Cuts loom for nursing homes in Indiana .....learn about Alternatives to SNF care

the world will be so much better without for profit nursing homes like Genesis. Decent countries take their parents in when they're old and don't send them off to decubiti hell.

If you know how ruthless some of these companies can be when it comes to money, life and death, you'd change your mind about NH as well.

My thoughts? get rid of em; it'll take our communities a couple decades to learn to cope and absorb the problem but there's no need to house family for a better selfish quality of life. They're our family! When they're too ill, it's time to go. All of the saved money can go for elderly bus services to do the appointment game.

Notice also how doctors prey on elderly...since when is a mole removal needed for a 90 year old? Insane....leave em at home with family and let them go with family with dignity. Stop the hospital doctor visits for profit and open bus services with the saved billions. I certainly don't want to burden the government when I'm old and no longer able to care for myself...let me die and find what's next!

to nascar nurse- the social worker I talked to worked in the LTC facility I worked in- she told me the only way to keep my mothers home from being signed over to a NH/LTC if this was the route my family and I wanted to take was to have it "gifted" to a family member. My mother is too mentally incompacitated at this point to sign any thing for it to be legal. I told this social worker I wanted medical day care and she said MEDICARE( elderly) doesn't pay for this, I checked this out and she was right. MEDICAID ( aka POVERTY LEVEL) does, it pays 100%. With my mother's MEDICARE- and survivor benefits from my dad, my family and I would have to come up with out of pocket- $2,000/ month to put my mother in a medical day care which is not affordable- my mother would have to liquidate her assets= to give up her home, my father's small social security pension and her survivor benefits=health insurance only to reduce her to below $2,000/mo to qualify for MEDICAID. There is no refund should she pass way and be in a NH.

The option to have a "medically needy" program allows states to extend Medicaid eligibility to additional qualified persons who may have too much income to qualify under the mandatory or optional categorically needy groups. This option allows them to "spend down" to Medicaid eligibility by incurring medical and/or remedial care expenses to offset their excess income, thereby reducing it to a level below the maximum allowed by that State's Medicaid plan. States may also allow families to establish eligibility as medically needy by paying monthly premiums to the State in an amount equal to the difference between family income (reduced by unpaid expenses, if any, incurred for medical care in previous months) and the income eligibility standard.

People with Medicare are notified of the Medicaid estate recovery program during their initial application for Medicaid eligibility and annual redetermination process. Individuals in medical facilities (who do not return home) are sent a notice of action by their county Department of Social Services informing them of any intent to place a lien/claim on their real property. The notice also informs them of their appeal rights. Estate recovery procedures are initiated after the beneficiary's death.

The Omnibus Budget Reconciliation Act (OBRA) of 1993 defines estate and requires each state to seek adjustment or recovery of amounts correctly paid by the state for certain people with Medicaid. The state must, at a minimum, seek recovery for services provided to a person of any age in a nursing facility, intermediate care facility for the mentally retarded, or other medical institution. The State may at its option recover amounts up to the total amount spent on the individual's behalf for medical assistance for other services under the state's plan. For individuals age 55 or older, States are required to seek recovery of payments from the individual's estate for nursing facility services, home and community-based services, and related hospital and prescription drug services. States have the option of recovering payments for all other Medicaid services provided to these individuals.

Section 1915(c) Home and Community-Based Services Waivers: This section provides the Secretary authority to waive Medicaid provisions in order to allow long-term care services to be delivered in community settings. This program is the Medicaid alternative to providing comprehensive long-term services in institutional settings http://www.cms.hhs.gov/MedicaidStWaivProgDemoPGI/01_Overview.asp

Philosophy
The Program of All-inclusive Care for the Elderly (PACE) model is centered around the belief that it is better for the well-being of seniors with chronic care needs and their families to be served in the community whenever possible.
PACE serves individuals who are age 55 or older, certified by their state to need nursing home care, are able to live safely in the community at the time of enrollment, and live in a PACE service area. Although all PACE participants must be certified to need nursing home care to enroll in PACE, only about seven percent of PACE participants nationally reside in a nursing home. If a PACE enrollee does need nursing home care, the PACE program pays for it and continues to coordinate the enrollee's care.



Services

• Delivering all needed medical and supportive services, the program is able to provide the entire continuum of care and services to seniors with chronic care needs while maintaining their independence in their homes for as long as possible. Care and services include:
• Adult day care that offers nursing; physical, occupational and recreational therapies; meals; nutritional counseling; social work and personal care
• Medical care provided by a PACE physician familiar with the history, needs and preferences of each participant
• Home health care and personal care
• All necessary prescription drugs
• Social services
• Medical specialists such as audiology, dentistry, optometry, podiatry, and speech therapy
• Respite care
• Hospital and nursing home care when necessary

http://www.npaonline.org/website/article.asp?id=12