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1) How is the nursing home chosen when I'm discharged from the hospital?
Each
nursing unit in the hospital has a social worker available to you to
explain their nursing home placement procedures. The hospital social
worker will provide you with a list of area nursing homes. If Broomall
Rehabilitation and Nursing Center is not on the list presented to you,
you may request our facility specifically. The hospital social worker
should be available to you to answer any questions you may have about
the nursing home placement process, how nursing home care will be paid
for, dates, times and transportation arrangements for discharge and any
other questions you may have about nursing home placement. Usually
nursing home placement decisions are time-limited and the patient will
benefit from a well-planned discharge plan that uses a variety of data
on quality and costs. Acceptance to a nursing home is based on bed
availability, the specific medical needs of each individual and the
facilities ability to meet those needs and financial information- all
factors are reviewed and decisions are made on an individual basis.
Nursing homes usually notify the hospitals social worker of their
decision to accept or deny an admission. Usually you will be expected
to accept the first bed offered to you by any of the nursing homes you
have selected. If none of your selected nursing homes has accepted your
application by the fifth business day after the application process has
begun, you will have to accept services offered by any other nursing
home in your geographic area qualified to provide for your care.
2) What is short-term rehabilitation?
In
the past patients stayed in a hospital until they were well enough to
go home without too much assistance. However, since hospital stays have
become so expensive, Medicare and other government programs and
insurance companies don’t want to pay for a hospital stay any longer
than medically necessary. Often, at the end of a hospital stay patients
are not well enough to return home directly after the discharge from
the hospital.
Many people come to Broomall Rehabilitation and Nursing Center for
post-operative care, such as a recent orthopedic surgery. Others come
for rehabilitation following a stroke, pneumonia, heart surgery or
other injuries and illnesses requiring extended treatment following a
hospital stay.
3) How will I receive updates
about my progress or my loved one's progress during my stay at Broomall
Rehabilitation and Nursing Center?
Our
patients can ask questions about their care and request progress/status
updates as often as they would like by speaking with a staff nurse or
the unit manager designated to their unit. We strive to actively
involve patients, their families and those acting in a legal capacity
on behalf of the patient (such as, power of attorney) in care decisions
and status updates as a normal part of our business. We ask that each
family appoint one designee to speak on behalf of the family and obtain
status updates, then disseminate the information to the other members
of the family. It can be overwhelming for our nurses to give 5 separate
status updates to 5 different family members and this type of practice
also takes our nurses away from providing care unnecessarily.
Residents, families and legal representatives will also be invited by
the patient’s social worker to attend interdisciplinary care
conferences at which time the patients total plan of care is reviewed.
Care conferences typically take place on a quarterly basis or as
necessary.
4) How long will I need skilled therapy service? Unfortunately,
there is no magic formula to equate how long your rehabilitation
process will take. In fact, the question of “How long will I need
therapy?” should really be replaced with “What can I do to make my
rehabilitation most effective?”
Our physical, occupational and speech therapists at Broomall
Rehabilitation and Nursing Center often treat numerous injuries, all of
which can have different treatment plans. In fact, even similar
injuries can have different healing time-frames. Numerous factors will
contribute to the rate in which patients heal, including, the patient’s
body and their dedication to the treatment plan. Our therapists will
put you on an appropriate plan and do everything possible to keep you
on the path to feeling better.
So, what can our patients do to expedite the healing process? A lot! In
fact, the success of any therapy treatment plan will depend on our
patients. The following are some tips we give to our new patients who
are beginning the path towards recovery:
1) Stick to the treatment plan - Injuries that are not treated
appropriately with therapy will only get worse. That is why we must do
all we can to stick with the treatment plan. Sticking with the plan
will ensure that our bodies have the best chance to heal properly and
as quickly as possible.
2) Set realistic goals - Your rehabilitation will take time; how much
time will depend on your body and your motivation to achieve your
therapy goals. It is important to take it one step at a time. Just like
anything else, stress and frustration will not help the body along, so
it is important to keep cool and understand that there is no quick fix.
3) Take what you learn during treatment and practice it outside of your
therapy session if advised to do so by your therapists - When the pain
begins to subside and we start to make the transition to educating you
how to take what you have learned and practice it on a daily basis
outside of the therapy gym. This education process starts under our
direct supervision and will gradually transition to your
responsibility. The amount of time for this portion of the
rehabilitation will depend heavily on you. Your dedication to returning
to wellness will pay huge dividends including expediting the
rehabilitation time frame.5) How often will I be seen by my primary care physician?
Patients are seen by their physician at least once
every 30 days during the first 90 days after an admission, and at least
once every 60 days thereafter. As with all medical services, physicians
visit facility patients as often as necessary when medical conditions
warrant a visit. Physician visits occur at the facility rather than the
doctor’s office unless office equipment is needed or a resident
specifically requests an office visit. At times and when appropriate,
physicians may delegate tasks to physician assistants, nurse
practitioners or clinical nurse specialists. Physicians are on-call 24
hours a day, in case of emergency. Additionally, Broomall
Rehabilitation and Nursing Center has two medical directors who
specialize in gerontology and are available to the facility at all
times when needs arise.
6) How will I know that I’m receiving proper medications when I am admitted to Broomall Rehabilitation and Nursing Center?
Prior to being discharged from a hospital stay, your
discharge medication orders will be received by Broomall Rehabilitation
and Nursing Center from the hospital. The medication record is then
transcribed by the admitting nurse who ensures necessary prior
authorizations are obtained. Upon admission to the facility, a pharmacy
consultant conducts an interim medication regime review to ensure each
individual’s medical history documentation corresponds appropriately to
the drug therapy being utilized. The pharmacy consultant will also
address potential areas of concern for negative drug interactions
and/or weight-based dosing concerns.
Our facility only utilizes one pharmacy, which allows for better
medication pricing, safer medication distribution and administration
and a high level of quality control. Our Medical Directors and facility
Administration strive to meet face-to-face with the pharmacy director
bi-weekly to discuss and review new pharmacy practices and individual
treatment concerns. The interdisciplinary team at Broomall
Rehabilitation and Nursing Center, in conjunction with the pharmacy,
practices a holistic approach to drug therapy; we want the medication
to treat symptoms as well as the underlying illness or condition.
7) What are the facility visiting hours?
Suggested
visiting hours are 10:00 A.M. to 8:00 P.M. We do understand that
circumstances may arise when families may want to stay later. Our
primary concern is that visitors do not interfere with resident care or
compromise the resident’s health by causing the resident to over-exert
themselves. We also ask that visitors don’t disturb their loved ones
roommate. If large groups of family members wish to stay after
suggested visiting hours, a nurse may limit the number of people
allowed in a resident room at one time to ensure all residents remain
comfortable at all times.
8) What should I bring to the facility upon admission? We
suggest you bring the following clothing and footwear items when you
come to our facility: 5 pants/shirts (8 if incontinent), 5 changes of
underwear (8 if incontinent), 2 pairs of shoes, 8 pairs of socks, 1
pairs of slippers (please ensure all footwear is non-skid, including
socks), 3 pairs of pajamas (6 if incontinent), 2 robes, 3 sweaters and
1 coat and hat/scarf (when seasonally appropriate). For ladies, we also
recommend that you bring several dresses.
Other items a patient may want to bring to make their stay more
enjoyable include: a small radio and/or television, a clock, personal
toiletries, magazines/books and other personal recreation interests.
All personal belongings should be clearly marked with the patient’s name.
We recommend that you label clothing by writing the patient’s name
inside the collar, cuffs or pockets with a permanent marker. Personal
care items such as hearing aides, dentures and eyeglasses should also
be clearly labeled. If you need assistance labeling your belongings,
our staff will be happy to help you.
Valuables and Money.
Ideally, valuables and money should be left at home or with family and
friends. Should you desire to bring valuables, especially those with a
high monetary and or sentimental value, such as wedding and anniversary
bands, expensive jewelry, furs, credit cards or checkbooks, etc. we ask
that you and your family members properly secure the items. It is
anticipated that you will only need a limited amount of cash on-hand
during your stay. Therefore, we recommend that large sums of money not
be brought to the facility. Our Business Office will be happy to
establish and maintain an account for you in conjunction with our
Protection of Resident Funds policy. Broomall Rehabilitation and
Nursing Center does its best to safeguard residents’ personal property;
however, the facility is not responsible for lost, missing or broken
items, unless such loss is found to be due to the facility’s or
facility staffs’ direct negligence.
9) How is the facility staffed?
We
practice acuity-based staffing for all shifts, seven day per week. What
this means is that we look at the clinical needs of our entire resident
population each day and staff the facility based on the total resident
populations’ needs on any given day. We understand the importance of
permanent staffing assignments and make every attempt on each of our
nursing units to provide permanent staff; however, as the needs of our
patients change, at times we must change staff assignments to best meet
the needs of all of our patients.
10) Who pays for the nursing home care? Prior
to, or upon admission to Broomall Rehabilitation and Nursing Center,
one of our Admissions Coordinators will ask about your finances to
determine if you will be "private pay" (you use your own funds) or
covered by Medicaid, managed insurance or Medicare.
Privately Paying for Your Stay
If your assets exceed allowable limits as set by Pennsylvania Medicaid
you will be asked to spend down (use) private funds in excess of the
allowable limit (as specified by Pennsylvania Medicaid) to pay for your
room and board, pharmacy expenses, equipment and supplies, etc., until
you have reduced your assets below the allowable limit as established
by Pennsylvania Medicaid.
Medicaid
Once you have completed the spend-down, your Medicaid application will
be submitted and you will be considered Medicaid Pending until you
application is approved. Once your Medicaid application is approved
Medicaid will pay retroactively for covered expenses incurred after the
spend-down is completed and going back to the date of the Medicaid
application.
Individuals who apply for Medicaid assistance for nursing home services
are subject to a “look back” period of five years for asset transfers
during which eligibility may be denied. This is intended to prevent
those above the eligibility levels for Medicaid from giving away their
resources in order to qualify. If you need Medicaid to cover the cost
of nursing home care, your admissions coordinator will refer you to a
financial counselor to help you apply for Medicaid. Medicaid is
intended to assist low-income individuals and is not available to
everyone who needs nursing home services. Those who need long-term
services must meet both financial and functional eligibility criteria
to qualify for Medicaid.
Nursing home residents who qualify for Medicaid must apply all their
monthly income towards the cost of care, except for a small personal
needs allowance. Those with spouses living in the community are allowed
to disregard a certain amount of income for the support of the
community-residing spouse.
Managed Care/Commercial Insurance
Some people have commercial insurance or managed insurance that covers
nursing home costs. In this situation, our case manager will provide
regular status updates to the commercial insurance company and they
determine the length of time each patient continues with coverage based
on progress (or lack thereof) toward pre-established treatment goals.
Medicare
Medicare provides limited post-acute care through its skilled nursing
facility benefit. In some cases, Medicare pays for nursing home care.
Medicare may pay a portion of the bill for a very specific period of
time if the patient is determined to have skilled nursing needs. The
maximum benefit period is for Medicare to cover a nursing home stay is
100 days. Examples of skilled needs include: an open wound that needs
dressings and treatments, a tracheostomy, a newly placed feeding tube
or the need for extensive physical and occupational therapy. Most
people do not qualify for skilled care for an extended period of time.
To qualify for a Medicare stay in a nursing home you must have been
hospitalized for at least three consecutive days (the day of discharge
is not counted) within the last 30 days prior to admission to a skilled
nursing facility. (Some Managed Medicare policies do vary on this
requirement.) The skilled services provided by the nursing home must be
related to the reason for the hospital stay. The physician must verify
that you require the types of treatment and intensity of care that
meets Medicare criteria for skilled nursing facility care.
Many details determine a patient’s payment source for their stay in a
nursing home. We understand that financing nursing home care may be new
to you and we strive to make the financial considerations seamless. Our
business office is committed to assisting you throughout the financial
process and is available to answer any questions.
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