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I recently found myself having to decide between a skilled nursing facility or inpatient rehabilitation center when it was time for my 104-year-old grandmother to be discharged from the hospital. Here she was doing well, and ready to transfer out of the hospital setting, but not strong enough to go back to her apartment in independent living.
How does one make the decision to go to one over the other? What are the pros/cons? Where will your loved one be the safest and get the care needed to regain strength and make it back home? These are questions that run through one’s mind and need to be answered when making this type of decision. While it is best to work on prevention to avoid a hospital stay in the first place, it’s good to know that there are options available that can help one transition between the hospital and home.
Remember that the number one cause of injury for seniors is due to falls. (CDC.gov) See our blog for information on How to Prevent Falling How to Prevent Fallin... (rubycaresenior.com)
Skilled Nursing Facilities and Rehabilitation Centers are great transition options. Medicare often required a min 3 day hospital stay before qualifying to stay at a Skilled Nursing Facilities and Independent Rehabilitation Centers. (cms.gov)
Skilled Nursing Facility (SNF)
Definition: Skilled nursing is a term that refers to a patient's need for care or treatment that can only be done by licensed nurses. Skilled nursing is mostly regulated by the U.S. Department of Health and Centers for Medicare & Medicaid Services (CMS). To be certified by CMS, skilled nursing communities must meet strict criteria and are subject to periodic inspections to ensure quality standards are being met. Often referred to as a nursing home although that actually refers to the actual building that skilled nursing is provided. (verywellhealth.com and harrogatelifecare.org)
The focus of care in SNF’s is on 24/7 medical care, assistance with activities of daily living (ADLs), and rehabilitation for those who require ongoing medical care.
Types of patients that go to SNFs typically require ongoing medical care, such as those needing wound care, healing from surgery, or chronic medical conditions.
One will typically have a longer stay, often a few weeks to months, when in a skilled nursing facility. Rehabilitation therapy is required 5 days a week, but not as intense.
Services covered by Medicare:
· 24/7 Nursing available
· Activities of Daily Living (ADL) assistance
· physical, occupational therapy, speech therapy
· medication management
· social services
· medical equipment (DME)
· ambulance transportation to a medical facility for additional services needed when not available at the skilled nursing facility
Services NOT covered by Medicare:
· palliative or hospice care services or long-term care needs.
(Hospice care services are covered once rehabilitation is no longer an option and end of life is needed).
Inpatient Rehabilitation Center (IRF)
Definition: Inpatient Rehabilitation Facilities (IRFs) are freestanding rehabilitation hospitals and rehabilitation units in acute care hospitals. They provide an intensive rehabilitation program and patients who are admitted must be able to tolerate three hours of intense rehabilitation services per day. (cms.gov)
The focus of care in an inpatient rehabilitation facility is on rehabilitation and helping patients regain independence and mobility.
Types of patients that typically go to an IRF are those who have had a recent injury, illness, or surgery that requires intense rehabilitation to regain their ability to function independently.
One typically has a shorter stay of days up to several weeks and is required by Medicare to participate in a min of 3 hours a day or min of 15 hours per week of therapy (Physical/Occupational/Speech).
Who helps me decide where to go?
The Hospitalist – This is the internal Medicine doctor that oversees patient care while staying in the hospital. They will often make a recommendation.
Case Manager (Hospital) – Assigned to the patient to aid in navigation the transition from the hospital to SNF, Rehab Center, or home. If going directly home, they would also assist with Home Care options and DME.
· Rehabilitation – Short or Long-term inpatient rehabilitation is often covered under insurance after a serious surgery or injury. This can help not only provide daily therapy, but also provide a family caregiver some respite or allow for the injured party to gain some strength and mobility back before returning home.
· Physical Therapy - Often covered by insurance. One can receive physical therapy to help build overall strength and mobility of the area that was impacted. Services can be given in the hospital, skilled nursing, rehab, outpatient setting, or through Home Health.
· Occupational Therapy – This type of therapy is great for helping to discover new ways to do everyday activities that have become more challenging since an injury or fall. Typically covered by Insurance. Services can be given in the hospital, skilled nursing, rehab, outpatient setting, or through Home Health.
· Speech Therapy – This type of therapy is great for making sure swallowing, eating, drinking, and talking are all in good working order after surgery, injury, or serious illness. Is often covered by insurance, and services can be given in in the hospital, skilled nursing, rehab, outpatient setting, or through Home Health.
· Home Care – Bringing in some assistance temporarily while recovering can help take the load off the day-to-day chores and assist with Activities of Daily Living (ADLs), allowing you to focus on healing and getting stronger. This is often private pay unless you have long-term care insurance or qualify for VA benefits.
While both SNFs and IRFs provide 24/7 medical care and rehabilitation services, they differ in what they focus on regarding the patients that they admit and the intensity of the rehabilitation services they offer.
What happened to grandma? Based on her level of energy and weakness due to her illness and the fact that it would take another week for her to start getting some energy back, it was decided the best choice would be a Skilled Nursing Facility. The 3 hours a day therapy requirement would have been too much at the time for her to endure. Happy to report she is truly remarkable and making good strides toward a full recovery. Go grandma go!
Britt Hemsell – Ruby Care Senior Living Advisor & Blog Contributor
Life is a journey filled with transitions, and one of the most significant transitions many individuals face as they age is transitioning from independent living to assisted living. This transition can be a challenging decision, but it often becomes necessary when daily tasks and self-care become more difficult to manage alone. In this blog, we will explore the steps and considerations for patients and their families when making the move from independent care to assisted living, with a special focus on the Grace Pointe Continuum of Care difference.Assessing the Need for Assisted LivingThe first step in transitioning to assisted living is recognizing the signs that indicate a need for additional support. These signs may include:Difficulty with activities of daily living (ADLs) such as bathing, dressing, grooming, and meal preparationMemory problems or cognitive decline that impact safety and well-beingFrequent falls or injuries due to mobility issuesSocial isolation and lonelinessMedication management challengesThe need for regular medical supervision and assistance Open CommunicationOnce the need for assisted living becomes apparent and the process of transitioning from independent living to assisted living begins, it is essential to have open and honest discussions with the individual who will be making the transition. This may involve a family meeting or conversations with healthcare professionals. It is crucial to listen to the concerns and preferences of the person who will be moving, as their input should be valued throughout the decision-making process. Navigating the Continuum of Care with Grace Pointe: Your Assurance of a Smooth TransitionAs weve discussed earlier, the decision to move from independent care to assisted living, marking the transition from independent living to assisted living, is a significant one, and its natural to have concerns about the future. Many individuals and families worry about whether theyll receive the care they need as their health requirements change.At Grace Pointe of Greeley, we understand these concerns and are committed to ensuring a seamless transition through our Continuum of Care. Lets explore how Grace Pointes approach is different and how we provide residents with the assurance they deserve.The Continuum of Care Approach: A Personalized PathwayOne of the key features that sets Grace Pointe apart is our Continuum of Care approach. This approach is designed to help residents and their families identify their current care needs and anticipate future requirements. Ongoing assessments are done by our care team to help create a personalized care plan that evolves with the individuals changing needs. This means that residents at Grace Pointe who are looking into transitioning from independent living to assisted living are not locked into a specific level of care, and theres no need to worry about a dishonest bait and switch scenario.Heres how the Continuum of Care approach works:Initial Assessment: When a resident joins Grace Pointe, we conduct a thorough assessment of their health, preferences, and care needs. This forms the foundation of their care plan.Regular Reassessment: We understand that health can change over time. Thats why we commit to regular reassessments of our residents. If their care needs increase or decrease, we adjust their care plan accordingly.Transparent Communication: We foster open and transparent communication with our residents and their families. If a change in care level is required, we discuss it thoroughly and collaboratively.To provide you with a deeper understanding of the exceptional care and support offered at Grace Pointe of Greeley, we invite you to read testimonials from residents and their families who have experienced our continuum of care firsthand. These heartfelt accounts will shed light on the compassionate and personalized care that sets Grace Pointe apart in the journey and benefits from independent living to assisted living.The benefits of independent living at Grace Pointe of Greeley are clear; here, residents can enjoy a worry-free life without the burden of household maintenance while maintaining a healthy level of independence. Yet, when it comes to transitioning to higher levels of care, such as assisted living or nursing care, the process can be emotionally challenging for both loved ones and their families. This shift can be accompanied by mixed feelings, as it often involves adapting to new routines, healthcare requirements, and a shift in the level of autonomy. Grace Pointes Continuum of Care approach supports each transition without the need for residents to physically relocate. Instead, they add necessary services while remaining in their current living units, tailored to each individual and their family for the ultimate peace of mind.Your Peace of Mind at Grace Pointe of GreeleyAt Grace Pointe of Greeley, we are deeply committed to our residents well-being. The transition from independent living to assisted living should not be a source of anxiety. At Grace Pointe of Greeley, we go above and beyond to ensure that residents have peace of mind about their care journey. Experience the Grace Pointe difference through our Continuum of Care approach, where we tailor each transition, ensuring that your family member moves seamlessly from one living arrangement to another with care, compassion, and a deep sense of belonging.We understand that everyones care needs are unique, and we are dedicated to providing the right level of care at the right time, tailored to you and your familys needs. With Grace Pointe, you can be confident that you or your loved one will receive the care and support needed to thrive at every stage of life.
Many people believe that having a Will is all they need, and they dont need an estate plan. Over the years we have worked with many families who only had a Will, and no provisions for needing care in a nursing home. As a result, the healthy spouses financial security was neglected and the family went broke.Many of my clients who want to protect assets from long term care costs, own their houses in an asset protection trust. These are the top 6 reasons why our clients decide to use this trustWhile Your Parents Or Grandparents Didnt Have An Asset Protection Trust, They Didnt Often Need Long Term Care. They likely had family members nearby caring for them.Statistically speaking, your odds of needing long term care are increasing. Estimates point to two out of three people who will need long term care in nursing homes in their 80s. Nursing homes currently cost $15,000 a month, and they will cost even more 20 years from now. Asset protection is important, to avoid losing everything to long term care costs.Estate Planning Is Not Just About Answering The Question Of Who Gets Your Stuff When You Pass Away. Its also about planning for what happens if you get really sick. Weve all been paying into this government system with the promise that when we turn 65, we will have healthcare. Unfortunately Medicare doesnt pay for the single biggest health care expense that seniors face, which is custodial long term care in a nursing home.If your health issue is acute, such as a heart attack, or you need surgery, or have cancer, and require acute care in hospital, Medicare will cover the costs of treatment. Whether my spouse and I are financially secure in our retirement years, depends on the healthcare issue either of us will have. This is often beyond our control, but what we can do is to prepare for all eventualities, by protecting our house with a trust. Medicaid Is The Only Government Payment Source For Long Term Care, But The Rules Are Broken. If youre a single person going to a nursing home, youre allowed to own up to $8,000 of assets, a house and car. A couple with $100,000 in a retirement account, must spend that money on care in the nursing home. Once the money is gone you can apply for Medicaid benefits. However, your monthly income is used to pay for care, and you are only allowed to keep $45 a month for all your personal needs. We have a situation where seniors are going broke before they get Medicaid benefits. Theyre allowed to own a house but if they have no money, they cannot pay property taxes, utility bills or maintenance costs.Assuming your child is a power of attorney, they may sell your house to avoid paying the taxes and bills. However, this means you will now have cash which will result in you losing your Medicaid benefits. Not only do you lose your house, but you will need to spend the money on care. When you are broke, you are eligible for Medicaid benefits again. It is not obvious in the Medicaid rules that you will lose the house. The problem is that it becomes financially impossible to keep the house. Putting your house in a trust will protect it from being lost to Nursing home costs.If The House Is Left To Your Child In Your Will, By Paying The Taxes And Keeping The House, Does Not Guarantee That They Wont Lose The House. When somebody who passes away was on Medicaid, the executor is forced to sell the house. The proceeds are used to pay the state for the care the senior received in the nursing home. This is known as the Estate Recovery Program, and the claim in Pennsylvania is limited to someones probate estate. This means that if the assets go through the Will, it will be a probate case, and the state will have a claim against the house.If your house is in the asset protection trust when you pass away, the state cant get your house while its in the trust. Your kids will inherit the house if you go to a nursing home, or you pass away.Your Kids Will Receive Their Inheritance Faster If Your House In An Asset Protection Trust.We dont have to wait 12 months to make the distribution of the inheritance to the children. The distribution process usually happens after four to five months. This is because we dont have to pay creditors. Usually, in probate cases, creditors can make a claim a year after the person has passed away. Once the creditors are paid, distributions are made to the heirs.When Your House Is In An Asset Protection Trust, The Only Thing You Would Have To Give Up Is Having Access To The Home Equity. However, if you have money in the bank, you wont need home equity. Giving up access to the equity, means the nursing home cant access it either. You have protected your house, so you wont lose it. If you or your spouse need long term care, the healthy spouse can still live at home.There are opportunities to protect yourself, and thats what we teach you at our Three Secrets Workshop. If you want to protect your assets, and you want the best plan for your family, we can help you! After attending our Three Secrets Workshop, most of our clients have participated in our Blueprint Workshop. As a result, many of our clients chose to work with us and put their houses into a trust.Register to attend one of our upcoming free workshops. Our workshops are offered various dates/times and locations throughout the Greater Pittsburgh Area, call 724-564-6615 to learn of upcoming Workshops and to register. We will teach you about the estate planning tools you can use to do some good planning.
In a home-like, caring atmosphere, we strive to provide the highest quality of care and comfort for our residents and families. Long-Term Care: Residents are our number one priority. We are always looking for ways to make individual residents feel at home and to help families feel welcome, giving them the peace of mind knowing that their loved one is well cared for. The facility is staffed with licensed nurses 24 hours each day, 7 days a week, to provide for the needs of our residents at Eagle Ridge. Skilled Rehabilitation: Our experienced and well-trained staff of therapists offers the highest level of therapy services. We offer Physical Therapy, Occupational Therapy and Speech Therapy to assist our residents to attain their optimal functioning level. After therapy is completed, we will assist them in making the transition to long-term care or back to their previous home. Hospice Care: We work closely with Hospice organizations to provide the resident with comfort and love in their time of need, as well as providing additional support for family members. The Hospice groups we contract with are also a wonderful resource for spiritual support. Respite Care: For those families who are taking care of a loved one, we offer this service in our building, as availability allows. For vacations or just needing a week of rest, we would be more than happy to care for your loved one. Our staff is here to serve the residents and families. We offer many wonderful services including Activities, Dietary, Social Services, Housekeeping and Laundry, Maintenance, Pharmacy, Physician and Nursing. We accept Medicare, Medicaid, Private Pay, and many other insurances as well. For more information, please contact: Michelle Vigil Admissions & Marketing Director 970-243-3381 (main) 970-210-1660 (cell) 970-243-1917 (fax) email@example.com 2425 Teller Avenue Grand Junction, Co 81501.
When Its Time for Senior Living, We Help You Find the Perfect Community for You! With over 900 senior living options in the DFW area, Ruby Care helps families make informed decisions. We provide complimentary assistance to find the most appropriate living community including Indepenent Living, Assisted Living, Residential Care Homes, Memory Care & Nursing Home. Our ExperienceIf you've been searching for senior housing for you or your loved one, you know there are hundreds of senior living communities in the Dallas/Fort Worth area. Let Ruby Care help you. We do the legwork at no cost to you and help you find the place that is perfect for you and your family.Our professionals are well-known in the communities they serve. In order to help you best, they network with health care providers, such as home health, hospice, rehabilitation facilities, hospitals, physicians and other senior service providers.Collectively, our team has over 50 years of experience in healthcare and we are trained to listen to your needs so that we can work to find the best options for you...at no cost! Why Us?We know this can be a stressful time for you as you choose your next home. When you work with us, you will be assigned a Senior Living Advisor (SLA) who knows the community and has first-hand knowledge of the communities you are considering. Your SLA will meet with you in person and will listen to your wishes, wants and needs in order to help guide your next steps. Your SLA will also help you with senior living community tours and preparation to help guide you through the selection process. We serve as your advocate and help make this a smooth, seamless transition. Once you have selected a community, we continue to follow up for at least the next thirty days to make sure things are going well and there are no outstanding concerns. possibilities. placement. peace of mind.