A nursing home is a long-term residence for people who do not need hospital care but who cannot be cared for or live independently in the home setting.

What is a nursing home?

Nursing homes are long-term residential facilities for individuals who require day-to-day support with routine tasks or medical services. People who require nursing home care are individuals who do not require high level medical care, like that provided in a skilled nursing facility, but require too much day-to-day assistance to live independently in their home.



What types of services are offered in nursing homes?

Nursing home care can be medical or non-medical in nature and is for individuals who don’t need to be in a hospital but cannot be cared for at home. Understanding the quality, type, and diversity of the services offered in a nursing home is an important part of making an informed decision about what facility to trust with you or your family member.

Nursing homes have staff members available 24/7 to provide non-medical assistance such as help with bathing, dressing, preparing meals, and more. Many homes also have medical care available on site. This medical care may include memory care for patients with dementia or Alzheimer's or physical rehabilitation for patients who recently experienced an injury or surgery.

Examples of medical services offered through nursing homes are physical therapy, occupational therapy, and medication management.

Examples of non-medical services offered through nursing homes are assistance in bathing, dressing, and eating.


What is the difference between a nursing home and a skilled nursing facility?

Although the words “nursing home” and “skilled nursing facility” are often used interchangeably, they are different. Skilled nursing facilities are for patients who require a high level of medical care for a short period so that they can rehabilitate and return to the home setting. Nursing homes are for individuals who can no longer live in the home setting and require a long-term solution for support with day-to-tasks


How to Select a Nursing home

There are four main steps to selecting a nursing home.

1) Understand Your Medical Needs

Meet with a medical professional or primary care physician to make sure that a nursing home is the best option for you or your loved one. A nursing home is the best option for patients who may have minor medical needs and require help completing daily tasks such as dressing or bathing. If the patient has significant medical needs or rehabilitative care, a skilled nursing facility may be more appropriate. If the patient requires some rehabilitative care but can live independently in their own home, home health care or home care may be a better option. If the patient has a specific medical need (diabetes, chronic disease, wound care, etc.), you can narrow down your search by evaluating nursing homes based on what specialty care they can provide.

2) Verify Your Insurance Coverage

When selecting a nursing home, it’s important to consider your payment options and understand what your insurance policy will and will not cover. repisodic.com allows you to contact providers to verify whether or not they accept your insurance.

3) Compare Facilities Based on Quality Measures

Quality measures are strong indicators of the quality and level of care and rehabilitation you will receive at a facility. Different qualities to compare are how many of the residents at a given facility showed marked improvements during their rehabilitation, how many were re-hospitalized or had to go to the emergency department, how many had a fall that resulted in a major injury, and how many would recommend this provider to friends and family. repisodic provides these metrics, and more, for each facility and measures them against state and national averages to help put them in context and make the comparison process easier for you.

4) Visit the Locations

By visiting the nursing home, you can evaluate cleanliness and entertainment options and talk to employees and current residents about their experience. Ask the staff members how different situations are handled and how you or your loved one will fit in at this location.

Checklist of Things to Consider

Medicare.gov has a list of suggested things to consider when selecting a nursing home:

Basic Information

  • Is the facility Medicare/Medicaid certified?
  • Does the facility provide necessary skilled care and special services?
  • Is there an available bed?
  • Are there visiting hours? What are they?
  • Are residents clean and appropriately dressed?

Living Spaces

  • Are there any unpleasant odors?
  • Are the facilities clean and well-kept?
  • Are the noise levels appropriate?
  • What are the restrictions on smoking?
  • Is the facility well furnished?
  • Is the temperature comfortable?
  • Is there good lighting?

Staff

  • Does the staff have good relationships with the residents?
  • Do staff members knock on doors before entering?
  • Are background checks conducted on staff members?
  • Is a full-time registered nurse (RN) available at all times?
  • What are the rotations of nurses and staff members working with a given resident?
  • Is there a reasonable ratio of staff members to patients?
  • Are certified nursing assistants (CNAs) involved with care planning meetings?
  • How often is a licensed doctor available?
  • How long has the management team worked together?

Residents’ Rooms

  • Are residents allowed to have personal belongings?
  • Is there personal storage space?
  • Do the rooms have adequate windows and natural light?
  • Do residents have access to personal phone and television?
  • What is the roommate selection process?
  • How much protection is available for personal possessions?

Common Spaces

  • Are exits are clearly marked?
  • Are the visiting areas quiet and well-kept?
  • Are there appropriate safety features (emergency evacuation plan, smoke detectors, sprinklers, etc.)?
  • Are all areas wheelchair accessible?
  • Are there handrails and grab bars in common spaces?

Dining and Activities

  • Is there an appropriate variety and choice of foods?
  • Are there nutritious snacks?
  • Does the facility offer assistance in eating?
  • Are a variety of activities offered?
  • Are there outdoor areas for residents to use?
  • Are there volunteer programs?

Safety and Care

  • Does the facility offer preventative care (flu shots, etc.)?
  • Are residents allowed to see their regular doctors?
  • How does the facility handle emergency situations?
  • Are care planning meetings scheduled with residents and family members?
  • Has the facility corrected all deficiencies from last state inspection?

If you determine that a nursing home is the right choice, the next step is to search facilities in your area. repisodic helps you search and compare nursing homes by location and provides insightful quality data, patient reviews, and facility ratings to help you find sites that best fit your needs.



How to Pay for a Nursing Home

Nursing home care can be expensive and is generally not covered by Medicare. Most people entering nursing homes begin by paying for their care out-of-pocket. Medicaid can be applied if the patient is or becomes eligible during their stay. Although Medicare does not cover nursing home care, it can be applied for hospital care, physician services, and medical supplies during a stay at a nursing home. A patient’s individual insurance policy determines what specific home health care services are covered and paid for. Insurance coverage and network participation are two of the most important factors to consider when choosing a home health agency.

Nursing home care can be expensive and insurance coverage is limited. Most people entering nursing homes begin by paying for their care out-of-pocket.

Medicare

The traditional Medicare plan does not cover long-term care in a nursing home, however it does cover limited, medically necessary, skilled nursing care provided in some nursing homes. Medicare may be applied for specific hospital care, physician services, and medical supplies.

Medicare may be applied for extended stays at a nursing home if the nursing home is a certified psychiatric hospital and the patient is receiving care for a psychiatric condition. In this situation, Medicare will provide financial support for the first 190 days that the patient receives care at the nursing home.

Some Medicare Advantage plans or other Medicare plans do cover care in a nursing home if they have a contract with that nursing home. It’s important to check with your insurance plan as well as with the provider to verify what insurance will and will not pay for during your stay.

Medicaid

Most people entering nursing homes begin by paying for their care out-of-pocket however Medicaid can be applied if the patient is or becomes eligible during their stay. Most nursing homes accept Medicaid payments however Medicaid programs vary from state to state and eligibility depends on income and personal resources. Call your state’s Medicaid office and verify coverage with a nursing home before making final care arrangements.

Long-Term Care Insurance

Some individuals get long-term care insurance to assist in paying for nursing home care. Long-term care insurance care insurance can be used for a wide variety of extended care including home care, adult day care, and care through an assisted living facility. When shopping for long-term care insurance, it’s important to consider what facilities and what services are covered by which plans.

Other considerations

Lastly, some health insurance policies will allow patients to use their life insurance to pay for long-term care. repisodic encourages all patients to consult with their insurance company or administrator for final determination of what nursing home care their policy covers.


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