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Commentary by Cate Kortzeborn
| Tuesday, May 17, 2016

CateKortzebornAre you looking for a nursing home for yourself or a loved one?

People go to nursing homes for different reasons. They may be sick or hurt and require ongoing nursing care. They may have had surgery and need time to recuperate. Or they may have chronic care needs or disabilities that make long-term nursing care a necessity.

Many communities have nursing homes. But how do you pick one that’s best for you or your family member in need?

The first step is to learn about the available facilities in your area. You can do that in a number of ways.

* Ask people you trust, like your family, friends, or neighbors if they’ve had personal experience with nursing homes. They may be able to recommend one to you.

* Ask your doctor if he or she provides care at any local nursing homes. If so, ask your doctor which nursing homes he or she visits so you may continue to see him or her while you’re in the nursing home.

* If you’re in the hospital, ask your social worker about discharge planning as early in your hospital stay as possible. The hospital’s staff should be able to help you find a nursing home that meets your needs and help with your transfer when you’re ready to be discharged.

Medicare provides a handy way to check out local nursing homes, using our Nursing Home Compare website: www.Medicare.gov/nursinghomecompare.

Nursing Home Compare provides a wealth of information on quality of care and staffing levels at more than 15,000 nursing homes certified for Medicare and Medicaid patients throughout the United States. One excellent feature is the star rating system. Facilities can receive from one to five stars, with five stars being the highest rating. These star ratings give you a quick snapshot of the facility.

Keep in mind that Medicare covers short-term nursing home stays following hospitalization, but generally doesn’t cover long-term care stays in a nursing home. Medicare coverage of home and community-based long-term care services is very limited.

Medicaid covers long-term nursing home stays, and may include coverage of home- and community-based services (HCBS). HCBS provide opportunities for people with Medicaid to get services in their own home or community. These programs serve a variety of groups, including people with mental illnesses, intellectual or developmental disabilities, and/or physical disabilities.

But a nursing home may not be the best option. A variety of community services may help with your personal care and activities, as well as with home modification and equipment to support you staying at home.

Some services, like volunteer groups that help with things like shopping or transportation, may be low cost or may ask for a voluntary donation. Some services may be available at varied costs depending on where you live and the services you need.

These home services and programs may be available in your community:

* Adult day care;

* Adult day health care, which offers nursing and therapy;

* Meal programs;

* Senior centers;

* Friendly visitor programs;

* Help with shopping and transportation;

* Help with legal questions, paying bills, and other financial matters.

How do you find such local services? Try the Eldercare Locator, a guide to help older adults and their caregivers connect to services, including long-term care services and supports.

Visit https://eldercare.acl.gov/ or call 1-800-677-1116.

For additional information, see the “Senior Living Costs” resource assembled by SeniorCare.com.

Cate Kortzeborn is Medicare’s acting regional administrator for Arizona, California, Hawaii, Nevada, and the Pacific Territories. You can always get answers to your Medicare questions by calling 1-800-MEDICARE (1-800-633-4227).

Comment On This Story
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1 Comment

  1. Gene Uzawa Dorio, M.D. says:

    Just adding to this post:

    If you are on Medicare but not Medicaid (MediCal), the out-of-pocket cost for a nursing home might be prohibitive. You could lose your retirement nest-egg, lifesavings, investments, or your home. Plus, a lien might be placed against property or accounts. Awareness of potential healthcare needs is difficult, but one should anticipate them by seeking legal advice to avoid financial disaster.

    Should you be hospitalized, you must be an “in-patient” for 3 days before you become eligible for Medicare payments to a nursing home. Here is a quirk: Should you be “Observation Status”, Medicare does not pay for nursing home care. Ask your doctor or nurse to provide you with your status.

    Gene Uzawa Dorio, M.D.

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