The True Benefit of Palliative Care: Talking to Patients About Their Goals and Wishes

VERY IMPORTANT: Regarding Medicare it is illegal for an insurance agent to call, text, e-mail, knock on your door, hang anything on your door or vehicle or approach you without your consent. If they do ask for their National Producer Number NPN, and you will hear a click and removed from their list. If they dont hang up, get their number and report them to Medicare. There is so much fraud where people are being switched to plans that they never approved or they were miss led. Shop local, do background checks before you give anyone your personal information. You can google them, google reviews, check their Facebook, etc. Make sure that if you are working with someone you can call them personally if you have any questions or concerns. Medicare Annual Enrollment is October 15-December 7th for January 1st, 2027, effective. What can be changed at this time is Medicare Part D Drug Plans and Medicare Part C (Advantage Plans). You should have received your Notification of Change from your current insurance plan. This outlines the current year to the new year changes, as an example if your specialist provider costs $20 now it might say $35 in 2027 (no correlation just an example). Medicare Part C / Advantage Plans, most carriers have raised out of pocket limits and copays along with decreased extra value benefits for 2027.  Annually Medicare Advantage Plans make changes. They must all include the same features as Original Medicare but not at the same cost share. They can have a premium, Medical and or Prescription deductible, copays and coinsurance can change. Extra Value such as Vision, Dental, Over the Counter, Part B Give Back, transportation, etc. can all change or be eliminated. Medicare sets the annual in-network out of pocket maximum; in 2026 it is $9,250 for in-network and $13,900 out-of-network services combined (2027 this will increase). However, individual insurance plans may set lower limits. The old saying if it is not broken do not fix it DOES NOT apply to Annual Enrollment. Every year I see many people that have not checked/compared their current plan to what is new. I have saved so many people hundreds and in many cases thousands of dollars. You should be working with a broker that represents many insurance companies. Make sure you check them out, especially if you are going to allow someone in your house. I recommend meeting in their office. For me we represent most insurance carriers in our area and carrying all their literature with me is almost impossible. We use three large screens so that our clients can clearly see and compare the differences between the plans. The minimum information always needed is all your doctors, medications: names, milligrams, and dosage. We load your current plan and then compare it to all the other companies in your area. What companies have all your doctors, the price for your medication normally makes a significant difference. Then the Extra Value is what is most important to you. We do NOT CHARGE for your review and if warranted to change your insurance plan. Ethics is most important and if you are on the best plan we will tell you, plus you can see for yourself. If your plan was CANCELLED/DROPPED for 2027, you have a guaranteed issue into a Medigap/Medicare Supplement.  This is huge and very important, know your options!Medicare Seminars they are good for general information. A one-to-one appointment where you can dive into your doctors and medication is best, plus you can then compare other companies in one place. Medicare Part D most insurance carriers have taken away insurance agents ability to help you with your Part D Only drug plans this does not apply to most Advantage plans, standalone drug plans as well as Advantage Plans, you wont have to pay more than $2,400 in out-of-pocket drug costs, which include deductibles, co-pays, coinsurance. It is especially important to check your plans formulary as medication must be in formulary to be capped. 2027 RX deductible will be capped at $715.00. As a reminder the cost of the plan is not as important as the cost plus your medications, that is what you look at, the total cost. It is important to know what the medication is used for to determine if it is covered by the plan. Example Wycovy may be covered but to be covered it must be used for certain heart conditions or diabetes, Medicare does not cover weight lose medications at this time.  As a reminder if you choose NOT to ENROLL in a Part D drug plan and in later years you want one you will have to wait for Annual Enrollment and then you will assed a penalty for every month you did not have a drug plan, that penalty will last for the REST OF YOUR LIFE! When you turn 65 you are eligible for Medicare, once you have worked 40 quarters roughly 10 years there is no cost for Medicare Part A. Part A covers Hospitals, Skilled Nursing, Home Health & Hospice. Medicare Part B you can choose to take at 65, or you can hold off if you are still working and have credible coverage. If you do not have group health insurance that is considered qualified, and then you want Medicare you would have a late enrollment penalty for each month you did not have Part B & Part D, and that penalty will last for the rest of your life. Part B covers doctors, imaging, blood work, ambulance, durable medical equipment, etc. Part D is a Medicare Drug Plan and covers medications. During your initial enrollment period it is especially important to understand your options! Medicare Supplements/Medigap Plans are NOT guaranteed issues; you may need to medically qualify. You can purchase a Medigap Plan during your 1st 6 months on Medicare Part B without medical underwriting. There are a lot of things you need to know. Again, work with an agent you can trust! Especially important: when you move you need to know your options. Can you keep the same plan? Do you need to make a change and what does that look like? Logical Insurance Solutions is a SWFL Insurance Broker that works with most of the insurance carriers in your area, we are happy to help you through the maze. We offer Free Medicare Seminars, Personal Appointments & Virtual appointments. Please e-mail [email protected] to register or call 239-362-0855 for dates. Medicares website is www.Medicare.gov. www.Logicalinsurance.com    239-362-0855    [email protected] Ulla-Undine Merritt (Dee) National Producer Number (NPN) 8853366 

One of the most important decisions families can make as their loved one's age is when to begin exploring senior living options. Too often, the conversation doesnt happen until a crisis occursa fall, hospitalization, medication concern, caregiver burnout, or sudden change in care needs.At that point, families may feel overwhelmed and pressured to make a major decision quickly. Instead of choosing what truly feels right, they may simply choose what is immediately available.Senior Living Should Be a ChoiceNot a CrisisPlanning ahead gives seniors and their families something incredibly valuable: time.Time to tour communities.Time to ask questions.Time to compare services and costs.Time to meet the team.Time to understand care options.And most importantly, time for the senior to have a voice in the decision.When the decision is made proactively, seniors can participate in choosing where they want to live, what lifestyle appeals to them, and what is important to their daily happiness and independence.Why Families Choose Springwood CourtAt Springwood Court Assisted Living, we believe the transition to senior living should feel like a new beginningnot a response to an emergency.Our goal is to provide a warm, welcoming environment where residents can receive support while continuing to enjoy the things that make life meaningful.With a tenured, experienced team, 24/7 staff presence, engaging activities, chef-prepared meals, housekeeping, outings, and a strong focus on personalized care, Springwood Court strives to create a community where residents feel known, valued, and at home.Our philosophy is simple:The building may be brick and mortar, but the people are what make it a home to thrive! That is why we encourage families to visit us before there is a crisis. Come through the doors. Meet our team. Talk with residents. Ask questions. Learn about our services and how we can support changing needs.Planning Ahead Protects ChoiceExploring senior living early does not mean someone has to move immediately.Sometimes the best first step is simply taking a tour and beginning a conversation. A senior may decide they arent ready todaybut now the family knows their options and has a relationship with a community they trust.That preparation can make an enormous difference when circumstances eventually change.Dont Wait Until There Is No ChoiceA crisis can take away options. Planning creates them.At Springwood Court, we want families to feel comfortable starting the conversation earlywhen there is time to make thoughtful decisions, involve their loved one, and find the right fit.Start the conversation. Take the tour. Ask the questions. Know your options.Because senior living should be about choosing where you want to livenot simply finding somewhere to go when you have nowhere else to turn.Springwood Court Assisted LivingFeel the Difference.The Residents Are Not Our Business. They Are Our Why.

What Families Should ExpectA hospital discharge does not always mean someone is ready to return home.An older adult may still need wound care after surgery. Another person may need physical therapy after a fall or joint replacement. Someone recovering from pneumonia, a stroke, or another serious illness may require nursing oversight, medication management, rehabilitation, and help rebuilding strength before living independently again.Other families face a different situation.Their loved one may need ongoing nursing care for a chronic health condition that can no longer be safely managed at home or in assisted living.In both situations, skilled nursing can provide a higher level of clinical support.For families in Boise, Idaho, The Terraces of Boise provides both short-term rehabilitation and long-term skilled nursing care within its nonprofit HumanGood Life Plan Community. The skilled nursing center is located at 5301 East Warm Springs Avenue in Boise and accepts both current Terraces residents and people from the wider community through direct admission.What Is Skilled Nursing?Skilled nursing is different from ordinary personal assistance.According to Medicare, skilled care involves nursing or therapy services that must be safely and effectively performed by, or under the supervision of, qualified healthcare professionals. Skilled nursing facilities may provide nursing care, physical therapy, occupational therapy, speech-language pathology, meals, and other medically necessary services.Skilled nursing may be appropriate when someone needs:Nursing oversightRehabilitation after hospitalizationWound careMedication managementRespiratory treatmentAssistance recovering from surgeryPhysical, occupational, or speech therapyOngoing long-term nursing careThe level of care is generally more medically intensive than assisted living.Family Tip: When comparing senior care options, ask whether the person primarily needs help with everyday activities or whether they require ongoing clinical nursing and rehabilitation services. That distinction can help determine whether assisted living or skilled nursing is the more appropriate setting.Skilled Nursing Is Different From Assisted LivingFamilies sometimes use the terms interchangeably, but assisted living and skilled nursing serve different needs.Assisted living generally helps older adults who need support with daily activities such as:BathingDressingMedication routinesMobilityMealsHousekeepingSkilled nursing is designed for people who require more intensive medical monitoring or rehabilitation.Medicare describes nursing homes as facilities for people who typically require 24-hour care and notes that they may provide both short-term rehabilitation and long-term assistance.At The Terraces of Boise, assisted living and skilled nursing are both available on the same Life Plan campus, but they are separate levels of care.Short-Term Rehabilitation Can Help Bridge the Gap Between Hospital and HomeOne of the most common reasons someone enters skilled nursing is short-term rehabilitation following hospitalization.A person may be medically stable enough to leave the hospital but still not strong or independent enough to return home safely.The Terraces of Boise provides post-acute rehabilitation designed around helping patients regain function and return home as quickly and confidently as possible. HumanGood describes the program as individualized around each person's recovery goals, including physical and emotional needs.Short-term rehabilitation may be appropriate after:SurgeryIllnessInjuryHospitalizationA significant decline in mobilityThe goal is not necessarily long-term residence.For many patients, skilled nursing is a temporary step between the hospital and home.Physical Therapy Can Help Rebuild Strength and MobilityPhysical therapy is one of the primary rehabilitation services offered at The Terraces of Boise.The program includes customized therapy intended to improve:Muscular strengthCoordinationBalanceConfidenceMobilityThe Terraces also maintains multiple therapy gyms and state-of-the-art rehabilitation equipment.Physical therapy may be especially helpful following:Hip or knee surgeryA fallExtended hospitalizationStrokeGeneral weakness after illnessThe goal is individualized.For one person, success may mean safely walking with a walker.For another, it may mean navigating stairs or transferring independently from bed to chair.Occupational Therapy Focuses on Everyday IndependenceOccupational therapy is another important part of rehabilitation.While physical therapy often focuses heavily on strength and mobility, occupational therapy can help people regain the skills needed for everyday life.The Terraces of Boise includes occupational therapy within its skilled nursing program and provides an occupational therapy environment for practicing daily activities before returning home.Therapy may address tasks such as:DressingGroomingTransfersHousehold activitiesOther daily routinesThis can be particularly important when a person is physically improving but still lacks confidence completing practical tasks independently.Speech Therapy Can Address More Than SpeechSpeech-language pathology can help with communication, cognition, and swallowing.The Terraces currently includes speech therapy among its rehabilitation services, with care aimed at cognitive skills as well as the muscles involved in eating and speaking.A speech-language pathologist may become part of recovery after conditions such as:StrokeNeurological illnessCertain surgeriesOther health events affecting communication or swallowingFamilies should ask the rehabilitation team which therapies are included in the individual's treatment plan and what goals are being addressed.Registered Nurses and Physicians Are Available Around the ClockThe Terraces of Boise currently states that its skilled nursing program includes 24/7 physician and registered nurse availability.This can be particularly important for people recovering from complex medical events or managing ongoing health needs.Round-the-clock professional support may help address:Changes in conditionMedication needsTreatment concernsPost-surgical recoveryOther clinical needsFamilies should still ask who is physically on-site at different times of day and how physicians are involved in care planning.Medication Management and Monitoring Are IncludedMedication regimens can become complicated following hospitalization.New prescriptions may be added.Other medications may be discontinued.Dosages may change.The Terraces includes medication management and monitoring among its skilled nursing services.This can help ensure that the treatment plan established by physicians is followed consistently during recovery.Medication questions, side effects, and treatment changes should still be discussed with the appropriate healthcare professionals.Wound Care and Surgical Recovery Are AvailableSome patients leave the hospital still requiring wound care.The Terraces of Boise currently lists wound management and surgical recovery among its skilled nursing services.This may be relevant for people recovering from:Major surgeryOrthopedic proceduresChronic woundsOther medical conditions requiring professional treatmentFamilies should discuss the specific wound-care requirements with the clinical team before admission to make sure the facility can meet the person's needs.Respiratory Treatments May Also Be ProvidedThe Terraces' skilled nursing program currently lists respiratory services including:Oxygen therapySuctioningBiPAPCPAPThese services can be important for people with respiratory conditions or those recovering from certain illnesses.Because respiratory needs vary considerably, families should verify whether the facility can accommodate the specific equipment and treatment plan required.Restorative Nursing Can Help Maintain FunctionThe Terraces also lists restorative nursing among its skilled nursing services.Restorative nursing is intended to help patients maintain or improve physical function and support continued independence following formal therapy.This can be especially valuable when a person has completed more intensive rehabilitation but still needs encouragement and structured support to maintain progress.The "House Model" Creates a More Residential EnvironmentSkilled nursing environments do not all look the same.The Terraces of Boise uses what HumanGood calls a house model.Its skilled nursing center consists of smaller household-style areas built around open living rooms, dining rooms, and kitchens. Each house contains only 16 private suites, and each suite has a private bathroom.The Seniors Blue Book skilled nursing profile currently lists 48 total beds, consistent with three 16-suite households.This smaller-scale layout is intended to create a more home-like environment rather than a traditional institutional feeling.Families touring skilled nursing may want to look beyond the clinical services and ask:How private are the rooms?Where do residents eat?Are there comfortable places for visitors?Does the setting feel calm?Can patients spend time outside their rooms?The environment can have a meaningful impact on the recovery experience.All Skilled Nursing Suites Are PrivateThe Terraces currently states that all skilled nursing accommodations are private suites with private bathrooms.This can provide additional comfort during both short-term rehabilitation and long-term care.Private rooms may give patients:More privacyA quieter recovery environmentBetter space for visitorsGreater comfort during personal careFamilies should confirm current room availability when discussing admission.Meals Are Prepared in the Household KitchenDining can be another way a skilled nursing environment feels more residential.The Terraces states that meals are prepared fresh in open-concept kitchens and served in each household dining area.The current Seniors Blue Book profile also notes that meals can be customized for certain dietary needs, including vegetarian and gluten-free options.Patients with medically prescribed diets should have those requirements reviewed by the clinical and dietary team.Families may want to ask about:Texture-modified dietsFood allergiesSodium restrictionsDiabetes-related needsIndividual preferencesLong-Term Skilled Nursing Is Available TooNot every skilled nursing admission is temporary.Some older adults require ongoing care because their medical needs are too complex for home or assisted living.The Terraces provides long-term skilled nursing care in addition to short-stay rehabilitation. HumanGood describes its approach as person-centered and intended for both short- and long-term needs.Long-term residents may need ongoing support with:Nursing careMedication managementPersonal careMobilityChronic health conditionsMedical treatmentsThe clinical team works with residents and families to develop personalized care plans.The Terraces Works With Boise Health SystemsThe Terraces of Boise states that it is a preferred post-acute partner of both St. Luke's and Saint Alphonsus Health System for rehabilitation and skilled nursing care.HumanGood also lists a partnership with St. Luke's Medical Group as part of the post-acute program.These relationships can help support continuity as patients transition from hospital care into rehabilitation.Families should still ask how medical information, discharge instructions, appointments, and follow-up needs are communicated between providers.Skilled Nursing Is Open to the PublicA person does not need to live at The Terraces before using its skilled nursing center.The current Seniors Blue Book profile specifically states that The Village at The Terraces is open to the public, with no entrance fee or community fee required for skilled nursing admission.That means someone can be admitted directly after a hospital stay even if they have never lived in the independent or assisted living portions of the campus.Medicare Coverage Depends on EligibilityThe Terraces skilled nursing center is Medicare-certified according to the current Seniors Blue Book profile.However, Medicare does not automatically pay for every nursing home stay.Medicare Part A may cover skilled nursing facility care for a limited period when specific eligibility requirements are met and the skilled services are medically necessary. Medicare does not generally pay for long-term custodial nursing home care when skilled care is not required.Families should verify coverage directly with Medicare, their insurance plan, and The Terraces before admission.Current Skilled Nursing PricingThe current Seniors Blue Book skilled nursing listing for The Terraces of Boise shows rates beginning at approximately $469 per day. It also lists payment options including Medicare, private insurance, and Veterans Administration benefits.Rates, coverage, and benefit eligibility can change.Families should request a current written estimate that explains:Daily room rateTherapy chargesTreatment costsInsurance coverageMedicare coverageOut-of-pocket responsibilityLong-term care pricingDo not rely only on an advertised starting rate.Why the Life Plan Community Model MattersThe Terraces of Boise is more than a skilled nursing center.It is a nonprofit Life Plan Community offering:Independent livingAssisted livingMemory supportSkilled nursingShort-term rehabilitationFor existing residents, having skilled nursing on the same campus may provide continuity if a health event occurs.For example, an independent living resident who undergoes surgery may temporarily receive rehabilitation in the skilled nursing center and later return to their independent residence when ready.Long-term nursing is also available when needs become more permanent.The Terraces of Boise Contact InformationThe Terraces of Boise5301 East Warm Springs AvenueBoise, Idaho 83716Main Phone: 208-336-5550Skilled Nursing / Rapid Response: 208-504-2990Sales Office: 208-795-3405The campus is located in Southeast Boise near Harris Ranch and the Boise River Greenbelt.The Terraces is operated by nonprofit affiliates of HumanGood, a nonprofit organization serving older adults since 1949.Questions to Ask Before Choosing Skilled NursingWhat Medical Needs Can the Facility Manage?Discuss wound care, respiratory needs, medications, mobility, and other treatments.Which Therapies Will Be Provided?Ask whether physical, occupational, and speech therapy are included in the plan.How Often Will Therapy Occur?Frequency depends on the person's condition, goals, and insurance authorization.Who Is Available Overnight?The Terraces currently lists physician and registered nurse availability around the clock.Is the Goal Short-Term Recovery or Long-Term Care?Make sure the family and care team have the same expectations.How Will Discharge Planning Work?For short-term rehabilitation, ask what milestones need to be achieved before returning home.What Will Insurance Pay?Verify Medicare and insurance benefits before admission.Frequently Asked Questions About Skilled Nursing at The Terraces of BoiseDoes The Terraces offer both rehabilitation and long-term skilled nursing?Yes. The community provides short-term post-acute rehabilitation as well as long-term skilled nursing care.Are the rooms private?Yes. HumanGood currently states that all skilled nursing suites are private and include private bathrooms.Is rehabilitation available after hospitalization?Yes. Short-term rehabilitation is specifically designed for people recovering from illness, injury, surgery, or another health event.What rehabilitation therapies are available?Current services include physical therapy, occupational therapy, and speech-language pathology.Can someone who does not already live at The Terraces be admitted?Yes. The skilled nursing center accepts direct admissions from the community and is open to nonresidents.Find The Terraces of Boise Through Seniors Blue BookFamilies researching skilled nursing in Boise, Idaho can also review The Terraces of Boise on SeniorsBlueBook.com.The current skilled nursing profile lists:48 skilled nursing bedsPrivate roomsShort-term rehabilitationLong-term carePhysical, occupational, and speech therapyRespiratory treatmentWound managementSkilled nursing servicesMedicare certificationCurrent starting daily pricingBecause availability, pricing, insurance coverage, and clinical needs vary, families should contact The Terraces directly before making an admission decision.Skilled Nursing Can Be a Bridge or a Long-Term SolutionSome people come to skilled nursing because they are working toward home.They need therapy.Time.Nursing support.A safe place to rebuild strength.Others need an ongoing level of care that can no longer be provided safely in a less intensive setting.At The Terraces of Boise, the skilled nursing program supports both situations through 24-hour professional care, individualized rehabilitation, private suites, therapy services, medication management, wound and respiratory care, and long-term nursing options.For Boise families, the most important question is not simply:Does my loved one need a nursing home?A better question is:What level of clinical care, rehabilitation, and daily support does this person need right now, and what setting can safely provide it?Sometimes skilled nursing is the bridge between the hospital and home.Sometimes it becomes the right long-term setting.Either way, understanding the purpose of skilled nursing can help families make the next decision with greater clarity.