Folks have two basic concerns:
- They would like to avoid nursing home care if they can. If they can’t, they wanna get the best they can.
- They would like to avoid becoming a burden on their friends and family. If they can’t, they wanna make life as easy on the family as possible.
In my area there is a disproportionately large number of people that leave inpatient rehab. Inpatient rehab is when, for example, you survive a stroke and you are getting better. Now you might benefit from some rehabilitation. But because you’re still not well, you need to be in a hospital-type setting. You have what they call inpatient rehab.
So how do you start your post-hospital-recovery while being responsible, cost effective, and with as little bother to your family as possible?
We have, for example, under the Medicaid program, there is a in-home care benefit program. It’s what’s called a Medicaid waiver program.
- On the Arkansas side they call it Elder Choices.
- On the Texas side they call it the Star Plus waiver.
Most people I deal with cannot afford to pay $15 to $20 an hour for somebody to help them get off the couch, to the bathroom, and back to the couch all day long. If you’re talking 24 hours a day at $15 an hour, you’re looking at 300 bucks a day, give or take. That’s $9,000 a month depending on how often you’re using it.
Most people cannot afford to just private pay for that care. In which case they have a tendency to opt for, trying to look at something like a Medicaid program.
This has its advantages like being able to stay at home, but you also have a long waiting list, and more often than not, the program is underfunded. In some cases the wait can be 12 months, 16 months, 18 months, two years depending on your location. It can be hard to be treated like a priority.
Veteran programs can help pay the cost. But, even if the VA is surprisingly fast at processing your claim, you will still expect to be spending about two to three months waiting for that claim to find its way into your bank account.
You need the care to start on day one.
This is where the Skilled Nursing Rehab comes into play
Skilled Nursing Rehabs offer the same therapies as rehab, physical therapy, occupational and speech therapy facilities, but they are not licensed to give as many hours as hospitals are. So, their therapies are a little more intense.
And so, we’re talking about the difference between, say, three to four hours in an inpatient. A skilled nursing rehab is licensed for anywhere between two and two and a half hours per day. All your care is provided in the facility everywhere from your therapies, lab draws, and they provide medications 6 days a week.
So the Skilled Nursing Facility can most likely see you day one, offer you professional care, and you can still have visits from your family. Some facilities have individual rooms. If you do your research you will see that the facilities are always upgrading and getting better by the day. Your chances of a speedy recovery are good.
But, with all that being said, there’s still a lot of confusion, because they’re changing these rules all the time. Most of this stuff is at least initially paid for by Medicare. So whether you’re in that inpatient rehab at the hospital, or in a skilled nursing facility, at least for that first 20 to 100 days, you are covered.
This is how to take advantage of it. The first 20 to 100 days could be covered by medicare. The rise in popularity in Skilled Nurse Rehab centers could be because people are getting a personalized recovery.
20 to 100 days may be all you need to get back on your feet. This is an interesting idea to consider if you want to limit the amount of time you will have with an at home caretaker.
Choosing the facility that is right for you
Ranking systems like that provided by the CMS are about as reliable as tap water in Nuevo Laredo. Not necessarily something you wanna put all your faith in.
Essentially, the rating systems are based on a very brief window on the facility. They basically come in and look at the facility for about a week.
I was reading an article from the caring.com website and it was talking about how poorly these reports actually reflect anything. For example, the staffing issue. They don’t look at it across, say a six month period or a year period, they’re basically looking at it that day or that week that they’re there. They say these reports are often wildly inaccurate at describing the staffing levels for example.
Although CMS has put a lot of effort into creating these star rating programs and making them available on the internet, the fact is, they’re just not particularly reliable.
So, you’ve got to come up with another way of determining which of these facilities you wanna go to if you’re headed that direction. And I wouldn’t give this stuff much credit. One of the things it was noting on here is that the rating system and how they’re rated vary from state-to-state.
Two identical facilities with identical situations and identical staffing numbers… If everything else were the same, just by being on one side of the state line or the other, one ends up with a higher star rating than the other.
And that’s why we would encourage everybody to go look at the facilities. Physically go and take a tour (or send a trusted companion). You can tell a lot about the atmosphere of that facility and how your loved one would fit there just by walking in the doors.
If I’m gonna be making that kind of recommendation, I need to go in and put eyeballs on the place. And if you’re talking about moving a family member in there, do the same.
And compare. Especially when you’re talking about the difference between the long term care rehab environment versus a Skilled Nursing Rehab, make sure you understand the differences in care.
What did you think of our insight? Like I stated before, these things can get confusing and laws are always changing, so please feel free to get in contact with us if you would like to get more information and go on the the next step.
Ross & Shoalmire are able to bring you this information in part because it’s our passion. We know its importance and we want this information to reach you so bad that we’ve taken the time away from our 6-7 day work week to bring you this blog post.