Insurance Insights ~ March 2000

Finding a Nursing Home

Choosing a nursing home is one of the most important decisions you may ever have to make for yourself or a loved one. You may have to make such a decision with little or no notice such as after a serious illness. Since Medicare or Medicaid finances most nursing home care, the Health Care Financing Administration (HCFA) makes sure nursing homes provide good care to residents.

The following information was obtained from "Your Guide to Choosing a Nursing Home." We hope you find this information helpful and informative. If you would like to view the entire booklet it can be found at www.medicare.gov. Another source of information is the Nursing Home Compare database at this website. It will give you information about every Medicare and Medicaid certified nursing home in the country and the results from their latest nursing home inspection.

When choosing the proper nursing home, we suggest using the following guideline as a starting point:

STEP #1 Talk to People

Talk with people you trust and who can help you make a good choice. Such people could be family, friends, doctors, dietitians, social workers, and hospital discharge planners. If your loved one is able to be involved let them. Remember his or her wishes need to be respected.

STEP #2 Look at Options

The Elder Care Locator can help you find necessary and convenient services that serve the elderly in their community (1-800-677-1116). If you cannot live independently, but don’t want to live in a nursing home, there are some alternatives such as; home and community care, subsidized senior housing, assisted living, board and care homes, and continuing care retirement communities.

STEP #3 Gather Information

Begin obtaining information about the nursing homes in an area that is near family and friends. Talk with your doctors or other health providers for suggestions. Also, your State or county Office on Aging (blue pages of phone book) should have a listing of nursing homes in your area.

STEP #4 Evaluate Factors

Call the nursing homes on your list. The following factors are very important and can help with your decision.

1. Location
2. Availability
3. Staffing
4. Medicare and Medicaid
5. Services and Fees
6. Religious and Cultural Preferences
7. Language
8. Special Care Needs

STEP #5 Paying for Care

Finding ways to pay for nursing home care is a major concern because it is expensive. The following are several payment methods:

1. Medicare
2. Medicaid
3. Personal Resources
4. Managed Care Plans
5. Medicare-Supplemental Insurance
6. Long-Term Care Insurance

STEP #6 Visit Nursing Homes

Make sure you visit the nursing home you are interested in. You should insist on a formal tour and meet the staff who will care for you. Most importantly, you should meet with the people who reside and receive care at the home. You should also ask to receive the nursing home’s latest inspection. Employees of the state where the nursing home is located conduct the inspections every nine to fifteen months.

STEP #7 Follow-Up Visits

Make a point of returning to visit during weekend or evening hours when the staffing may be different. You may want to take the time to get a copy of the nursing home’s admission or contract agreements.

STEP #8 After Admission

Make sure you know about your resident rights and some special protections under the law (as listed below). Your family and friends also have rights too.

1. Respect
2. Restraints
3. Managing Money
4. Privacy, Property, and Living Arrangements
5. Guardianship and Advance Directives
6. Visitors
7. Medical Care
8. Social Services
9. Moving Out
10. Discharge and Transfer

By planning ahead and visiting several nursing homes and making sure your financial plans are in order, your and/or your family should not be pressured into choosing a nursing home. A checklist is provided at the back of the booklet "your guide to Choosing a Nursing Home" which you may find helpful. Check with your local personal insurance agent for pricing on Long Term Care Insurance protection.

INSURANCE INSIGHTS is an electronic newsletter published monthly by G. C. Weimer Associates, Inc. Information contained herein is accurate to the best of our knowledge and belief as of 3/1/2000. If you have a topic of interest for a future issue, e-mail us at info@gcwinsure.com.