Searching for the Right Nursing Home

Once you have reviewed all of the care options in Georgia (see last week’s blog) and have determined that you or your loved one truly needs nursing home care, it can be overwhelming to figure out how to find the right nursing home care. The process can seem complicated, and the options are scarce.

Short-Term Rehab vs. Long-Term Care

The first thing to know is that there are only two ways to be admitted to a nursing home: one is as a short-term rehab resident and the other is as a long-term care resident.

To be admitted to a nursing as a short-term rehab resident, a person must have a 3-night stay in a hospital whereupon the doctor feels a sub-acute rehabilitation stay is needed in order to maintain or improve functioning. This rehab care must be related to the hospital diagnosis, and Medicare Part A will pay for most of the rehab stay. For this type of nursing home admission, the hospital social worker or discharge planner usually handles the arrangements in coordination with the patient and family.

The second way that individuals are admitted to a nursing home is from home or other long term care community. They had no hospitalization and are not getting Medicare-reimbursed rehab services. Finding a nursing home that will accept an individual for long-term care (and not for sub-acute or short-term rehab) can be difficult. The reimbursement rates for long-term residents is much lower than for short-term rehab residents, and nursing homes try to limit their number of long-term care beds. Medicare does not pay for long-term care in a nursing home, and residents must use other funds (including Medicaid) to pay for their care.

Finding Nursing Homes Near You

Once you know if you are looking for a short-term rehab bed or a long-term care bed, you should begin identifying the nursing homes in your area and visit them. Listings of facilities in the Metropolitan Atlanta Area can be obtained from:

Hurley Elder Care Law’s Nursing Home Guide

Medicare’s Nursing Home Compare

Georgia Healthcare Facility Regulator

Empowerline

Finding the Right Nursing Home

Once you have created your list, you can contact the local or state ombudsman for information about the nursing home and then request a copy of the facility’s state inspection report from the nursing home, the healthcare facility regulator or the ombudsman. Medicare offers information for nursing homes participating in Medicare. This is called “Nursing Home Compare” and can be found at medicare.gov. Medicare’s Nursing Home Compare includes a five-star rating system for each facility. This rating system is based upon health inspections, staffing and quality measures. The Medicare Nursing Home Compare should be one of the many tools you use when selecting a nursing home. Do not use the Medicare Nursing Home Compare as your only source of information about a facility; always visit the facility in person.

Plan to visit each community twice, once scheduled and then another time unscheduled. For the scheduled visit, contact the admissions director at each facility to set up a time to meet with them. For the second visit, just show up in the evening or on the weekend to see if there is a drastic difference in the atmosphere of the facility or the care being provided. It is important to tour at least two facilities so you can see the difference in the physical plan and the staff. When you are touring, pay attention to your gut feeling. Ask yourself the following questions: Did I feel welcome? How long did I have to wait to meet with someone? Did the staff member find out my family member’s wants and needs? Was the facility clean? Were there any strong odors? Was the staff friendly? Did they seem to generally care for the residents? Did the staff seem to get along with each other? Listen and observe. You can learn so much just by watching and paying attention. Ask any questions that come to mind. There are no “dumb” questions.

After visiting all of your options, select your top 5 nursing homes, and talk to their admissions director about getting a bed for your loved one and about the process for admissions—your loved one may be placed on a waiting list. The task of finding good quality long-term care can be difficult. It takes time and patient.

Paying for Nursing Home Care

After finding a nursing home bed, you may be faced with the difficult question of how to pay for it. Nursing homes in Georgia cost on average between $6,000 and $9,000 per month and some facilities are over $10,000 per month! This is hard to sustain for even the most diligent savers! Despite many years of working and saving, families are concerned that there simply won’t be enough money to cover the cost of care. Georgia rules restrict who may qualify for Medicaid’s nursing home benefit. When an individual has income and assets that exceed the Medicaid threshold, we have devised a series of strategies for these circumstances. This allows an individual to qualify for Georgia Nursing Home Medicaid while preserving a substantive amount of their assets. To learn more please visit our website or contact our office at (404) 843-0121 or info@hurleyeclaw.com

Click here to learn more about Nursing Home Medicaid.