Expert Guest Column
Choosing a Nursing Home
by Robert J. Fogg
Selecting a nursing home or assisted living facility can be a
challenging process, but there are many resources to help you find one to match your needs. First, it may useful to get advice from either the attending physician, social worker, or a geriatrician to determine what level of care is the most appropriate for you or your loved one. The choices include skilled nursing care, assisted living services, and an independent living community for seniors. If the patient needs skilled nursing or is being discharged from a hospital for post -acute rehabilitation and needs 24/7 supervision, a skilled nursing facility is your best option. If the patient can live somewhat independently and needs only limited nursing services and some assistance with personal care activities, assisted living may be the best choice. If the patient is independent but in declining health, or dementia is beginning, a Continuing Care Retirement Community may be a good option.
Government regulators have brought consumers the value-added service of quality ratings for nursing homes, notably the federal “Nursing Home Compare” five-star rating service created by the Centers for Medicare and Medicaid Services (CMS), at www.medicare.gov/
NHCompare. CMS uses measures such as health survey and inspection results, staffing levels, and quality indicators such as percentage of residents with pressure sores, weight loss or urinary tract infections. CMS also offers the free, 72 page “Your Guide to Choosing a Nursing Home” at http://www.medicare.gov/
Publications/Pubs/pdf/02174.pdf. The Health Care Association of New Jersey provides helpful information on choosing long term care on its website at www.HCANJ.org
. Other information, such as facility report cards, can be found at www.nj.gov/health
healthfacilities, the website of New Jersey Department of Health and Senior Services, which is also developing a rating system for assisted living facilities.
Long-term care services are, of course, expensive. To the extent that your loved one has remaining financial resources,
they will need to be used or “spent down” before they may qualify for Medicaid. To plan for Medicaid eligibility, consult a qualified elder law attorney. If the patient is being discharged from an acute care hospital, Medicare will typically pay for at least 20 days of rehabilitation in a skilled nursing facility. Assisted living is mostly paid for privately, although Medicaid may be available to cover a limited portion of the cost. Continuing Care Retirement Communities have all three levels of care, but typically have large entrance fees and monthly maintenance charges.
Robert J. Fogg, the former Director of Licensing and Certification at the New Jersey Department of Health and Senior Services, is Chairman of the Health Care Law Group of Archer & Greiner P.C. in Haddonfield and Princeton, where he concentrates on representing health care providers including hospitals, nursing homes, physicians and other health care facilities. He can be reached at 609-580-3702 or email@example.com
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