In "My Mom Has Long-Term Care Insurance-How do I Interview Nursing Homes-Part 1," we looked at the importance of first determining the per diem rate your parent's long-term care insurance policy provides. You will want to check with your health care insurance company to find out exactly how much the policy your parent purchased will pay to a nursing home for your parent's daily care.
This question is very important because different health care insurance companies provide different long-term care insurance policies purchased at different rates.
One daughter told me that her health care insurance company told her that she could pick any nursing home for her mother, so she immediately wanted to know what to look for in nursing homes.
Great question, but the first question to ask is how much will you have to spend under the terms of your parent's long-term care insurance company policy -- how much in additional funds will you or your parent have to pay if you pick a nursing home of better quality than the per diem allowable cost of Mom or Dad's long-term care plan.
As you're looking at nursing homes, ask what is the nursing homes' daily cost? Will there be extra charges for diapers, gloves, wipes, laundry, medicine? If you have to purchase these, they CAN be brought in from the outside. Don't pay the rates the nursing home charges--that's usually where they make extra money. Save your money for the important expenses. Go to Costco or Sam's Club or order on line.
There are also outside mail-order pharmacies for any medications covered or not by Medicare or secondary insurance. A good nursing home facility will help you arrange for that. If not, you can also do it on your own.
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Many facilities have trouble finding quality nurses to work in their facilities. Often you will see that they don't even have every shift covered by one registered nurse.
This is a bad sign.
You should also look at the most recent state health board report on the nursing home facility. Check out how many negative notices have been made against the nursing homes your are looking at. Often times, nursing homes will be cited for not giving medications at the proper time (very important) or skipping them altogether. Ask also what is the turnover rate of staff?
Stop in some time during the week when the nursing homes are not typically expecting family visitors and ask to take a tour -- look through the entire facility. Is there a cup with a straw and filled water pitcher by each person's bed? Is there a television, telephone?
How will you reach your parent by phone? Will your Mom or Dad have to use a cell phone to talk to you? Will you have to rely on the nurse's desk to take a phone to your parent's when you call (good luck with that!). Communication between the elder and family members is crucial to the elder's mental health. Make sure you and your family members can communicate easily with Mom or Dad.
Also ask to look into the shower areas and see how clean they are.
And, of course, as I recommended in Part 1, talk to other family members of other patients. But still make sure you make a surprise visit during the week to really see what happens when the nursing home is not typically expecting visitors.
Also, find out about doctors. Does the facility have a Medical Director who visits or is on call? Typically, only the highest-end facilities do. So, you need to make sure that your parent's physician will come to the nursing home you choose or that it's easy for you to arrange for transportation to the doctor's office.
I've written before and will mention again that elder and disability transportation services are one of the highest growth areas of necessary services as boomers and our parents age. Many available services are run very poorly.
If you are looking for a growth business, I recommend strongly that you check out elder/disability transportation service opportunities. This resource I'm recommending may look a little intimidating at first but it's a great investment in learning how to build a transportation service company--Click Here!
I can tell you from first-hand experience that a well-organized, caring, service-oriented transportation company for the aging and disabled will attract many clients, both private individuals and families as well as nursing home facilities that have to arrange for transportation of their patients to and from hospitals and doctors' appointments.
Finally, meals. Some facilities do not want to serve individuals in bed because they want them up and out, they say, it's more social for the seniors, but it's also more work for the staff. You should find a nursing home facility that will allow meals to be served in the room, at the patient's discretion. There may be days or come a time when your parent will want/need meals to be served in bed.
Keep in mind, you are not alone through all of this. We offer telephone consultations to guide you through your health care planning, both pre-planning and emergency situations. To contact us, Click Here!
Blessings and encouragement, Jane Allison
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