New Horizons Un-Limited Inc.
Guide to Searching for and Selecting a Nursing Home
June 8, 1998 [Updated July 31, 2012]
The following is a Guide on Searching for and Selecting a Nursing Home. As there are many people and caregivers facing the problem of searching for and selecting a nursing home, we are including this guide in the hope it will benefit our readers.
The purpose of this guide is to provide information for people with disabilities who are 18 to 59 years of age, and does not necessarily offer information for the elderly.
New Horizons Un-limited assumes no responsibility in guaranteeing the services, programs or conditions as described. If you are interested in a resource listed below, call or contact the resource to verify the current situation. Evaluate information and make your own decisions when using the guide and in choosing your Long Term Care.
One usually doesnít begin to look for something until one is at need. It is important however, to consider and investigate your options for any type of long term care before you need this type of care. Many wish they had started planning years in advance, or at least, began to consider their options well in advance. Being informed may assist you in taking an active role in selecting your long term care.
Have you considered all the options for long term care that may be available to you or better meet your needs? Is a nursing home what you need, or would a group home, day care, assisted living, or home care be better for you?
Doing research, evaluating all your options will help you make your own decision concerning your long term care.
Begin by assessing your situation:
- Checking your insurance coverage, assessing your ability to pay will assist you in what options are available.
- If you are seeking financial assistance from the government or your insurance company, check that nursing home care is covered.
Identify your needs:
- What kind of care do you need?
- Consult your doctor to determine your medical needs.
- Consider your abilities and disabilities.
- To what extent are you able to care for yourself (personal hygiene, dressing, personal care, eating, moving around oneís living environment etc.)?
- For what areas do you need help (do you need ambulatory care, help with medication, etc.)?
Identify your resources:
Identify your resources and begin to gather information from these resources.
- Contact friends, neighbors, and family
- Doctor, hospital
- State and county health departments
- Insurance or financial resources
- Area agencies on aging
- Local library
- Telephone book yellow pages
- Disability organizations
- Clergy or religious organizations
- Long term care ombudsman
- State survey agencies
- Insurance counseling and assistance
Contact friends, neighbors, family:
Or people you know who have dealt with selecting a nursing home. You may be able to get the most reliable information on a nursing home from people you know.
Consult your doctor:
Only a doctor can admit a person to a nursing home
The hospital from which you will be or you have been released:
- Hospital discharge social workers that deal with the needs of the patients being released may be able to recommend a local, quality care nursing home. If you need to receive financial assistance from the government or your insurance company, check that the nursing home will be covered. If you will be unable to get assistance for this care, you may need to ask the hospital or medical social worker to help you evaluate other options for your care; such as home care or respite care, etc.
- Be aware that hospitals may recommend affiliated nursing homes. The hospital may be part of a corporation of health services. Through this affiliation, they may recommend a nursing home. If they cannot, or you do not like the affiliated nursing home, you do have the right to choose another nursing home.
Guides to choosing a nursing home:
There are some resource guides to help you with the selection of a nursing home. Consult Medicare and local agencies on aging.
Consult the Your Guide to Choosing a Nursing Home, published by the Health Care Financing Administration - Medicare and Medicaid U.S. Department of Health and Human Services. View the official government guide on-line or request a copy. The guide is available in several formats for people with disabilities, text audiocassette, large print (text only) Braille, or computer disk. To order call the Medicare hotline 1-800-638-4227, or if you use a TTY/TDD, call 1-800-820-1202.
- If you have questions for Medicare, by consulting Medicare resources, you will be able to be as informed as you can before you call. Be sure to write down all of your questions so you do not miss any while you have a representative on the phone. If you call this number, you will be asked to leave a message. Ask your question in detail and leave your name, address and telephone number.
The Medicare "Guide to Choosing a Nursing Home" is quite comprehensive, offering information on Long-Term Care Options, gathering information about nursing homes in your area, visiting the nursing home (includes a checklist of things to observe), follow up visits before making the final decision, as well as after admission issues; such as resident rights, service and fees, medical care, respect, privacy, etc.
The guide includes a phone list of Long Term Care State Ombudsmans offices, State Survey Agencies, and Insurance Counseling and Assistance Services listed by state. These services should be of help in obtaining information about the nursing homes in your state.
If you are looking for a nursing home in the Southeastern Wisconsin area, contact Interfaith at (414) 291-7500, for "A Consumerís Directory of Nursing Homes and Community Alternatives." The guide includes information about how to select a nursing home, touring checklist, a checklist of questions, and provides profiles of all nursing homes organized by county. Interfaith is an organization for the elderly, and the guide is geared toward assisting the elderly, however Interfaith may assist you in directing you to what nursing homes include facilities and programs for people with disabilities.
Insurance or financial assistance:
You will need to assess how you will pay for your nursing home care. Personal resources, long-term care insurance, Medicaid, Medicare or Medicare Supplemental Insurance, may be ways in which nursing home costs will be covered.
Will you need to seek insurance coverage or government financial assistance for a nursing home?
You will need to ask the nursing home if it is certified by Medicare or Medicaid in order to receive coverage from Medicare or Medicaid.
- If you have any questions about trying to assess what coverage you have, or whether you are eligible for any government programs contact your Stateís Insurance Counseling and Assistance (ICA) program. Consult the Medicare "Guide to Choosing a Nursing Home" for the phone number to your State ICA office.
- Check with Medicare and Medicaid for coverage of nursing home care. "Your Medicare Handbook" describes the conditions under which Medicare will help pay for stay in a Medicare certified nursing home. To obtain a free copy of "Your Medicare Handbook , the Medicare hotline is listed above. You also can view information from Medicare on the internet address listed above.
Area agencies on aging:
Although these agencies will be specifically geared toward nursing homes that serve the elderly, they may be able to give information or guides on nursing homes that care for people with disabilities. If you are elderly, then you should contact your area agency on aging. If you are under 65, depending on your age be sure to inquire of the nursing home you will visit if they offer programs, rehabilitation or include services to non-elderly residents.
Contact disability organizations, or other non-profit organizations, religious organizations, etc.
Contact area churches, community centers, volunteer services, disability organizations, etc. that work with people with disabilities that may know about nursing homes in your area.
Prepare a list of nursing homes you would like to visit:
If you have decided that a nursing home is the long term care option that will be right for you, begin preparing a list of nursing homes that you would like to visit.
- Consult your list of resources mentioned above for recommendations.
- Check the yellow pages of the telephone book under the listings for "Nursing Homes" or "Residential Care Facilities" for nursing homes in your area.
For more information on nursing homes:
- If you are looking for a nursing home in the Milwaukee area, contact Interfaith for "A Consumerís Directory of Nursing Homes and Community Alternatives."
- Contact your local Long-term Care Ombudsman Program. A complete listing of State Long Term Care Ombudsman phone numbers is in the Medicare, "Guide to Choosing a Nursing Home."
Some items to consider when making your initial list:
- If you require care for special medical conditions or special care needs make sure the nursing home can meet these special needs.
- Consider your age and whether the nursing home can meet the needs of younger residents.
- Consider the proximity of the nursing home to family and friends so that they can visit you. Check with the nursing homes to see if they offer complimentary transportation to family and friends, and to verify the availability of this transportation.
- Is there space available in the nursing home?
- Religious or cultural affiliation
- Not all nursing homes are licensed to care for developmentally disabled, psychological needs or mental illness individuals. All nursing homes may preform a preadmission psychological screen, or may contact services or hospitals to perform this screening to determine if you are appropriate for a nursing home. Your doctor may be able to waive the screen if your medical condition supersedes your psychological screen determination. Check with the nursing home as to their licensing concerning psychological needs. They may not be able to offer you the special therapy, rehabilitation etc. that you need. If your doctor requests active treatment for your needs they may be able to refer you to a nursing home that can accommodate your needs
Call the nursing homes you wish to visit:
Asking the right questions regarding the nursing home, will get the answers you need.
- If you require insurance coverage is the nursing home certified by Medicare? Contact your state survey agency or watch for this posting at the lobby of the nursing home. Certification by medicare means the service meets federal requirements for patient care and financial management. Consult the Medicare "Guide to Choosing a Nursing Home" listed above for the list of phone numbers of State Survey Agencies.
- How many years has the nursing home been in business of health care?
- Ask for a written care plan that will detail the services to be provided you, and financial arrangements before service begins.
- How does the service protect client confidentiality?
- Ask for references of the nursing home, former patients, or caregivers that have first-hand knowledge of the nursing home.
- Does the nursing home offer rehabilitation care for all patients and how often? If you are considering a short stay, this may be very important in regards to being released in a timely manner.
- Ask for a tour packet.
The nursing home will ask you:
- They will want to call your doctor to get medical history, medication requirements, requirements for skilled care if ordered, such as nurses, physical therapy, medical education, or medical social work, etc.
- The nursing home will want to do an assessment or psychological screen.
- They will ask about your insurance benefits, Medicare, Medicaid prior authorization.
- Do you have advance directive or a power of attorney?
Visiting the nursing home, follow-up visits, admissions and after-admission rights:
Consult the Medicare/Medicaid publication Your Guide to Choosing a Nursing Home, and other resources for visiting the nursing home check lists, follow up visits, admissions and after admission rights. Being informed will help in taking an active role in choosing your nursing home care.
Nursing Homes in Wisconsin:
View the Choosing Wisconsin Residential Options for a county by county possibilities for health or residential care in Wisconsin.
Visit the Wisconsin Department of Health Services Wisconsin Nursing Homes Nursing homes are listed by county, city, facility name or see the download the spreadsheet. Call the nursing homes listed in which you are interested to check the current situation for people with disabilities.
If you have questions or ideas, information and solutions that you would like to share with us, contact us by e-mail at: firstname.lastname@example.org or to use our NHU E-Mail Form or NHU Community Forum, click the links below.
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[Updated July 31, 2012]
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