Finding a good nursing home is like finding a needle in a haystack… Many families prefer not to admit their ailing or aging loved ones into a nursing home. However, sometimes the circumstances of daily life prevent a family from providing adequate hospice care. In these situations, finding a quality nursing home is helpful and could significantly impact a loved one’s medical and end-of-life care.
For those reading this blog post, understanding Medicare eligibility may already be as simple as riding a bike. However, it is essential to explain the basic requirements. Medicare is split into two parts:
To be eligible for Medicare, a person must be at least 65 years or older, experiencing a disability, or suffering from End-Stage Renal Disease resulting in permanent kidney failure requiring dialysis or a transplant. In addition, to avoid paying Medicare Part A coverage premiums, a person or their spouse is 65 years or older and pays at least ten years of Medicare taxes.
The U.S. Centers for Medicare and Medicaid Services (CMS) established Medicare.gov, which allows the public to research Medicare services and apply for coverage. Although CMS updates the site often, members of the public may feel overwhelmed navigating the website. Below are valuable tips and resources to help those interested in nursing home care.
A skilled nursing facility (SNF) is designed to offer hospice care (care designed to treat a terminally ill patient and provide the physical and emotional needs for quality of life and reducing pain).
Medicare Part A covers temporary hospice care if the following conditions apply:
Medicare will not automatically require a recipient to pay for medical costs associated with SNF care. Instead, payments are divided into three time periods:
Skilled nursing care encompasses numerous services and programs for patients. All care must be performed by, or under the supervision of, trained medical personnel employed or contracted by the SNF. Services include:
On the Medicare.gov website, the public can search for nursing homes in their area and research the types of services offered and overall ratings from other users. Below are step-by-step instructions on how to use the site.
Click here or enter the following link (https://www.medicare.gov/care-compare/) into a web browser. A window will open with the title: “Find and Compare nursing homes, hospitals & other providers near you.”
In the box below “My Location” type in your city, state, and zip code. Then designate the provider type by clicking the drop-down menu and clicking on “Nursing homes.” Users may also search for specific facilities by typing the name in the “NAME OF FACILITY (optional)” search bar. Once the search parameters have been entered, click “Search.”
After searching by location and type, a list of nursing homes should appear in the surrounding area. Users can see a complete list on the left-hand side of the screen or search their area by using the map on the right-hand side of the screen. In addition, users may filter by distance, overall rating, other ratings, the number of certified beds, and more.
Once users identify nursing homes they would like to compare, click the “Compare” for that facility. Users can compare up to three nursing homes at a time. Once a user has chosen the nursing homes they would compare, click “Compare” in the right-hand corner. A web page will open with information about each facility and how they compare.
Each nursing home will have a list of services offered, staffing information, health inspection information, and ratings. Facilities with a four or five-star rating are of higher quality, while those with one- and two-star ratings are of lower quality.
Medicare.gov users searching for a nursing home in their area should be aware of nursing homes designated by CMS as special focus facilities (SFF). The SFF identifies nursing homes that have demonstrated a pattern of poor or substandard care for their residents.
Included on the web page is a changing list of qualifying facilities, facilities currently undergoing steps to improve, facilities that have shown improvement over time, or facilities that are no longer eligible for Medicare Part A recipients. CMS is frequently updating its list by periodic inspection of these facilities, so current residents or potential residents should continue to check the progress of these facilities.
Families seeking Medicare-eligible SNFs for their ailing or aging loved ones can contact our office for legal counsel on options that best suit their needs. Although Medicare.gov offers free information about many of these facilities, families should always be prepared for issues regarding care associated with Medicare eligibility and financing. Contact one of our nursing home attorneys at (918) 359-6600 or visit our website.
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