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SNFs. New Five-Star Rating System.

January 22, 2009 Leave a comment

The time has come where CMS has created a new 5-star rating system for Skilled Nursing Facilities across the nation representing over 16,000 facilities.  The new rating system will make the decision making process a little easier for patients and/or their families when it comes to choosing a SNF.  This new Zagat-like rating system is only to assist in the research for finding a quality facility.  I always strongly suggest that family and friends visit the facility and meet the team (administrative staff, nursing and rehab) to get a feel as to what kind of attention the patient and family will receive.  USAToday had written a great article regarding this new 5-star rating system on December 20, 2008, here is the link:

http://www.usatoday.com/printedition/news/20081219/editorial19_st.art.htm

First of all, you may be asking yourself what is CMS?  CMS is the Centers for Medicare and Medicaid Services.  In Pribble’s terms, CMS assists Facilities by establishing guidelines to ensure quality healthcare is given.  In addition to establishing guidelines, Pribble likes to refer to CMS as an invisible managed care entity managing Medicare.

Now we have CMS somewhat established or identified, onto the next step: How do I access the five-star rating system?

Easy.  Just visit this website:  http://www.medicare.gov/NHCompare/Include/DataSection/Questions/ProximitySearch.asp
Then, follow the easy instructions to find a listing of Skilled Nursing Facilities located in your area.  And voila! the results populate your computer screen with all of the facilities in your area and with corresponding rankings.

Please remember this is just another tool or resource for the community.  This rating system is to create an easy to read tool for your hunt on a SNF or Nursing Home.  Hope this assists with your search in finding the most suitable Skilled Nursing Facility for short term care rehabilitation or long term care.  For a couple of pointers on your search for a SNF, please read the section below on Skilled Nursing Facilities. 

 Have an Amazing Day!

M

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Patient Choice.

January 22, 2009 Leave a comment

2218743This is a friendly reminder:  When choosing a healthcare professional or establishment, the choice is yours.

People are misled at times or perhaps just not knowledgeable of the fact that the patient has a choice.  If a physician states that you or a loved one cannot go to a particular healthcare facility, whether it be a hospital or rehab center, you CAN.  I am not suggesting to go against medical advice, as your Physician is the expert in his or her field.  However, if you feel as though you have no options or feel forced to make a decision always ask your Doctor why. 

Why is Dr. X refusing to send mom to Hospital A?  Is it because they are not comfortable with quality of care?  Or, is it because Dr. X does not follow at Hospital A and wants to ensure mom gets continuity of care?  Perhaps, it is simply because their counterpart follows at Hospital B and they want to refer mom to Dr. Y.

Also, do not feel as though you will have to drive 1 hour to Hospital A because it is ‘in-network’ with your insurance.  However, should you decide to drive to Hospital A, as opposed to your in-network Hospital B, you will be financially responsible.  Remember that quality of care is EXTREMELY important.  When making decisions regarding your health focus on the quality of care received.  We only have one life to live, so be sure to take care of yourself and your health.

Hope you enjoy the holidays with your loved ones!

Skilled Nursing Facilities

January 22, 2009 Leave a comment

Mom or dad may have just been advised by his or her physician they may need a Skilled Nursing Facility.  Perhaps you have scheduled an elective surgery such as knee or hip replacement and need to go to a Skilled Nursing Facility to assist with your recovery process.

First of all you may be asking yourself a ‘nursing home’ … why?  Over the years, nursing homes have evolved into what is known as Skilled Nursing Facilities.  Skilled Nursing Facilities, or SNFs, are able to take care of more acute patients with aggressive clinical and rehabilitative needs.  A SNF is no longer for “old people” they are now a rehabilitative facility with a highly qualified nursing, therapeutic and physician staff.

A few things to do prior to choosing a SNF:
Ask around.  Word of mouth and personal experience speaks millions.
Tour the facility.  See the facility for yourself.  Does the staff interact with patients?  Is the staff happy?  Is the facility clean?  Is the DON (Director of Nursing) or the DOR (Director of Rehab) approachable and knowledgeable?
Ask questions.  How often does a Doctor round?  What kind of results does the rehab team produce?  What kind of programs are there for patients?
Ask the Physician.  Ask you or your loved one’s Physician what their thoughts are on the SNF and the care provided there.  Ask the same questions to your Surgeon.  Would these medical professionals recommend a particular SNF?  If so, make sure to tour and ask Admissions questions.
Trust your gut instinct.  How did you feel after touring or having all of your questions answered?  Does the SNF feel ‘right’?

This is just a starting off point.  Hope this helps.

Health Insurance.

January 22, 2009 Leave a comment

An important topic in the Presidential Election for 2008 is Health Insurance.  How many of you know exactly what your insurance covers?  Does the plan you currently have meet you and your family’s specific need?  Perhaps you have signed up with an insurance company and not know what product you agreed to purchase?

There are many issues from healthcare costs rising to insurances denying coverage for certain procedures.  As I have learned the sharpest, strongest, most lethal weapon for defense is education!  Learn about your insurance coverage, ask your insurance company questions and definitely do not sign anything without first completely understanding what it is you are signing.  I cannot recall the number of people I have met that do not remember enrolling in an insurance plan.  I will hear comments such as, “grandma said someone visited her, she signed some papers and she doesn’t know what the papers were,” or “they told me anyone will take this insurance.” 

A few websites I have stumbled across are:

Frequently-Asked Questions on Health Insurance – This website has good questions to ask when researching insurance.

America’s Health Insurance Plans – This website is for ‘a national trade association representing nearly 1,300 member companies providing health benefits to more than 200 million Americans.

Hi-Wire – Good resource for Healthcare News.  A link is also provided on the site covering 2008 Medicare and Medicaid Conferences regarding Presidential Candidates plans for Healthcare Reform.

A great website to visit is your insurance provider’s website.  Insurance companies generally have up to date news with preventative care, diagnoses and products they provide.

Blue Cross Blue Shield has a new approach towards finding new ways to provide better products and services.  If you have a moment, take the time to check it out and hear what people have to say:  The Power of the Human Voice

Medicare.gov

January 22, 2009 Leave a comment
*from Medicare.gov website

*from Medicare.gov website

Working in Long Term Care I have had the opportunity to learn about Medicare and how it helps with healthcare coverage.  Working in Long Term Care has also showed me a lot of people with Medicare Coverage do not understand what coverage they may have nor what Medicare Replacement Coverage they may have.  One tool I have found helpful for patients, family members and myself is to visit the Official Medicare Website:  http://www.medicare.gov/Default.asp

This website has an overabundance of information and tools to help make wise decisions when choosing Medicare Replacement Plans or Medicare Part D Prescription Plans.

I highly suggest to bookmark this site http://www.medicare.gov/Default.asp and to subscribe to the rss feed, getting up to date information on Medicare.