HOW DO YOU DEFINE QUALITY CARE in a nursing home? Being treated with dignity and respect, feeling safe, having input in your plan of care, or even liking the food? When choosing a facility for rehabilitation or long-term care, it is always helpful to consider what would make the experience quality for you or, in the case of a loved one, make sure they are providing input as to what is important for them to thrive and get better or maintain their abilities.
It is never an easy decision to place yourself or a loved one in a nursing home, but knowing a few things right at the start can make that daunting experience a little more manageable. Here are three common issues that you may run into when utilizing nursing-home services.
Medicare misunderstandings
First, it is important to note that a common misconception about Medicare is that someone will have 100 days of coverage, meaning if it takes 100 days, then so be it! Well, that isn’t exactly correct. Actually, the Medicare coverage for skilled nursing stays says they cover “up to 100 days,” meaning that many times a person won’t reach that 100-day mark because they are “cut” by insurance for reaching their previous functioning or for not progressing. (If this happens, you will get notice in writing that includes appeal rights.) Additionally, Medicare only covers the bill at 100% for 20 days of a skilled-nursing stay. After that there is a daily copay of 20% that residents will have to pay.
I will have to go without my “nightcap” if I am in a nursing home
Not always! Included in resident rights is a resident’s right to consume alcoholic beverages as long as it doesn’t interact with their medication or put them at risk for further complications.
Cameras can replace visits
With the introduction of Esther’s Law, families and residents now have the ability to install cameras in nursing homes. Many questions have been raised—most importantly, how to utilize them to ensure quality care. It is important to note that while cameras can be a helpful tool, they shouldn’t replace your personal interaction with your loved one. We must remember to still engage with our loved ones even if we are able to watch them from afar.
If you have questions about any of the above issues that we have discussed, please don’t hesitate to reach out to our program for more information. You don’t always have to have an ongoing problem; you can call us for answers and assistance before you or a loved one even needs long-term-care services so you are prepared and empowered to advocate for quality care in the future.
Another way you can empower others and advocate for nursing-home residents is to become a volunteer with our program. For more information on volunteering, the issues above, or anything you have questions about regarding long-term-care supports and services, please call us at 419-259-2891.
Megan Benner Senecal is a member of the Ombudsman Office. ✲
