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Home » Consumer Information » Elderly Care

A Guide to Nursing Homes

Nursing homes are safe havens for elderly people deemed too sick or frail to live at home. They also serve as recovery facilities during temporary recuperation from disease or illness.

Unfortunately, some nursing homes have also come under scrutiny for their unethical and illegal practices. If you suspect your loved one is a victim of nursing home abuse or neglect, fill out our free case evaluation form.

Selecting a Nursing Home

This day in age, many people are able to live rewarding lives and continue to manage their households with little to no assistance well into their 70s and 80s. However, others who have incapacitating physical or mental conditions often require the sort of attention that can't be provided by family or at-home care; they are better suited by the 24-hour care offered at nursing homes. It is highly recommended to begin researching these facilities prior to an emergency so that no hasty decisions have to be made that may come back to haunt you in the form of nursing home abuse or neglect. For tips that will assist you in selecting a nursing home based on personal preferences and objective measures, read on.

Many elderly residents who are able to maintain a productive level of daily functionality can stay in their homes with the assistance of family and friends, home care agencies, and other community services. These seniors are relieved of such tasks as shopping and food preparation. Delve deeper into the options available for seniors still capable of running their households with daily assistance. Reliable sources to assist with the selection process include a physician and the state Office on Aging.

People who are persistently ill or require nonstop medical care are ideal candidates to make the transition to a nursing home. Some nursing home patients only end up there following extended hospital stays for the sole purpose of receiving intensive care from a licensed nurse or treatment for an injury or debilitating sickness. Others are admitted because they cease to have the ability to manage daily tasks such as bathing, cooking, and excretory functions.

Types of Elderly Care

Contrary to common belief, nursing homes differ in terms of the nature of care provided. Depending on an individual's needs, there are generally three styles of facilities to choose from:

Skilled nursing care

Skilled nursing care is required for medical conditions that warrant treatment by medical personnel such as registered nurses or physical therapists. Some patients receive short-term skilled care following an acute illness, while others may demand long-term care. The course of therapy is usually ordered by a patient's primary care physician, who supervises a treatment plan to be executed in the nursing home.

Intermediate nursing care

Intermediate nursing care is similar to skilled nursing, but it is for more stable conditions that necessitate daily assistance and not round-the-clock nursing supervision. This brand of care is prescribed by the patient's personal doctor and administered by registered nurses. Intermediate care is not quite as concentrated as skilled care and focuses on providing assistance with routine chores such as bathing and eating. It generally lasts for an extended period of time.

Custodial care

Custodial care assists a patient with daily behaviors like eating, bathing, and getting dressed in addition to other habitual tasks. It is normally overseen by those with no medical background because it is simpler to carry out than skilled or immediate care.

Some nursing homes will also offer highly specialized rehabilitation programs. For example, there may be one dedicated to supplying treatment to improve the lives of Alzheimer's patients.

Visiting a Nursing Home

Aside from medical competence, another attribute one must take into account during a nursing home assessment is the social scene. The following are some questions you may want to ask:

  • Is the nursing home close enough to close friends and relatives that frequent visits are plausible?
  • Are there religious services on the premises?
  • Is there an outdoor area for residents to enjoy some fresh air?
  • What kinds of programs and activities can residents participate in?

Discuss values with the potential client, and try to determine their goals in selecting the right home. If this person is not mentally or physically fit to communicate, obtain feedback from friends and family members. For a complete list of options to consider that will help narrow down your search, refer to the Nursing Home Checklist.

Affording Nursing Home Care

Depending on where you looked in 1996, the average cost of nursing home care across the nation fell between $46,000 and $60,000. Not surprisingly, all facilities are willing to accept residents who can pay their bills independently. Approximately a third of all expenses are paid for by patients and their families. The majority of homes are contractually bound with the Veterans Administration (VA), the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), HMOs, and private insurance providers. If the nursing home is a participant, residents are admitted to a facility under the auspices of Medicare, a federal health insurance provider to people at least 65 years old. Residents with low income are often supported by a federal and state program known as Medicaid. Close to 50 percent of all nursing home care is paid for by state Medicaid programs.

Approved skilled nursing care is only covered by Medicare for the first 20 days. If a nursing home assumes a patient directly after a stay in a Medicare-approved hospital, a fraction of the cost for days 21 through 100 will be covered as well is skilled nursing care is required day to day; as of the year 2000, a daily copayment of $97 was required. On the other hand, if the patient's condition improves during those final 80 days and doesn't require such excessive care, Medicare payments will be halted even if the person remains in the home even longer. Most people are better within 30 days though. Beyond the 100-day coverage period, Medicare and Medigap insurance refuse to pay for nursing home care.

Unfortunately, income level too often manipulates people's decisions when it comes to picking a nursing home. Those who have to foot the bill themselves must determine how much they are willing to spend and locate homes in that price range. Even those who've elected to purchase nursing home insurance may have to compensate for some of the expenses and should be aware of exactly how much extra they are responsible for. If you know that your personal funds will be drained within a few years, and you'll be forced to apply for Medicaid, investigate whether the potential nursing homes possess Medicaid certified beds. As a result, you can confirm that there is no need to leave for another home that does accept Medicaid. Medicaid pays nursing homes lower fees than those paid by individuals. In essence, the more Medicaid residents that they take in, the more money they are losing, which is why not all nursing homes are Medicaid compliant. For the time being, Medicaid-certified homes must follow a federal code of conduct regulating quality of care. However, deregulation of the nursing home industry is under serious consideration by Congress.

People who have Medicaid at the time of placement in a nursing home are subject to placement in any facility within a 50-mile radius of their residence. This procedure is what's called "home assignment." In this process, you are typically allowed to turn down the first offer if it is disagreeable, but after that, you're probably out of luck if you don't like the following proposal. To get around this rule, some people have enough money reserved to pay their own way for about a year. After those funds have diminished, they can submit an application for Medicaid. This technique regularly allows them to enroll in the home of their wishes.

Regardless how you pay for your nursing home stay, it is in your best interest to meet with the nursing home administration to be sure every rule is clear prior to signing any contracts.

Beyond determining your needs and method of financing nursing home care, you need to know which homes near you meet these prerequisites. Call the state Department of Health, and request that they provide you with a list of nursing homes nearby. Next, contact the homes of interest, and ask some preliminary questions that will prove whether they really do meet your standards:

  • Do they offer Medicaid-certified beds?
  • How long is the wait list for a bed?
  • Do they accept Alzheimer's patients?

When you have reduced your choices down to two or three, make sure the homes are licensed appropriately, and find out if they have come under any fire or have been fined due to any deficiencies. Contact the Department of Health, and ask to speak with the office that is responsible for nursing homes. They will inform you as to whether the homes have passed state inspections and if any complaints were filed against them. The majority of states will even let you rummage through documents associated with the nursing homes on your list. Here, you will learn about the history of compliance with resident treatment guidelines. Having access to such inside information should make your decision fairly straightforward.

Constantly including yourself in this overall process will boost the spirits of your spouse, family member, or friend and give them the confidence they need to adjust to their new way of life. Families often work out a schedule so that the resident sees a new face each day for about an hour. During the visits, family members will bring items such as toiletries, reading material, and writing paper. If you plan to participate in an activity outside of the nursing home, schedule the outing for an afternoon, day, or weekend. Don't force the resident out of the nursing home; allow them to decide when they are ready for a public activity.

Remember, maintain regular contact with the patient's doctor to stay posted about fluctuations in health or changes in treatment.

If you suspect your loved one is the victim of nursing home abuse or neglect, contact us today. Our nursing home abuse attorneys will evaluate your claim and take the necessary steps to help end the abuse. Nursing home abuse is a violation of federal and state law, and should not be taken lightly. Contact our nursing home abuse lawyers today to find out how you can hold the nursing home liable for their actions

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