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Nursing Home

Nursing Home

Out of the four most common category or types of facilities, Nursing Homes are the facilities that can generally provide any level of care or maximum level of care.  Nursing Homes are very often very large institutions and tend to resemble hospitals.  Although there are several organizations that are providing a warmer feel to their facilities to make it look less hospital or institutionalized.  Nursing homes generally have an on site registered nurse 24 hours a day to provide care for their residents.   Residents can range from someone who just underwent a surgery and may be at the Nursing Home getting rehabilitation services and treatments.  Nursing Homes are the only of the four types of facilities that can directly bill Medicare and insurance for Rehabilitation services and treatments.  Nursing Homes are also very often easily able to get Medicaid approved very easy. 

Nursing Homes licensing requirements are the most stringent off all four major types of care in comparison to Independent Living, Assisted Living and Personal Care Homes.  Although Nursing Homes operational requirements are the most stringent they do have some advantages over the other types of care, generally.  Nursing Homes are truly the only facilities that are able to bill Medicare for rehabilitation services.  Not all Nursing Homes provide rehabilitation services but many do and are able to bill Medicare and Insurance.  Due to this financial advantage that Nursing Homes have they tend to be full and always in demand because while a patient is in rehab the family does not have to pay anything.  Free is always good in a consumers mind, and rightly so.  When someone requires rehabilitation services for say 60 days they may qualify under Medicare and or Insurance thus making the normally expensive stay absolutely free. 

If a person in on hospice services Medicare will pay for a Respite stay and it will be covered directly or indirectly to the Nursing Home but the cost is never billed to the resident or family, Medicare pays for all the Respite cost.  No other type of facility has been granted this ability only Nursing Home.   A resident may choose to do a short stay or Respite Stay at an Assisted Living Facility but the cost would come out of pocket.  Now, not everyone will qualify for free respite stay one must qualify. 

Due to certain Medicare, Insurance and Medicaid advantages that Nursing Homes are favored with they do tend to be very full.  The caregiver to patient ratio is generally the most disparaging.  In other words there are more residents per each caregiver, and a caregiver can only do so much when they have so much work load.  In Assisted Living facilities the ratio gets a little better and is the absolute best in Personal Care Homes by far.  Personal Care Homes are unmatched concerning caregiver to resident ratio because Personal Care Homes have such a small amount of residents to begin with. 

When considering a Nursing Home one must determine the level of care needed.  The nuts and bolts approach to analyzing if you need a Nursing Home is to ask yourself, do we need a Nurse Present for mom, dad or the loved one 24 hours a day right there near.  Someone with complicated medical care may be very appropriate.  Let’s say a resident has a bed sore on body, has a feeding tube and a colostomy bag, we can realistically say that they are very appropriate for a Nursing Home.  They would certainly not be appropriate in an Independent Living facility.  Some Assisted Living facilities and Personal Care Homes may provide the care under Nurse Delegation services and supervision. 

In a situation where a resident does not qualify under a diagnosis to be billed to Medicare or billed to insurance one would have to pay out of pocket.  In this case, a Nursing Homes would be the most absolute expensive option.  Although it may be necessary depending on your individual situation.  Many times folks falsely believe that thy need to have mom in a Nursing Home just because mom may have Alzheimer’s and needs help dressing, eating and some other help with daily tasks.  This type of resident could easily fit in at an Assisted Living or Personal Care Home setting with a much lower cost and better services. 

Ultimately, choosing the correct facility whether a Nursing Home or Assisted Living or a Personal Care Home you must first determine what care the person requires.  Most facilities will to a Free assessment and will let you know if your loved one is an appropriate fit for their facility and at what monthly cost.  No one facility type is best for everyone.  One type of facility may be best for one person while another type is best for another person.  Needs and circumstances make all the difference.

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