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The most important question when entering a Nursing Home

Posted by: mcrews on 11/23/2010 1:52:46 PM

Entering a nursing home can be a very stressful moment for the senior and loved ones. Nursing homes only do two things: 1. Rehabilitation.

  1. Custodial Care.

Usually a dramatic event has taken place and everyone is worried and concerned. After the senior is admitted the family will sit down with someone from the facility and be asked to sign admission papers. If there admission is for Rehabilitation, Medicare and a medsup plan will cover upto 100 days of SKILLED Nursing Home Care. Usually the admission person will state this, leaving the impression that you have coverage for 100 days. At this point you need to ask: OK, What is "THE PLAN OF CARE"? those 4 simple words are a KEY phrase in the Skilled Nursing Home business. A "PLAN OF CARE" is describes the type of rehabilitation and how long the rehabilitation will take given the age and diagnosis of the senior. Usually a PLAN OF CARE is created within the first 24-36 hours of admission. THE PLAN OF CARE is submitted to MEDICARE for approval. Medicare may approve upto 7-10 days upfront. The the facility has to report the progress to Medicare each week to get extensions. Medicare (medsup & HMOs) have a matrix. THey know with in a few days what the maximuum about of rehab is for a given age and a given diagnosis. By asking "WHAT IS THE PLAN OF CARE" you have put the facility on notice that you understand what UPTO 100 days really means. as a final note, the facility should schedule a family meeting once a week to discuss the progress of the rehabilitation and the status of the medicare approval. Remeber, a medsup policy can only cover what medicare approves. So if medicare stops at 16 days, the medsup will not cover 17, 18 ,19 etc. The medsup ONLY covers the gaps in medicare approved services.

Mark John Crews Strategic C.A.R.E. Plan

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