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How to Choose A Nursing Home, With Tips on Choosing During Covid-19

 

Choosing a Nursing Home 

During Covid-19

What is a nursing home?  A nursing home, also called a skilled nursing facility (SNF), provides health and personal care services to persons who need the care and assistance of another person on a regular basis.  Most nursing homes provide nursing care, assistance with the activities of daily living, three meals a day and supervision of the resident for 24-hours each day.  Most will also provide some form of rehabilitation services such as physical, occupational or speech therapy. 

Some people may stay at a nursing home or skilled nursing home while recovering from an injury or surgery after a stay in the hospital.  However, most people will stay permanently because they require full-time care or supervision because of their physical or mental disabilities.

If you are in the hospital, and are being discharged to a nursing home for rehabilitation, the hospital will help you find a facility.  If your stay will most likely be permanent, you can start by asking your doctor for recommendations of places that would meet your needs.

When choosing a nursing home, consider what is important to you.  Do you need physical, occupational or speech therapy?  Are you looking for specific care for dementia?  Will you be on hospice?  Is having good food a priority for you?  Do you have a religious affiliation that you want to consider?

Where does your family live? In my experience, having family members visit on a regular basis makes it more likely that you will receive the care you need.  If the nursing home is too far away, family may not be able to visit very often.

After you have thought about your wants and needs, talk to friends, family, social workers and healthcare providers to see if they have recommendations.  When trying to find a facility for my father, I hired a geriatric care manager, sometimes called “aging life care manager”,  to help me research facilities.  The geriatric care manager was already familiar with all of the facilities in the area, so she helped me quickly narrow down what seemed like unlimited choices. 

Once you have narrowed down the search, call the nursing homes that you are considering and ask them whether there is a waiting list, how many residents they have and the cost of care. 

It may be difficult to visit a facility during this time of Covid-19, so you may have to “visit” the facilities by video.  Many facilities have employees who will take you on a video tour of the nursing home while you watch and listen on your smartphone or computer.  If you cannot physically enter the facility, be sure to meet the director and the director of nursing by video or at least talk with them on the phone. 

Ask about Medicare and Medicaid certification, and ask if the facility is handicap accessible.  Although it may be difficult to see other residents while on a video tour, try to notice if the residents seem to be cared for and whether the staff seems attentive to their needs. One issue with nursing homes is often the turnover in staff, so be sure to ask how long the director has been at the facility, and ask the same question about the heads of the food, social services and nursing.  I also would ask about the history of ownership of the facility to see how often that turns over. 

Of course, read all the contracts you might be entering into and ask about the latest inspection reports.

You can look at ratings of the nursing homes on the Medicare.gov Nursing Home Compare website.  Another website you can check is Nursing Home Inspect.  This website is a project of ProPublica, and the site lists deficiencies and fines assessed against nursing homes throughout the United States.  The information on this website is compiled from the U.S. Centers for Medicare and Medicaid Services, and generally includes information for the last three years.  Information about COVID-19 Cases at Nursing Homes can also be found on ProPublica's website.

During this time of COVID-19, your family may be restricted from visiting you in person, so you may want to ask about their visitation policies, and whether the facility assists with alternatives to inpatient visits. See the article below for information about choosing an assisted living while COVID-19 restrictions are in place. See this article from Victoria Archable of Care Patrol discussing some things to consider while searching for an independent or assisted living during Covid-19. ****** Link

If you need to be approved for Medicaid in order to pay the nursing home costs, be sure to ask whether the facility accepts Medicaid.  Medicaid is a government program that pays medical costs and long-term care costs for persons who have insufficient income to pay for care. In Georgia, Long-term Care Medicaid is only available for persons who are in a nursing home, or who would be in a nursing home but can be cared for at home with home care.

Most facilities do have Medicaid beds, but you may find it is easier to find a facility with open beds if you are able to privately pay for a few months before applying for Medicaid.  The basics for Medicaid qualification are an individual applying for Medicaid can have $2,000 in their own name, plus a $10,000 burial fund or certain burial items with a value up to $10,000. The applicant can have a home, a car, and the personal property in the home.

The Income limit for Institutional Medicaid is $2,349.00 per month, but if an applicant has more monthly income the applicant can establish a Qualified Income Trust (sometimes known as a “Miller Trust”) and transfer the excess income to the trust to become qualified for Medicaid. Note that the income will be transferred from the trust to pay the Nursing Home monthly. If married, the Spouse not applying for Medicaid (Community Spouse) can have $128,640 plus a burial account of up to $10,000. The Community spouse can have unlimited income, but if the income is less than $3, 216.00, the Community Spouse can take some of the income from the Medicaid Applicant Spouse. Medicaid requires that resources over the $2,000 must be transferred to the Community Spouse within one year of the month eligibility for Medicaid begins.  There are some penalties for transferring assets, and Medicaid can look back at your finances for the five years before application.

If you want find out whether you will qualify for Medicaid, or if you want some assistance in getting qualified or in applying for Medicaid, our office can help! 

Give us a call at 770-416-0776 to schedule a consultation.



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