How do you know when it's time to find a nursing home for your loved one? This is the hardest and easiest of questions to answer or so it would seem. Let me explain. There are primarily two approaches to requiring nursing home care.

Approach Number One: A fall occurs and a hip is broken or the loved one may have had a stroke, a heart attack or pneumonia. These are examples of medical conditions that require hospitalization. Up until this point admission to a nursing home has never been considered. The hospital has finished caring for the immediate medical need and now you are contacted by the hospital discharge planner and told that your loved one will be discharged to a nursing home for rehabilation within a few days. They give you a list of nursing homes in your area and say good luck in your search.

If you are lucky, area nursing homes will have their admission coordinators visiting the hospitals daily to "shop for residents." The nursing home admission coordinator will look at your loved one's medical file and determine if the care required and the estimated length of stay will fit the nursing home's patient mix. The nursing home wants to balance the needs of your loved one with the current demands of their residents both medically and for staff availability. The nursing home will also look at how the care will be paid for. Keep in mind that the nursing home can't discriminate aginist admitting your loved one based upon how the care will be paid for, whether it's Medicare, Medicaid, long-term care insurance, an HMO, private funds or other payment plans.

Nursing homes, like other businesses have bills to pay, not the least of which is payroll. So naturally they will look for the maximum reimbursement possible to care for your loved one.

Your challenge now becomes deciding which nursing home you will place your loved one in, within the time allocated by the hospital. Note that the reason the hospital is pushing you to transfer your loved one to a nursing home is money. The reimbursement for the care received is about to run out. Keep this in the back of your mind; the hospital will find it extremely difficult to force your loved one into a nursing home that you are not agreeable with or that is out of your neighborhood, at an unreasonable distance for you to travel.

The best way to avoid confrontation with the hospital is to have a discussion with the discharge planner about which nursing homes have the best reputation in the area and in which one the discharge planner would place their loved one. After you visit each facility talk with the discharge planner about your observations, how you were received and your likes and dislikes about the facility.As long as the hospital knows you are making a good faith effort to transfer your loved one to a nusing home they will be less likely to put pressure on you. You have enough pressure on you at this point. You don't want to go looking for more. Your primary goal is to find a great nursing home for your loved one.

The decision to admit your loved one to a nursing home has been made for you by an unexpected medical condition; that's the easy part. Whether the stay in the nursing home is short or long term the process of finding a great nursing home is the same, but in this case time is of the essence.

In the next essay Iwill dicuss approach number two; a planned admission to a nursing home.

Also feel free to send any questions you have about nursing home admission to mailto:ken@greatnursinghomestrategies.com Be sure to put "questions GNHS" in the subject line!

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