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Medicare Rate Cuts

The Federal Government announced recently they (CMS- www.cms.gov)  would be cutting reimbursement rates to Nursing Homes across the country.  The National Average of the cuts to nursing homes’ reimbursements will be 11.1%.  This is an interesting premise.  Nursing homes continue to get sicker residents and more residents with signficant rehabilitation needs year after year.  This change in the dynamic of admissions to nursing homes  stems from hospital systems discharging patients earlier because their reimbursement rates changed.   Interestingly, nursing home reimbursement rates continue to be signficantly lower across the country than hospital reimbursement rates. 

 Read http://money.usnews.com/money/blogs/the-best-life/2011/08/08/nursing-homes-squeezed-by-medicare-cuts for a balanced article these cuts.

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How to Choose a Nursing Home

When the time comes for a family member to choose a nursing home for a loved one it can be extremely stressful.  Family members feel guilt, lost, and often question themselves as to which facility to choose.  I hope this information presented on this blog will help those family members.

Payment Issues

Explore financial issues first.  I know this sounds odd, however, you do not waste time and energy exploring a particular nursing home only to find out when you have made the decision that you want to place your loved one there that they do not accept Medicaid, your private insurance, or Medicare.  There are several methods of payments for nursing home care: Private Funds,  State Medicaid (usually meaning resident has no funds or minimal funds), Medicare (which only pays for 100 days of nursing home care and has a number of requirements that must be met), and in some cases Private Insurances (which can be a long-term care policy or a medical policy).   For more information on State Medicaid funding you should check with your particular State.  For information on Medicare requirements you can go to www.medicare.gov

 Special Needs

Next explore any special needs your loved one may have that the nursing home needs to meet.  Again, you do not want to waste time exploring a particular nursing home only to find out they don’t offer the services, programs etc. that your loved one needs.  Most nursing homes are general facilities that care for people with a host of medical issues.  However, your loved one may need special respiratory care, or special behavior programming or some other care level that general facilities may not be able to handle.  Ask detailed questions to make sure the nursing home you are considering can meet the needs of your loved one. 

Personal Visits

I cannot say enough about the personal visit.   Once you have narrowed down your choices on paper based the above information and geography,  pay the nursing home a visit.  You want to take a tour of the whole nursing home- meaning the areas accessible to visitors and residents.  Try to get a feel for how the residents are treated and cared for by the way staff are attending and talking to residents.   Watch for nurse call lights over the resident rooms- are they being answered timely?  Are there activities going on within the facility to keep residents active?  Residents’ appearance, the cleanliness of the facility, quality of the food and activities are all indicators of how well (or how badly) a nursing home may care for your loved one.   Other helpful resources may be: www.alz.org ;  www.hhs.gov/ ; and your local State’s Department of Aging and/or disability office. 

And a point about the Guilt

I know by me telling you not to feel guilty it won’t change your feelings, but sometimes the family has to do what is necessary.  Go back to being a loved one and leave the care giving to the professionals.   There are good nursing homes out there with caring, compassionate staff that work hard to meet the needs of the residents they serve.  There may be problems along the way, however, the sign of a good nursing home, a well-managed nursing home, is the way staff work to solve those issues.