Difference between Skilled Nursing and Assisted Living? Does Medicaid pay for Assisted Living?
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- čas přidán 8. 07. 2024
- This is a response to a longer discussion thread on Facebook that was posted yesterday.
Joe is a Certified Senior Advisor, and owner of Assisted Living Locators (Bergen County, NJ).
Free Consultation: (201) 345-5006
josephc@assistedlivinglocators.com
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This is just my nursing perspective, if you have a loved one diagnosed with advanced Dementia, I do recommend to put your loved one in a Nursing home/Custodial care rather than Assisted living. I have experience working both in skilled & Assisted living, I can tell the big difference between the two. Some states, for example, Arizona, allows Certified Caregiver to administer the medications to assisted living/memory care residents, these include, blood thinner, BP meds, Narc pill, Patches, eye gtts, & insulin. Companies in AZ are willing to certify their caregivers to become a MEDTECH ( Medication technician ) in only 2-3 extra days of training. Your loved one may not need skilled care such as IV's, PEG-tube, PT/OT because he or she is still able to live with minimal ADL's ( Activity of daily living ) such as, assist in bathing, dressing, grooming, cuing or meal supervision. At some point, maybe the assisted living/memory care unit would be ok, it's all depends on the family preference and of course their budget. I am talking about based on my nursing experience & perspective. The Skilled Nursing facility has it's own custodial care unit or LTC ( long term care ) Some SNF facility has a lockup unit for advance dementia residents. For residents who are diagnosed with early dementia or mild without significant deficiency, they will remain in an open unit environment. While Assisted living has it's own lockup building, the staff, mainly caregivers, sometime not even certified caregivers are the primary staff providing direct/beside care to their residents. Most of the time, the degree of training to handle the high level of impaired memory case is not sufficient. Assisted Living may have a Memory Care Coordinator or Supervisor, some of them are not Nurses & no nursing background at all. Lately, Arizona is now hiring an LPN as Memory Care coordinator. When I used to work in assisted living, the former Supervisor/Wellness Manager I replaced, was a Caregiver Manager for 14 yrs, so when other caregivers called the Wellness Manager for medications & fall incident's questions, what kind of clinical response would you expect from someone who does not have a Nursing clinical background? let alone, if the concerns are about, blood thinner, long acting vs rapid acting insulin. Most of the time you will see a lot of discrepancy on the medications. The reality in Memory care unit, the residents are very frail, high risk for fall, hight risk for pressure ulcers & other skin disorders, malnutrition, prone to abuse & neglect, which means they need more than just a certified caregiver in a daily basis. When residents frequently fell in assisted living, they are NOT trained to do a Neuro check because that's a skilled, it requires a nurse to do the neuro check. In LTC/Nursing home, they utilized Certified Nursing Assistant & RN/LPN on the floor. Yes, assisted living may look like a hotel or a home setting, unlike a Nursing Home which look like institutional settings but when it comes to your loved one, choose the most appropriate & according to their level of care. As for myself, I'm back in SNF.
Wow, thank you for sharing all this information. The important thing is to educate people so they can have the right information to make the best decision. Thank you.
NH is best and actually required if the demented persons will wander around. NH s are legally allowed to have locked doors.
Thank you sooo much for your expertise & l just appreciate you so much for helping explain this. You're wonderful!🌺
@@girliegirl-vk3vo you’re welcome.
Thanks for the info. I’m in LA and stumbled across your channel. I didn’t even know this was a service, my senior parent is starting to fall, some memory loss not dementia related, and doesn’t want to were a “call for help devise. Thanks to your video I will reach out for the help I “she needs”
Thank you for watching & for sharing your comment. Please call me. I would love to introduce you to the right people to help you in L.A. My number is 201-345-5006.
The main differences are the format and level of care provided. In general, assisted living communities are more like hotels, whereas nursing homes are akin to hospitals.
Yes I agree with your comment. Thank you!
Visit the facilities and listen to their pitches. Best way to learn.
Yes, visiting and seeing it for yourself is very important. Thank you!
awesome content
Thank you!
Good presentation on a difficult subject.
Thank you so much!
Currently working at a place that has people who cannot get up and go get water from the sink themselves. The company is saying that they are to only have those tiny dixie paper cups to drink out of unless the family brings them a water glass. That I am to immediately stop giving them glasses of water to drink from the facility kitchen. I have also been told that if family did not bring them toilet paper they are not to be given toilet paper. He said that medicaid residents are suppose to buy their own garbage bags, toilet paper and water glasses out of the tiny stipend they get per month. Do I need to just go get another job, or is there something I can do. They have a few hospice residents there who are in the process of dying who are not able to take care of themselves. I am concerned.
Lisa, I am so sorry to hear about how the residents are treated at your workplace. I really hope that things can improve with your company policy and with the treatment of your residents.
Well, myself I am still with it but use sleep apnea and the asthma nebulizer, Hmmm
Thank you for your comment. Wishing you strength and good health.
Very helpful video
Thank you Liberty!
Ok assisted or personal living is private pay. These facilities are for those who can no longer live alone. You are provided with meals laundry medicine help grooming dressing bathing. But here is the thing even if your care level changes these places will still keep you on if you can pay. They are not going to get rid of a paying resident. Doesn't matter if your stage 5 Parkinson's or have severe dementia laying bed ridden actively dying. Once the money runs out well then you can expect to be placed in skilled care. Which actually is for the best. Some homes after 3 years you can apply for benevolence fund which is donations which will keep you in assistant or personal care even if you need skilled care. Trust me it is all about $$$$. Even nonprofit places will drain your pockets as long as you let them. Asst. Living and personal care homes are not equipped to care for those who require skilled care. They do not have hoyer lifts. They do not use diapers only briefs. You must get up and use the toilet. You are brought to the dining room no matter how physically taxing it is you will not be spoon-fed because that is skilled care. I have seen this over the years working as a aid. Breaks my heart knowing a resident should be in a skill nursing unit would get better care but the family won't consider it the home doesn't tell the family their loved one sits all day staring at the television because that's all they can do. Or wondering around the hallways totally confused going in and out of other people's rooms even leaving the unit because these facilities aren't locked down. Only require one aid pre floor can not keep track of them because.....they should be in skilled care!!! Never hospice in personal or assistant living units once it gets to that stage place them in skilled. Someone in their 90s with severe Alzheimer's/ dementia is not going to improve only decline all the physical therapy in the world is not going to help.
Wow, thank you for sharing these details. Each case can be very complicated. Hopefully the whole system can improve to take care of our Senior population better.
Thank you so much. We are trapped in a legally confusing nightmare in FL. My parents both Have dementia. My dad has Lewy body Parkinson’s so although he is sharper than my mom mentally his body has declined to needing a chair. Therefore the amazing memory care they loooove kicked him out. (Hoyer lift laws) Now they are depressed and separated in facilities across town. They are loooost without each other. After a full year of this torture for them, We discovered the hospice loophole. That if we have hospice using a travel lift, and we add a care worker out of pocket we can have them back in memory care. Weeks of work later, set to move him today…the facility changed their minds. Which they are legally allowed to do. We are devastated. Moms too advanced for skilled and loves the activities. They are heart broken apart. 🥺
I am facing skilled nursing care.
(Nursing prison)
I am only 34.
I find myself A ward of the state under the realities of guardianship.
Please Universe,
(Council me.)
Prayers for your situation to improve.
Why can't we just call medicaid to. Find the answer to what they pay for and who is eligible?
I wish it were easier for everyone. I think the most accurate answers will come from finding out the policy for each specific building.
U can call Medicaid and find out when open enrollment and see what's covered.
Medicaid wants ALL your money & your assets. The state handles all of Medicaid individually. The Federal Gov't subsizes a % of the cost, but the states drive a hard bargain....well at least here in NC -it's that way. Seems like we work all our lives & still never really own nothing. I will be keeping all loved ones & the sick in my prayers faithfully. Hang in there. There are still some good days left! Make it count...
@@AssistedLivingAnswerMan Assisted living/memory care accepted private pay and public aid/altcs ( arizona for example) for instance, i am the nurse manager who’s responsible for assessing potential residents. Before accepting this potential resident i have to visit,
meet the family and the potential resident from either in their current home, hospital or another assisted living facility to check the medical status, diagnosis and medications of the resident. I have to check the Pt/OT, mental status and the level of care of this potential resident because the truth is, if the family paying the AL privately ( out of pocket ). Of course medicare does not cover AL stay. The services we put on the care plan/ service plan base on the level that the this potential resident need will reflect the total cost. Example, a private 1 bedroom, 1 bathroom a 400sq feet bedroom will cost you $, 6000.00 including once a week housekeeper, once a week laundry, meals. However, on the contract it says family has to provide residents essentials such as toothpaste, toothbrush, shampoo, soap, paper towels, toilet paper, briefs/under garments. Most of AL facilities won’t cover that unless it is written on the contract ( make sure to ask the marketing people before signing the contract ) Now, lets go back to service plan that the nurse put in place after seeing the potential resident Remember it depends on the level of care. If resident need a hands on bathroom assistance with 1-2 caregivers assist, need, shower, dressing, toileting, cuing, escort, medications assistance, grooming, all that services will be added to the $6,000 private room and basic service that i explained above. Some AL facility they go by points. Some they go by $10.00 per service. Lets say medications assistance is 4x/ daily then family has to pay $40 a day for just medications assistance only wjT about the shower, toileting schedules, grooming, etc? Those are expensive and public aid/medicaide/altecs WONT cover all of that. They have a bracket. Facility could charge the residents lets say $11,000 total but medicaide/public aid wont pay $11,000 monthly, they can only up to $4,000 or even less. Therefore AL would limit the # of public aid residents in their communities. Family has to pay the difference and if the family refused, the AL facility is not gonna make money, how would they able to pay their staff? That’s why instead of paying skilled nursing such as CNA’s, LPN’s, RN’s. Most of the time, you’ll see caregivers, med techs in AL. By the way i am talking Arizona dept of public health guidelines. Some states won’t allow caregivers or med techs.
Do you have a counterpart who offers these informative services in Palm Beach County, Florida?
Sorry for the late reply. I would love to introduce you to reputable people in Palm Beach. Can you contact me directly. 201-345-5006 (cell)
josephc@assistedlivinglocators.com. Sincere apologies for the late reply.
Do you have consultants in/for Atlantic County you can refer me to?
I am sorry for the late reply. I can help you. Can you please contact me directly. 201-345-5006
josephc@assistedlivinglocators.com
Is skilled nursing facilities better than convalesent home
"Skilled Nursing Facility (SNF)" is an umbrella term that covers the Rehab Section (Convalescent Home) and the Long Term Care (LTC) Section. It is hard to keep up with all the lingo. And the lingo can change/evolve over time.
I am a lifer am I able to go out side and meet people
Thank you for your comment. Unfortunately I did not fully understand your question.