Nursing Home Placement
When medical conditions prevent an individual from living at home or in an assisted living facility, Horizon Care Services can provide assistance in finding an appropriate nursing home, also called a skilled nursing facility (SNF).
A nursing home provides 24-hour care to people who can no longer care for themselves and have no full-time caregiver. When a person’s health, whether physical or mental, is fragile enough to need constant supervision, a nursing home may be the only option. Choosing a nursing home can be difficult and overwhelming for elderly individuals and their families. It is not a decision that people look forward to making. When family members are not local, it may be even harder to research and decide on an appropriate nursing home. During this difficult time, let Horizon Care Services assist you.
A nursing home may provide temporary rehabilitative care for someone who is transitioning from a hospital to an assisted living facility or home environment. A nursing home can also provide long-term custodial and medical care for permanent disabilities.
A nursing home may be an independent facility or part of a more encompassing senior care community. Regardless of the size, nursing homes must adhere to specific state regulations. A skilled nursing facility provides care by registered nurses, licensed practical nurses, and nursing assistants, who are all under the supervision of a licensed physician.
Most nursing homes provide two basic types of services: skilled medical care and custodial care.
Skilled medical care
Included services by trained professionals that are needed for an acute condition. Skilled care may also be needed on a long-term basis for permanent disabilities and illnesses.
- A registered nurse may be needed for wound care, I.V. monitoring, and medication management.
- A physical therapist may be needed to help a patient regain strength and balance after surgery or an illness.
- A speech therapist can help a person relearn how to communicate after a stroke.
- An occupational therapist may help a person relearn independent self-care, such as eating, grooming, and dressing.
Custodial or personal care
Included assistance with the activities of daily living (ADLs). These include:
- Eating
- Dressing
- Bathing
- Grooming
- Toileting (incontinence)
- Transferring (moving between surfaces such as the bed, chair, and bathtub or shower).
An elderly or injured person may only need assistance with ADLs on a temporary basis while recovering from an acute injury or illness. Others may need permanent assistance if they have lost the ability to function independently due to increasing frailty and chronic disease.
In severe cases when a resident is bed-bound, ongoing supervision by qualified nurses and nursing assistance may be needed along with custodial care. Determining the type of care that is needed is important in terms of who provides the care and who pays for it.
Who pays for what? Medicare, Medicaid, private insurance?
Long-term care insurance
If planned and purchased in advance will usually cover a large portion of nursing home care. Prior planning and purchasing a policy that specifically covers skilled nursing facilities are needed. Most regular medical insurance coverage follows Medicare guidelines. Both regular private insurance and Medicare pay for nursing home care only for a limited period of time following a qualified hospitalization (3 consecutive hospitalized days or more).
Medicare
Medicare does not cover custodial care. However, Medicare will pay for skilled care that is medically necessary such as changing sterile dressings. Medicare Part A will pay for care given in a certified skilled nursing facility under certain conditions for a limited time. Click here to read more about Medicare Benefits.
Medicaid is paid only for Medicaid recipients. Medicaid is a combination state and federally funded program. A person qualifies for Medicaid based on limited income and assets. Often the assistance of an elder law attorney who specializes in Medicaid planning is needed if someone is not already on Medicaid.
Horizon Care Services follows strict criteria before referring a skilled nursing facility. All facilities are personally researched and visited prior to recommendations. Care managers with Horizon Care Services are familiar with local nursing homes, the complaints against them, and current state inspections. The following services and conditions are researched.
- Licensed
- Medicare/Medicaid facility
- Current state inspections
- Clean and orderly
- Nutritious meals that meet medical requirements
- Qualified medical staff and caregivers
- Therapeutic recreation and activities
- Rehabilitation services: physical therapy, speech therapy, occupational therapy
Choosing a nursing home can be difficult and exhausting. You do not need to make this decision alone. Call us today and let us help you.
