Investigative Report Questions Five-Star Rating System for Nursing Homes
How reliable are the ratings given nursing homes under the five-star rating system that the federal government recently insti...
Read moreReunions, graduations, birthdays, and holidays: Whatever the occasion, nursing home residents don't want to miss out on family gatherings, but may be afraid that they will lose Medicare or Medicaid coverage if they leave the nursing home. In most cases, Medicare recipients can leave for a day or two, although the nursing home may bill them in order to hold their beds. Medicaid recipients will need to check with their state.
Medicare's coverage of nursing home care is quite limited and it only covers "skilled care" – i.e., treatment provided by a doctor or nurse. Coverage can stop if a patient is no longer benefitting from this skilled care. However, the Medicare policy manual states that a short leave of absence to attend a family occasion is not, by itself, evidence that the resident no longer needs to be in the nursing home. The manual also states that staff should not tell a resident that leaving the facility will cause coverage to lapse.
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If a resident leaves and returns by midnight the same day, the nursing home can bill Medicare for the day. However, if the resident is gone overnight, Medicare will not compensate the nursing home for the time missed. If the resident wants to leave for a few days, he or she should check with the nursing home to make sure the bed can be held. The nursing home may charge the resident a bed-hold fee in order to keep the space available.
If a Medicaid recipient leaves a nursing home to visit family, it is called "therapeutic leave." State laws regarding therapeutic leave vary widely. Some states will pay to hold a bed for as long as 30 days a year, while others pay nothing at all for such leave. Each nursing home is required to provide residents with information about their bed-hold policy before the resident leaves the facility. In addition, if a Medicaid recipient is absent longer than the nursing home's policy allows, federal law requires the nursing home to readmit the recipient to the first available room. For a list of state bed-hold policies, check out this online resource.
If a nursing home gives a resident a hard time about leaving for a few days, the resident should contact his or her attorney.
For more information about Medicare's nursing home coverage, read this article.
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Read moreIn addition to nursing home care, Medicaid may cover home care and some care in an assisted living facility. Coverage in your state may depend on waivers of federal rules.
READ MORETo be eligible for Medicaid long-term care, recipients must have limited incomes and no more than $2,000 (in most states). Special rules apply for the home and other assets.
READ MORESpouses of Medicaid nursing home residents have special protections to keep them from becoming impoverished.
READ MOREIn addition to nursing home care, Medicaid may cover home care and some care in an assisted living facility. Coverage in your state may depend on waivers of federal rules.
READ MORETo be eligible for Medicaid long-term care, recipients must have limited incomes and no more than $2,000 (in most states). Special rules apply for the home and other assets.
READ MORESpouses of Medicaid nursing home residents have special protections to keep them from becoming impoverished.
READ MORECareful planning for potentially devastating long-term care costs can help protect your estate, whether for your spouse or for your children.
READ MOREIf steps aren't taken to protect the Medicaid recipient's house from the state’s attempts to recover benefits paid, the house may need to be sold.
READ MOREThere are ways to handle excess income or assets and still qualify for Medicaid long-term care, and programs that deliver care at home rather than in a nursing home.
READ MORECareful planning for potentially devastating long-term care costs can help protect your estate, whether for your spouse or for your children.
READ MOREIf steps aren't taken to protect the Medicaid recipient's house from the state’s attempts to recover benefits paid, the house may need to be sold.
READ MOREThere are ways to handle excess income or assets and still qualify for Medicaid long-term care, and programs that deliver care at home rather than in a nursing home.
READ MOREMost states have laws on the books making adult children responsible if their parents can't afford to take care of themselves.
READ MOREApplying for Medicaid is a highly technical and complex process, and bad advice can actually make it more difficult to qualify for benefits.
READ MOREMedicare's coverage of nursing home care is quite limited. For those who can afford it and who can qualify for coverage, long-term care insurance is the best alternative to Medicaid.
READ MOREMost states have laws on the books making adult children responsible if their parents can't afford to take care of themselves.
READ MOREApplying for Medicaid is a highly technical and complex process, and bad advice can actually make it more difficult to qualify for benefits.
READ MOREMedicare's coverage of nursing home care is quite limited. For those who can afford it and who can qualify for coverage, long-term care insurance is the best alternative to Medicaid.
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READ MOREDistinguish the key concepts in estate planning, including the will, the trust, probate, the power of attorney, and how to avoid estate taxes.
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READ MOREUnderstand when and how a court appoints a guardian or conservator for an adult who becomes incapacitated, and how to avoid guardianship.
READ MOREWe need to plan for the possibility that we will become unable to make our own medical decisions. This may take the form of a health care proxy, a medical directive, a living will, or a combination of these.
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READ MOREWe explain the five phases of retirement planning, the difference between a 401(k) and an IRA, types of investments, asset diversification, the required minimum distribution rules, and more.
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READ MORELearn how a special needs trust can preserve assets for a person with disabilities without jeopardizing Medicaid and SSI, and how to plan for when caregivers are gone.
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