Q. What is MEDICARE?
A. Medicare is a health insurance program for people 65 or older or people under 65 with Certain disabilities.
MEDICARE PAYS: 100 days per benefit period (based on your need for daily skilled care).
Covered services include:
- Room/Meals/Routine Nursing Care
- Rehabilitation Therapies and Services — Physical, Occupational, Speech
- Medications/Medical Supplies
Prior Medicare-covered 3-day inpatient hospital stay.
Skilled nursing care must begin within 30 days of hospital discharge.
To qualify for a new 100-day benefit period, there must be a 60-day break in services, a new 3-day hospital stay, and you must not have been receiving skilled services (i.e., tube feeding, wound care).
Medicare covers the first 20 days in full. After day 20, there is a $161.00 per day co-pay with Medicare (the amount is subject to change). This is your responsibility. In many instances, your private medical insurance will reimburse you for the co-pay amount.
SERVICES NOT INCLUDED: Private duty nurses, newspaper, hairdresser and other personal convenience items, custodial nursing home care.
It is important to remember that Medicare allows you UP TO 100 days of skilled nursing care. As long as it is
determined by the Medicare Utilization Review that there is a need for skilled nursing and/or rehabilitation care,
Medicare benefits apply within the 100-day benefit. Our billing office will be happy to provide you with current rates and coverage.
As of June 22, 1998 we are required to electronically transmit resident assessment information to the State. The
State is then required to transmit the data to the Federal Central Office Minimum Data Set (MDS) Repository of
the Health Care Financing Administration.
All resident assessment information is protected under the requirements of the Federal Privacy Act of 1974 and
the MDS Long Term Care system of Records.
Q. What is MEDICAID?
A. The Medicaid program provides medical benefits to people who have no medical insurance or inadequate medical insurance. The federal government establishes general guidelines for the program, but each state establishes the program's requirements including eligibility. You can find out more about the Medicaid program through cms.gov or by contacting our billing office.
Q. What are the different levels of care available?
A. Skilled nursing and rehabilitation centers are for those recovering from illness, injury or surgery. Many patients need additional medical and rehabilitative therapies before successfully transitioning form hospital to home. Some resident choose to make a skilled nursing center their home. In this case, it usually means residents need medical supervision and more support than can be provided safely at home.
Q. What should I look for when choosing a skilled nursing and rehabilitation center?
A. Inquire about the facility's experience with providing treatment for your loved one's specific needs. Ask about the commitment and longevity of management. Tour the Facility! Meet staff and speak with other patients and family members. Is the facility clean, is the staff friendly is the food appealing? Ask questions about concerns that may be specific to you or your loved one.
Q. What should I think about when moving a loved one into a long-term care setting?
A. This decision involves assessing the ability of the chosen facility to provide a personalized plan of care for your loved one. Meeting the individual needs of the resident along with the expectations of the family is of the utmost importance. How is this achieved? Tour the Facility! Ask questions of staff, residents and their family members. Ask about the commitment and longevity of management and key staff. Is the staff friendly? Are the residents engaged in activities? Is the facility clean? Is the food appealing? Ask the county ombudsmen and the Office of Health Care Quality about the facility you are considering. Review the annual Maryland family satisfaction survey at http://mhcc.maryland.gov/consumerinfo/nhguide/default.aspx, along with the Nursing Home compare at Medicare.gov.
Q. What are the visiting hours?
A. The lobby is open 8AM to 8PM to welcome visitors. Visiting from 8PM to 8AM can be arranged.
Q. Can my pet visit?
A. Yes, vaccination records must be up to date and a copy provided to the facility.