Articles Posted in Skilled Nursing Homes

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I attended a networking breakfast that was organized for professionals involved in different areas of the senior industry. I was asked by the leader to share the greatest challenge that I was currently experiencing with my business. I didn’t have to think too long to respond.

Over the past year or so, I have witnessed my nursing homes engage in the process of converting entire floors to short-term rehabilitation units. Short-term rehabilitation costs are covered by Medicare. Without going into great detail, Medicare covers the first 100 days of short-term rehabilitation after a three night qualifying stay in the hospital. It doesn’t cover long-term custodial care, which many people don’t understand. Short-term rehab is where nursing homes are currently making their money. The tendency is to admit the senior and rehabilitate him or her until a plateau on the therapy is reached. The senior is then discharged and it’s on to the next person.

So what is the impact of facilities converting entire floors to short-term rehab? Many of the nursing homes making this change are not currently accepting any long-term residents. The long-term residents who currently live in the community are slowly being transitioned from their current floors and moved to another floor. So now there is a shortage of long-term beds at selected communities. The certification change to short-term beds results in not only a smaller number of long-term beds, but fewer beds that are certified for Medicaid (public aid).

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When I opened my doors in 2006, I began touring and evaluating communities under wrap; meaning, I didn’t volunteer to the admissions director at a community that I was a consultant. I did this because I wanted to see how an outsider would be treated during an unexpected “walk-in”, if the community was a mess from a housekeeping standpoint, and how long I would have to wait for someone to take care of me. All my findings have been duly noted, documented, and shared with my clients.

The practice of “walk-in” tours is a great strategy when you’re conducting your senior living search. In my opinion, your first tour should always be a confirmed appointment with the admissions director. The second tour (you’ll always want to take a second one to confirm your first impressions) should be unannounced. That way, you’ll receive an initial tour from the person who has expertise in the care, features, and amenities that a community has to offer. Many times, the admissions director will have marketing responsibilities that will cause him/her to be out of the building. If you choose to tour at a time when the admissions director isn’t available, you will be handed off to the activity, maintenance, or dietary director. At times, the “manager of the day” is responsible for conducting the tours on the weekends, another time when the admissions director may not be available. Unless that person has been thoroughly trained on how to conduct a good tour, you’ll be on the receiving end of a presentation that’s unsatisfactory. In the end, you may pass on a community that is totally acceptable as exemplified in the following “real life story.”

real-life-story200Real-Life Story

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“When choosing a long-term care community for your loved one, make sure his/her care-level needs and financial realities are appropriately assessed.”

Greetings!

As part of my services, I always meet and get to know the person I’m about to place. My past experience as an admissions director of a continuing care community (one offering Independent living, assisted living, and a nursing home on a single campus) taught me how to assess an individual’s mobility and cognitive impairment (if any). An assessment also affords me the opportunity to meet family members, see the person’s current living conditions, and find out the person’s financial realities. All of these factors play an important part in the options I present to my clients. As families who “go it alone” and clients of other service providers have sometimes discovered too late, a mistake in assessing any one of these factors can result in misplacement of a client. This, in turn, can lead to a rapid decline in a senior’s well-being, more serious adversities, and even yet another move – a heartache and inconvenience that no resident or family should ever have to endure. This month’s real life story emphasizes that fact.

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Greetings!

The holidays are a cherished time for families to be together – a time to make new memories and to celebrate the past. The holidays are also a time when family members might notice that an older loved one is declining physically or mentally. For example, the onset of winter weather might make a senior’s physical limitations more evident or more worrisome. Gradual changes that were not obvious to nearby family members over the past year might be very apparent to a visiting relative. Suddenly, family members might be aware that they have entered yet another new season in life: a season of care-giving and or long-term care planning. This is when I can help.

Over the past four years, I’ve been blessed to be able to help many families place their elderly loved ones in a community that matches their medical needs and financial realities.

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“Prepare for your loved one’s transition from the hospital to a long-term care community.”

Four years ago, my mom, who is 88 and a registered nurse, had a triple bypass with a valve replacement. The hospital staff informed me that their transitional care unit was full and I would have to find a rehab community for her. As I was searching, I asked myself, “What if something goes wrong and she can’t return home?” As I narrowed my search to three options, I was mindful to choose places that could accommodate her needs long term.

As it turned out, a bed opened up in the transitional unit. She completed several days of her rehab. Then she complained it was too noisy, disagreed with the staff over her course of treatment, called my sister to take her home, and had herself discharged. So much for my worries about her returning home.

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People often ask for my opinion of the 5-star nursing home rating system that was instituted approximately two years ago by the Center for Medicare and Medicaid Service. The system is a comparative tool that assigns nursing homes composite rankings from 1 (below average) to 5 (above average). Rankings can be viewed on www.Medicare.gov. The scores are determined by a combination score based upon three items:

  1. The results from the annual inspection from the Illinois Department of Public Health
  2. Quality measures
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Over half of my clients are children of seniors who are already living in a community. The children are looking to move them because the senior needs a higher level of care or they are dissatisfied with the care the senior is receiving. But the most common reason clients contact me for my services is the senior is depleting his or her finances and cannot stay at the current community.

Most senior housing placements occur as the result of a crisis in the senior’s health. The unfortunate reality is that people don’t plan for this sort of crisis. The immediate reaction is to put a bandage on the problem to solve it short term without examining the senior’s long term financial realities. People often choose a community because it has name recognition or “it looks like a really nice place.” Yet, when people are in a rush, they fail to ask common sense questions such as “Does your community accept Medicare or Medicaid?” Or, “What happens when my mother or father runs out of money?”

We are now living in a society where people are living longer. We need to take that fact into account when searching for the right senior living alternative whether it be home care or community living. We plan for disasters and accidents by purchasing insurance. Many of us have pre-planned our funerals. Why not take some time to think about what will happen if your loved one needs to enter a community and outlives his or her finances? This month’s real-life story will supply you with some food for thought.

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“Delaying a loved one’s move to a long term care community might not be a good decision in the long run.”

The decision to move a senior to an assisted living community or nursing home can be an unpleasant experience. Because our parents took care of us, it is a decision laden with guilt. Children often enter a state of denial with thinking the parent is “doing just fine.” Reality may be the opposite situation. Deferring the decision seems to be a good short-term decision; but, in actuality, it may be placing the loved one’s health and finances in jeopardy. It never hurts to do some thinking or pre-planning about what may happen down the road.

While I’m not an advocate of moving a senior before they are ready, let me share some experiences that I’ve encountered with my clients:

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I’m pleased to introduce my monthly newsletter, “Senior Living Moments–Words to the Wise.” My clients, contacts and associates have suggested that I provide tips on how to demystify what can be a daunting task: dealing with the issues of an elderly relative or friend.

“Boomer Bind”

More than 44 million Americans help to care for or support an elderly loved one, and many of these caregivers are employed. Not everyone is easily able to cope with what I call the “Boomer Bind,” juggling a job, personal life, and caring for an elderly person. It’s never easy when the children live far away; there aren’t enough siblings to share in these responsibilities, or there is no firm caregiving plan in place.

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Happy Holidays! My very best wishes to you and your loved ones for a blessed and prosperous new year.

The holidays are a time to celebrate with family and friends. It is also a time when families might observe that their loved ones’ health is declining. With these observations comes the stress of thinking ahead to the future. And the one thing folks might begin thinking about is choosing the right long-term care community or home care option for a loved one. There is also added concern about how the loved ones’ care will be financed. Here is a snapshot of the types of long-term care options available and their approximate costs:

Independent Living Communities – The senior can function on his or her own, but may receive help with housekeeping and meals. The cost runs about $1,500 to $3,000 per month, depending upon the community.

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