Seniors
Long Term Care
Frequently Asked Questions About Nursing Homes
When is a nursing home needed?
Your doctor or a member of your health care team will talk to you, your family, or your appointed representative as soon as the need for a nursing home is identified. Early discussion should allow time for everyone to participate in developing the plan of action.
How will my family or friends and I know which nursing home to choose?
If your loved one is in the hospital, your social worker will help in planning for nursing home placement. You and your caregiver should select at least 10 nursing homes for admission. Placement often happens very quickly after applications are completed. Contact, visit and tour as many nursing homes as you can.
Will I stay in the hospital until discharged to a nursing home?
The hospital may transfer any patient waiting for a nursing home bed to Strong Health’s Alternative Level of care (ALC) Unit at Highland Hospital. If you have any questions or concerns about this transfer, please speak with your social worker.
Why can’t I stay in the hospital rather than going to a nursing home?
Hospitals are designed for patients who have serious medical problems that can be treated only in a hospital. Insurance companies can review and stop insurance benefits when you no longer need acute hospital care.
How much do they cost?
The cost of a nursing home in Monroe County can range anywhere from $3,000 to $10,000 a month.
Who pays for the nursing home care?
Your social workers will ask about your finances to determine if you will be a "private pay" (you use your own funds) or covered by Medicaid. Some people have commercial insurance that covers nursing home costs. In limited cases, Medicare pays for nursing home care. If you need Medicaid to cover the cost of nursing home care, your social worker will refer you to a financial counselor or a Medicaid worker to help you apply for Medicaid.
WiIl my long-term care insurance pay for the nursing home?
Long Term Care Planning and Insurance is becoming more common, but not all policies are legal in N. Y. State. To avoid being taken advantage of, contact The N. Y. State Dept. of Aging Health Insurance Information Counseling and Assistance Program, called HIICAP.The information is free and confidential. Or call the HIICAP help line at 1-212-333-5511. For insurance questions other than long-term insurance, call the N. Y. State Insurance Department at 800-342-3736.
How is my nursing home chosen if I'm discharged from the hospital?
Admission is based on your medical and financial information. Nursing homes notify the hospital of their decision. 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.
How far away can a nursing home be?
You and your caregiver are expected to accept nursing homes within fifty miles of your home. If, for whatever reason, you have waited for placement for sixty days, you will be asked to consider a nursing home farther than fifty miles away from home. In this event, your social worker will discuss these issues with you.
What happens if I refuse to transfer to the nursing home with the first available bed?
If you do not accept the first bed offered, the hospital staff will review your medical chart. A hospital representative will give you a written notice of insurance non-coverage. Hospital staff will then explain the steps to follow if you choose to appeal your insurance benefits being stopped. The outcome of your appeal will be given to you in writing. It is possible that you may have to pay for any days you stay in the hospital following the day the first bed was offered to you.
What happens when I run out of money? Will they kick me out?
When private pay residents have used nearly all of their financial resources, they become eligible for Medicaid. When they reach Medicaid eligibility, residents can't be "kicked out" of a nursing home.
Can I leave the nursing home and return home?
Nursing home residents who, following assessment from a psychiatrist, have "capacity" (the ability to make sound decisions about their own care) always have the right to leave a nursing home if they choose to do so.
How can I best plan for care ahead of time?
Meet with a lawyer with expertise in senior issues (called an elder attorney) for advice on estate planning, Medicaid, Medicare, and long-term care insurance. Call 800-342-3661 for a list of attorneys in N. Y. State who specialize in Elder Care. Also, there are senior care consultants who offer advice on a fee-for-service basis.
How do I make my wishes known about a DNR?
Making plans for this is called "Advance Directives." By filing a Health Care Proxy Form and a Do Not Resuscitate (DNR) order, your doctors and caregivers can carry out your wishes if you are no longer able to express them yourself.