nursing treatment but at less of a frequency.

That said home care does have an element of DIY and has the best outcome when supported by family and friends.  Our Senior Care Sherpas can evaluate the seniors current need and help develop a plan that is effective a cost efficient.  Fill out the form below to set up a free consultation.

MORE COST EFFICIENT

According to Genworth.com average cost for Nursing Home nationwide ranges from $6,844 to 7,689.  In some states costs can reach as high as $14,000 a month!  Why so expensive?  Medicare only covers 100% for 20 days into your stay. After that there is a 20% co-payment that could cost around $160 a day!  Nursing Home care is so expensive because of  the licensed and certified staff needed to meet federal and state guidelines.

Unless a senior has a health condition that requires these expensive services, explore other options. There may be services that would be better and cost efficient options suited to meet current needs.