| Step 3 - Gathering Information |
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Once you have decided that a nursing home is the right
choice for you, it is time to gather information about the nursing homes in your
area. A good first step in this process is finding out exactly how many nursing
homes there are in your area (because nursing homes are frequently located in
out of the way areas there might be more than you think).
Some Facts About Nursing Homes
On any given day, nursing homes are caring for about one in twenty
Americans over the age of 65. Al- most half of all Americans turning 65 this
year will be admitted into a nursing home at least once. One fifth of those
people admitted into nursing homes stay at least one year - one tenth stay three
years or more. There are a number of ways that you can team about the nursing
homes in your area. The easiest ways to find out about local nursing homes begin
with the phone book. Your yellow pages list many of the nursing homes in your
area. In addition, your local Office on Aging (in the Blue Pages of your phone
book) should have a listing of nursing homes in your area and will be able to
refer you to your local Long-Term Care Ombudsman. You can get information on the
nursing homes in your area from a variety of sources. Word of mouth can be a
good source of information. Ask your friends and neighbors if they know people
who have stayed in local nursing homes. Learn all you can from these different
sources.
The Long-Term Care Ombudsman
One of the best sources of information is your local long-term care
ombudsman. Nationwide, there are more than 500 local ombudsman programs.
Ombudsman visit nursing homes on a regular basis -- their job is to investigate
complaints, advocate for residents, and mediate disputes. Ombudsman often have
very good knowledge about the quality of life and care inside each nursing home
in their area. Ombudsman are not allowed to recommend one nursing home over
another. But when asked about specific nursing homes they can provide
information on these important subjects:
Ľ the results of the latest survey,
Ľ the number of outstanding complaints,
Ľ the number and nature of complaints lodged in the last year,
Ľ the results and conclusions of recent com- plaint investigations.
In addition, the ombudsman may provide general advice on
what to look for when visiting the various area nursing homes. The phone number
of your State Long-Term Care Ombudsman is provided at the back of this booklet.
Other Community Resources
In addition to the Long-Term Care Ombudsman, there are many other
resources that you should consult before selecting a nursing home. Some other
people who might be helpful are:
Ľ hospital discharge planners or social workers,
Ľ physicians who serve the elderly,
Ľ clergy and religious organizations,
Ľ volunteer groups that work with the elderly and chronically ill
Ľ nursing home professional associations.
By using these resources, you will tap into a community of
people who under- stand nursing homes and have a good deal of knowledge about
the homes in your area. You should now be able to make a list of the homes in
your area which have good reputations.
Other Information You Will Need
There are also some types of basic information that should help you
narrow your list of nursing homes. Consider some of these factors -- a quick
phone call to the nursing home should answer these concerns:
Religious and Cultural Preferences
If you have religious or cultural preferences, contact the nursing homes on
your list and see if they offer the type of environment which you would prefer.
Medicare and Medicaid Participation
If you will be using Medicare or Medicaid, make certain that the nursing
homes on your list accept Medicare or Medicaid payment. Often, only a portion of
the home is certified for Medicare or Medicaid, so make sure that the home has
Medicare or Medic- aid "beds" available. For more information how Medicare and
Medicaid pay for nursing home care, see below.
HMO Contracts
If you belong to a managed care plan that contracts with particular nursing
homes in your area, make sure the homes you are considering have con- tracts
with your HMO.
Availability
Make certain that the nursing homes on your list will have space available
at the time you might need to be admitted.
Special Care Needs
If you require care for special medical conditions or dementia, make sure
that the nursing homes on your list are capable of meeting these special
circumstances.
Location
If you have a large number of nursing home choices, it is usually a good
idea to consider nursing homes that your family and friends can visit easily.
Why Location is Important
In most cases, it is a mistake to select a nursing home
that is difficult to visit on a regular basis. Frequent visits are the best way
to make sure that you or your relative does well in the nursing home. Visitors
are important advocates for chronically ill residents. Frequent visits often
make the transition to the nursing home easier for new residents and their
families.
You will now be able figure out which homes in-your area
may or may not be worth visiting. You will also now be better in- formed when
you begin visiting your area's nursing homes.
Paying For Nursing home Care
Nursing home care is expensive (a skilled nursing home will cost about
$200 a day in many parts of the country). For most people, finding ways to
finance nursing home care is a major concern. There are several ways that
nursing home care is financed:
Personal Resources
About half of all nursing home residents pay nursing home costs out of
personal resources. When most people enter nursing homes, they usually pay out
of their own savings. As personal resources are spent, many people who stay in
nursing homes for long periods eventually become eligible for Medicaid.
Long-Term Care Insurance
Long-Term Care Insurance is private insurance designed to cover long-term
care costs. Plans vary widely, and you would be wise to do some research before
purchasing any long-term care policy. Generally, only relatively healthy people
may purchase long-term insurance. For further information on this type of
insurance, contact the National Association of Insurance Com- missioners and ask
for their free book- let, The Shopper's Guide to Long- Term Care Insurance. Call
(816) 374-7259 for your copy.
Medicaid
Medicaid is a State and Federal pro- gram that will pay most nursing home
costs for people with limited income and assets. Eligibility varies by state,
and you should check into your state's eligibility requirements before assuming
that you are either eligible or ineligible. Medic- aid will only pay for nursing
home care provided in Medicaid-certified facilities.
Medicare
Under certain limited conditions, Medicare will pay some nursing home costs
for Medicare beneficiaries who require skilled nursing or rehabilitation
services. To be covered, you must (after a qualifying hospital stay) receive the
services from a Medicare-certified skilled nursing home. HCFA's book, Your
Medicare Hand- book, discusses the conditions under which Medicare will help pay
for nursing home costs in a Medicare- certified nursing home. To obtain a free
copy of Your Medicare Hand- book, call (800) 638-6833.
Medicare Supplemental Insurance
This is private insurance (often called Medigap) that pays Medicare's
deductibles and co-insurances, and may cover services not covered by Medicare.
Most Medigap plans will help pay for skilled nursing care, but only when that
care is covered by Medicare. In addition, some people have nursing home costs
covered, or partially covered, by managed care plans or employer benefit
packages. If you have any questions about how you will pay for nursing home
care, what cover- age you may already have, or whether there are any government
programs that will help with expenses, there are people who can help. Your
State's Insurance Counseling and Assistance (ICA) program has counselors ready
to help you figure out how you can finance your long-term care. Your State's ICA
phone number is printed in the back of this booklet.
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