Frequently Asked Questions
Choosing the right care facility for someone you love is not an easy decision. Following are some answers to frequently asked questions. When you’re ready to find out more please contact us directly.
- Can I keep my family doctor?
- Who is my main contact to discuss concerns?
- Will I have a roommate?
- What are visiting hours and are pets allowed?
- What are the payment options?
- Will I have to spend all of my savings if my spouse needs skilled care?
- Will Medicare cover a Nursing Home stay?
- Do I have to accept the first available bed?
- What can be brought from home?
- Is there any choice in meal selection?
- What are a person’s rights within a nursing home?
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Can I keep my family doctor?
Local physicians continue to care for you or your loved one while here. If you are coming from out of the area or currently use an out of area physician, you would need to choose a local physician to follow your needs. This choice can be aided by your current physician and/or our Social Worker.
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Who is my main contact to discuss concerns?
Your questions could be about something as simple as getting a TV to work or something more complex, such as your treatment plan. The nurse on charge of your unit would be the place to begin for any questions. They will directly answer your concern or connect you with the appropriate staff person. The Administrator and Director of Nursing are always willing to help you with any unresolved questions or issues you may have.
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Will I have a roommate?
You may have a roommate depending on the accommodations you require or those that are available at the time of admission. If you desire a room change, you and/or your family may discuss this with the Social Worker.
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What are visiting hours and are pets allowed?
Our visiting hours are normally 8:00 am to 8:00 pm. If circumstances require, extended visiting is not only possible, it is encouraged. Pets are welcome to visit under the control of the visitor they are with.
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What are the payment options?
The source of payment for each stay depends upon circumstances and the financial ability to pay. Sometimes this may be a combination of private funds, insurances and/or Medicare/Medicaid funds.
Private Insurance
Private long-term care insurance policies are becoming more and more available.They are advertised as a possible alternative to Medicaid or as a way to avoid exhausting resources when nursing home care is needed. They vary in the coverage they provide and should be carefully examined before purchasing. In New York state, only a few policies are valid. The state Insurance Department (SID) publishes materials comparing long-term care policies offered by different companies. call1-800-342-3736 or contact the SID at www.ins.state.ny.us for more information.
The federal government is now permitting New York state to authorize Medicaid without someone exhausting his/her assets if that person first purchases a long-term care insurance policy sponsored by the state. Such a policy must cover at least three years of long-term care, six years of home care or an equivalent combination of both.
Once an individual purchases such a policy and once the benefits for such a policy are exhausted, that person, if income eligible, will be eligible for Medicaid payment for longterm care for the remainder of his/her life without consideration of his/her assets. Most importantly, however, whatever assets that person has will be protected and will not have to be used to meet long-term care costs. You may hear this type of insurance referred to as a "partnership" long-term care policy.
The New York state Partnership for Long-term Care is a program that combines long-term care private insurance and Medicaid to help New Yorkers prepare financially for the possibilities of needing nursing home or home care. Information on the Partnership can be obtained by calling 1-888-697-7582 or from its website at www.nyspltc.org
Medicaid
Medicaid, established by Congress in 1965, is a government health insurance program for people of all ages whose income is too low to provide for routine health care costs, or whose health care costs are too high to be covered by their income. This health insurance covers the cost of nursing care for as long as the care is required if a resident is eligible.A comprehensive application process is used to determine eligibility for the Medicaid program. This process requires that applicants provide detailed information and documentation regarding income and assets. A Medicaid applicant must be a citizen or permanent resident in the United States, must meet New York state income and resource limitations and must show medical need.
Currently, a Medicaid recipient in a nursing home is allowed to retain a portion of their cash assets as well as certain prepaid funeral expenses and life insurances. Also, $50 of monthly income may be kept as a personal needs allowance to meet personal expenses that are not covered by Medicaid. Call your local Department of Social Services office for additional information on Medicaid.
Medicare
Medicare is a federal health insurance program for disabled people and people over age 65. Skilled nursing services must be needed on a daily basis to be eligible for Medicare. Medicare may pay a maximum of 100 days of care in our facility. This would be for patients in need of skilled care following a hospitalization of at least three full days. To qualify, the patient must be admitted to the nursing home within 30 days of discharge from the hospital.Many people leave a hospital and enter a nursing home expecting Medicare to continue to pay for health services. This is not the case. Medicare will not pay for a nursing home stay if it is determined that only custodial care is required, or if skilled nursing home care and/or rehabilitative services are needed only on a periodic basis.
Under Medicare rules, the need for skilled nursing care must be daily. The program has a number of specifics about what services are included and requires that you be responsible for a co-payment. For further information, contact your local Social Security office or call 1-800-772-1213 for a copy of the Medicare Handbook.
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Will I have to spend all of my savings if my spouse needs skilled care?
No. New York state Medicaid guidelines for eligibility for a spousal situation differ from those that apply to an individual. The "community" or well spouse is allowed to keep some savings and the home in which they reside. Please contact your designated Social Worker with any additional questions you may have.
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Will Medicare cover a Nursing Home stay?
Yes, under certain circumstances. If you have been an inpatient in the hospital for 3 consecutive days within the last 30 days prior to nursing home admission you would qualify. However, upon entering the nursing home you must have a skilled need as defined by Medicare. If both conditions are met Medicare will pay the first 20 days in full and from day 21 to100 you will be responsible to pay a co-pay (unless you have secondary insurance which will cover, check with your health insurer) If at any time during these 100 days the skilled service ceases, Medicare may no longer cover and payment either becomes private pay or Medicaid (if eligible).
Also see Medicare answer under "What are the payment options?"
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Do I have to accept the first available bed?
No. You can usually designate any one of the 8 facilities of choice and rank them in order of preference. However, when the physician determines that you are medically stable for discharge, bed availability will be confirmed with the facilities. If no bed is available in the preferred facility it is expected that you will accept the bed that is offered. Note: When pursuing placement in your home community, you can usually wait until the facility of your choice becomes available. Discuss this with your hospital Social Worker as well as our Social Worker.
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What can be brought from home?
If you expect a temporary stay, photographs and other small keepsakes may be the only remembrances of home that are needed. But if you expect to be here permanently or for an extended stay, a favorite chair, TV, paintings for the walls and plants can be brought from home. Creating a comfortable atmosphere that feels like home will help adjust to the new surroundings.
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Is there any choice in meal selection?
Yes. Your meal preferences will be made in consultation with the dietician and your physician. Meals are served in our dining rooms with the exception of breakfast which is traditionally served in your room.
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What are a person’s rights within a nursing home?
This is their home and residents have the right to make their own decisions regarding care and treatments. Please feel free to call, fax, mail or email us with any questions you may have. We may not know the answer right away, but we will find it for you.