It's generally recommended that everyone with significant medical problems wear a medical ID bracelet. Unfortunately, these are limited to a few lines of information and many people need to communicate more critical information than a line allows. How can you utilize your phone for important health information?
In the preceding blogs titled Crash Course in Nursing Homes, Part 1, Part 2 and Part 3, I shared Susan's experiences with illegal nursing home practices and lessons learned. This post summarized the lessons learned for easy reference.
Lesson 1: Rehab/nursing home stays are only covered by Medicare if a patient is first admitted to a hospital for 3 midnights. You may think you're admitted to the hospital but you may actually only be on observation status. Observation status does not qualify you for medicare coverage for a skilled nursing facility. Ask your nurse, doctor, or the admissions team if you are "admitted" or on "observation status."
In Part 1, I shared Susan's story and shared Lessons 1-3. Susan was staying in a Skilled Nursing Facility (SNF) for rehab and was unsafe for discharge to home. The SNF threatened eviction once Susan's Medicare approved stay was completed. In Part 2, I shared the steps we took to fight Susan's illegal eviction and share Lessons 4-8. Today's post will cover final lessons learned, including resident rights when transferred to the hospital.
|Glossary of Terms|
|SNF = Skilled Nursing Facility. Commonly called a "nursing home." Offers skilled nursing, lodging, food, and medication therapy. May offer rehab services like physical therapy, occupational therapy, and speech therapy.|
|ALF = Assisted Living Facility. Offer long-term housing to residents who may need assistance with Activities of Daily Living (ADLs) such as bathing, dressing, eating and toileting, but do not require the level of medical or nursing care available in a SNF.|
|RCFE = Residential Care Facility for the Elderly. These are a type of ALF, but tend to be in homes. Also known as "board and care."|
|Room and Board= Frequently confused with "board and care" in discussions. These are group homes with multiple residents but they do NOT provide any assistance and are unsupervised. They may offer a food plan, but are otherwise just homes with multiple residents.|
|Medi-Cal = Name of California's medicaid program. Helps provide basic insurance for those below a specific income. Medi-cal will cover long term SNF placement for residents who have specific medical needs. They will also cover "custodial" (not needing medical care) if specific criteria are met.|
|Medicare = Medical insurance for those over 65 years old or those who qualify for Social Security Disability. Medicare does not cover long-term custodial care. Specific criteria must be met in order for Medicare to cover care in a long-term care facility.|
Susan lived comfortably in the nursing home for several months under Medi-Cal custodial care payment when an illness required transfer to the hospital. Lesson 9: Skilled Nursing Facilities are required to readmit residents within 30 days of transfer to the hospital and they are required to hold the resident's same bed if transferred to the hospital for less than 7 days. I was aware of these regulations already. We requested to sign a bed hold form at the facility. This bed hold meant that Susan's exact bed would be available to her for the next 7 days.
In Part 1, I shared Susan's story and shared Lessons 1-3. Susan was staying in a Skilled Nursing Facility (SNF) for rehab and was unsafe for discharge to home. The SNF threatened eviction once Susan's Medicare approved stay was completed. This post will review the steps we took to fight Susan's illegal eviction and share Lessons 4-8. Part 3 will cover final lessons learned, including resident rights when transferred to the hospital.
Who pays for a nursing home stay when a patient isn't able to pay for it themselves? I went through a crash course recently while helping a friend who needed a nursing home. I'll share a few insights with you from that experience.
I received a friendly call the other day from" Medicare" offering me a FREE back brace. Never mind that I don't need a back brace; it's FREE through Medicare! I politely told the caller that this was Medicare fraud and requested that my number be removed from the list. For some reason, he hung up on me!
When they hear "palliative care," most people think "hospice"--but this isn't quite correct. While hospice does include palliative care, palliative care is not limited to patients qualified for hospice. Palliative care focuses on relief from the symptoms of illness and addresses physical, emotional, and spiritual needs. Many hospital systems now employ palliative care specialists and some outpatient centers do as well. Some hospice organizations are offering palliative care services in the home to patients not qualified for hospice.