The Top 5 Questions to Ask Providers When Choosing a Care Facility
After working in the healthcare industry for more than 20 years, I get asked a lot about care providers and how to choose the right facility by friends, family members and patients. Unfortunately, unless you’ve been in this situation before, the selection process is overwhelming. The financial issues alone are very confusing, especially when dealing with Medicare and Medicaid benefits.
Before we dive into the typical questions you should ask before choosing a care facility, let’s define the different types of care facilities. There are two primary types– skilled nursing facilities and assisted living facilities. Skilled nursing facilities offer skilled nursing care 24 hours a day, and often have dedicated rehabilitation units that focus on discharging patients to eventually return home. Assisted living facilities on the other hand provide meals and limited assistance to those who can maintain a more normal daily routine. If you would like to talk to one of our Healthcare Coaches about long term care insurance, contact us. We’re here for you.
Here are five questions to keep in mind when beginning your search for a skilled nursing care facility:
1. What is the cost?
If your loved one has had a three-day hospital stay, they will be eligible for part A Medicare benefits to be paid 100 percent for the first 20 days in a skilled nursing facility. Medicare will pay 80 percent of the cost from Day 21-100, as long as the patient has a skilled need. The remaining 20 percent can be paid by private insurance, Medicaid or private pay by the individual or family member. The private pay costs vary at each facility. It is important to ask what is included in the private pay rate, such as medicines, doctor’s appointment, etc.
2. What additional services are provided?
It is important to find out what therapy services are provided, as well as if restorative services are offered. What disciplines are available: occupation, physical and speech therapy? How many days a week is therapy provided? Is therapy offered on the weekends? How many hours of therapy will they receive per day? Restorative programs are developed after patients are discharged from skilled therapy services with the goal of maintaining the current level of function.
3. How often do you receive doctor visits and what is the staff to patient ratio?
In a skilled nursing facility, the physician is required to and should make rounds once a month. However, each facility is different and the physician can come more often. Nursing staff are in contact with the physician when necessary for medication, changes in condition and other needs of the individual being treated. It is important to ask how many aides and nurses are working per areas and how many people they care for during a shift. The ratios can be very different for nights and weekends, so ask about each shift. Here are the ratio minimums per Federal Guidelines. (Although, the more caregivers per patient, the better.)
Direct caregivers (BN,LPN,LVN,CNA):
– Day 1:5 residents
– Evening 1:10 residents
– Night 1:15 residents
Licensed Nurses (RN,LPN,LVN):
– Day 1:15 residents
– Evening 1:20 residents
– Night 1:30 residents
4. What does a normal day look like at the care facility?
Ask to look at the activities calendar. Find out when meals are served. Additionally, there will be exercise or walking groups, as well as shopping sprees and field trips to restaurants and local attractions for those who are able to participate. Individuals should also have mental activities such as Bingo, Jeopardy, Wheel of Fortune, Jingo and other stimulating activities. It is imperative individuals stay active, both physically and mentally, so ask how often these activities occur. Look for a calendar of posted activities and join in with your loved ones when possible!
5. What about smoking, visiting, pets, etc.?
Not all facilities allow smoking or pets. Find out about the visiting policy, and if overnight guests are allowed. Is there a cost of guest trays? Can we bring pictures and items from home to make an individual feel more comfortable? Can family sign the individual out for a few hours during the day to go home? Do you offer onsite beautician services? If there’s a particular want or need for your loved one, always be sure to ask.
These are just a few questions to consider when searching for a skilled nursing facility. Some of the questions can work for assisted living centers, however, skilled care facilities offer more direct care 24/7. Not sure what is needed for your loved one? Cariloop healthcare coaches can guide you through the process.
By Carla Sumner, MCD CCC/SLP
If you are caring for a loved one and need some help figuring out the next step, a Cariloop Healthcare Coach would love to walk you and your family through whatever you may be dealing with. Become a member or call 1-844-790-5667 to get started.
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