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.

21- Jul2016
Posted By: Tony Fischer
115 Views

Home Care: How It Works

Home Care is the fastest growing segment of the senior healthcare continuum and for good reason. Seniors want great healthcare but they also want control.  With the negative stigmas surrounding nursing homes, seniors are often choosing care in their own home rather than care in a facility.

Nursing Home care has its place in the healthcare continuum but it is costly.  With monthly rates ranging between $8,500 to $15,000 many are opting to spend their healthcare dollars in the comfort of their own home. Medicare has also shifted healthcare dollars by cutting funding to nursing homes and funding pilot programs designed to promote home care innovations.

With so much opportunity comes competition.  Thousands of Home Care companies have sprung onto the market hoping to capitalize on the Baby Boomer retirement rush causing confusion for consumers and referral sources.

Every level of the senior care continuum has its place but large caseloads prevent social workers from spending the time it takes to explain how each level works.

In this post we will talk about home care, how it starts and how it works.

How it Starts

Home Care is covered by Medicare Part A. It is approved in 60 day increments called “certification periods”.  In order for someone to qualify for Home Care they must be homebound.  Homebound is defined by Medicare as an individual who is confined to home because …a condition, due to an illness or injury, that restricts the ability of the individual to leave his or her home except with the assistance of another individual or the aid of a supportive device… according to the Centers for Medicare Advocacy.

A patient doesn’t need to have a qualifying hospital stay in order to begin home care but they do need an order from a doctor.  That order can come at any time but must be prescribed specifically to treat a particular diagnosis. Additionally it must be explained to the patient why they are being prescribed home care treatment (called a face-to-face).

Home Care is an excellent tool if used to prevent a possible hospital stay.  If prescribed at the first sign of weakness or exacerbation of a chronic illness it can prevent the senior from entering a cycle of hospitalization.

How it Works

After the home care company receives the referral they have 48 hours to open the case.  In order to do that a nurse must go to the patient’s home to complete an evaluation.  After the case is opened a physical therapist and sometimes an occupational therapist will come out to complete their own evaluations.  After all the initial evaluations and paperwork is complete, the treatment team will decide on a schedule (also known as frequency) they will use to provide the physician directed treatment.

As with any other type of short-term health care insurance, coverage only continues if the patient continues to show progress. Coverage ends when the patient achieves their treatment goals or stops showing progress toward them.