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SKILLED NURSING FACILITIES—FREQUENTLY ASKED QUESTIONS
Moving yourself or a loved one into a facility is never an easy decision. The thought of making such a decision can cause anxiety, anger, guilt or depression.
Below is helpful information to consider before your visit to the community.
With strict state regulations and accreditation procedures, today's health care facilities no longer resemble those of the past. Within weeks of placement in today's clean, professionally managed and stimulating health care facilities, the resident generally finds the experience positive—relieving their children's anxiety level.
The hospital discharge planner and the admissions director of the retirement/health care facility will assist you in finding the most appropriate setting and making any arrangements for admission. Be sure to tour the facility before making a decision. If you are unable to visit the facility, ask a family member or close friend to assist you in the selection process.
Consider those facilities which earn superior ratings on their annual state/joint commission surveys. All facilities are required to post their survey results. Also ask about financial certifications—are they licensed to accept Medicare and Medicaid as payment? What insurances are they able to accept?
Try to plan in advance—putting your name on a waiting list does not obligate you to anything. A minimal charge may occur to maintain your status on the waiting list—be sure to ask. Having an idea of where you would like to go if the need should arise can alleviate a lot of anxiety if you should become ill. Keep in mind that lack of financial resources may limit choices.
Consider touring several facilities and take into consideration cleanliness, amount of nursing supervision, menu and dining choices. Trust your instincts.
Not all physicians follow their patients to all facilities. Ask your doctor if he or she will see you or recommend a physician who will. The facility can provide you with a list of doctors who do go to their facility.
Independent—provides a living arrangement which integrates a home like environment and services for seniors who need very little supervision. Services vary so be sure to ask what is included in the rate. Insurances would not cover these expenses.
Assisted living—Temporary or long term assistance is provided twenty-four hours a day. This may include meals, assistance with bathing/dressing assistance with medications, etc. Be sure to ask what is included in the rate. Is there twenty-four hour nursing supervision? Is there a waiting list?
Health care:
- Intermediate Care—Short- and long-term care requiring custodial assistance (not requiring an RN). Medicare, as well as most insurance companies, does not pay for this level of care.
- Skilled Care—Short-term care requiring daily professional care by a RN or a Licensed Therapist. Medicare and other insurance companies do pay for this level of care.
- Subacute Care—Subacute Care provides more intensive skilled care for a short time, usually for someone with multiple medical problems. Medicare considers this level as skilled and pays the same.
Specialized Care units (Dementia/behavioral)—Provides specialized services twenty-four hours a day to those requiring such services. Be sure to ask about resident to staff ratio, criteria for admission, rates and payment source.
Respite Care—Some facilities offer temporary relief for caregivers ranging from two days to a few weeks.
Not all facilities accept Medicaid and Medicare and all managed policies. You will need to discuss this matter with the Admissions Director. Consider your finances before choosing a facility. The facility will want to know how they will be paid.
- Medicare—Medicare will pay a finite number of days under skilled and subacute care if you meet specific criteria. The same conditions apply for Medicare supplements.
- Medicaid—If you qualify, Medicaid will pay most health care costs.
- Managed Care—providers contract with certain facilities. Be sure to ask your provider for a full list of facilities.
- Private Insurance—Long-term care insurance policies are available and must be reviewed carefully for adequate coverage. This may apply to assisted living or health care areas. Be sure to contact the insurance company for coverage details.
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