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Nursing Homes

August 3, 2010

Nursing homes, also known as skilled nursing facilities, care for individuals who require 24-hour nursing supervision.

There are two types of care provided in nursing homes:

Skilled Care entails services that can be rendered only by a doctor, licensed nurse, physical therapist, occupational therapist, speech and language therapist, social worker or respiratory therapist. It usually follows a hospital visit involving a short-term stay, during which the patient receives nursing care and/or therapy until he or she is stable enough to return home. Due to the skilled nature of the care, it is covered by Medicare and secondary insurance for up to 100 days. Beyond that length of time, it must be paid for privately.

Long-Term Care is appropriate for the individual who can no longer take care of him or herself and will continue to require a high level of care for the remainder of his or her lifetime. Such care may include help with any “activity of daily living,” such as bathing, dressing, transferring (moving from one place to another), toileting, eating and walking. Medicare does not cover this type of care. However, when the individual’s financial resources are exhausted, the state-funded source (Medicaid) will supplement the cost. If the nursing home does not accept state funding, you must find another long-term care facility that will. Unfortunately, most nursing homes have waiting lists for people entering the facility under state funding. Planning ahead with an appropriate strategy may help the patient and family avoid these conflicts.

How do I know which nursing home to choose?
The Centers for Medicare and Medicaid Services (CMS), the government agency that administers these medical-assistance programs, has developed a database of information on every Medicare- and Medicaid-certified nursing home in the country, including more than 17,000 nationwide.

To help people search for a nursing home that meets their needs, the CMS has developed Nursing Home Compare, an interactive tool that allows Medicare beneficiaries and their caregivers to compare information among all the nursing homes on the list. Nursing Home Compare enables you to search for nursing homes based on:

What do I look for in a nursing home?
The Centers for Medicare and Medicaid Services (CMS), the agency that administers Medicare and Medicaid, also certifies individual nursing homes for inclusion in these government medical-assistance programs. The CMS has developed a detailed checklist for rating different nursing homes visited based upon:

The Nursing Home Checklist (Adobe Acrobat Reader is required to view this file.) is a useful tool when you are investigating possible homes and want to keep track of the capabilities and characteristics of each home you visit. It guides you through a point-by-point review of every aspect of a nursing home, from basic information about Medicare or Medicaid certification and special services offered to the comfort and attractiveness of furnishings (in other words, if your combined income and financial assets fall within certain limits). The categories the checklist makes note of include:

How do I pay for nursing home care?

Source: Center for Medicare and Medicaid Services, U.S. Department of Health and Human Services, Paying for Nursing Home Care.

Where do I find a nursing home?
To search the Department of Health and Human Services database of more than 17,000 nursing homes that are Medicare- and Medicaid-certified, click here. Keep in mind that many nursing homes have Special Care Units (SCUs) that are designed especially for the care of people with Alzheimer’s disease and related dementias.

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