They say “Knowledge is Power.” To help, we’ve created a place where you can find answers to the most frequently asked questions we receive. Click on any of the categories below to see the questions and answers related to that category. Click on the topic again if you wish to collapse the text prior to selecting another topic.
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What is the CMS 5-Star Quality Rating and how reliable is the rating?
In 2008, The Centers for Medicare and Medicaid Services (CMS) released the controversial Five-Star Quality Rating System on the Medicare.gov website. The Nursing Home Compare website features a quality rating system that gives each nursing home a rating of 1 to 5 stars. CMS cautions the public that no rating system can address all of the important considerations that go into a decision about which nursing home may be best for a particular person.There are limitations of the Five-Star Quality Rating System. The overall rating is made up of 3 subcategories, which include Health Inspection Results, Staffing and Quality Measures. CMS notes the limitations of the rating are due to the fact that two of the three subcategories are based on self-reported data and only capture a small period of time.
It is because of these limitations that CMS advises consumers to use other sources, including a visit, before making a decision.
American Senior Communities understands this is an important decision and warmly opens its doors and invites you to visit and get to know the staff before you make a decision. We are here to help answer any questions you have to ensure you feel confident regarding your decision.
What types of therapy services are offered at American Senior Communities?
Our Moving Forward Rehabilitation program offers physical, occupational, and speech therapies. Physical therapy focuses primarily on independent mobility, strength and balance, use of proper body mechanics, and energy-saving techniques. Occupational Therapy helps participants improve their activities of daily living such as bathing, eating, dressing, self-care, and home management tasks by improving strength and coordination. The Speech/Language therapy program targets functional communication, cognitive skills, and teaches safe swallowing techniques. Programs vary in frequency and intensity. Our goal is to return our participants home safely with the skills they need to continue life on their own terms.
Is therapy done on an in-patient or outpatient basis?
It’s your choice. For those who qualify to be part of the Moving Forward Rehabilitation Program we offer upscale benefits in our special Moving Forward Wing (at select locations), which includes a spacious living room, a family lounge, an exclusive dining area, and a private courtyard for relaxation. Private suites are available with electric beds, cable tv, phone, and other amenities that make the stay comfortable and enjoyable.
How does a person go about getting started in the program?
All you have to do is call or visit one of our communities. Our admissions team will work with you initially and then a meeting between our interdisciplinary team takes place to assess goals and map out a plan of recovery. Because a strong support system is so vital to recovery, we encourage family and friends to take part in the plan.
Will I work with the same therapist through my entire program?
Our licensed therapists are on-site at our communities and are part of our regular staff. They are warm, caring team members who take a vested interest in the success of each therapy patient. Because of the shared goals and commitment between the participant and therapist, and because our therapy team takes a special interest in the overall wellbeing of each person, participants often become very close to their therapists and it’s common for us to see them return just to visit even after they’ve graduated from the program.
What happens when I’m done with my therapy program?
When you’ve completed your individualized program that means you’ve joined the ranks of our many successful Moving Forward graduates! But before you leave us, we provide an in-home assessment to ensure a safe transition back into your home and to be sure there are no obstacles to your continued success. If more therapy is required or different areas of need become apparent, our team is available and will welcome the chance to help participants increase their success level. We also offer our New Energy Wellness program (at select locations) for increased strength building and conditioning.
Are therapy services covered by Medicare and Insurances?
Yes, if you meet their criteria. Typically, it requires a recent stay in a hospital and a few other factors. Our admissions team will asses and help you determine if you qualify.
What types of nursing services are offered at American Senior Communities?
Our Skilled Nursing Care is designed to provide compassionate care to those recovering from stroke, heart attack, orthopedic conditions or other disabilities. We’ve built a team of geriatric specialists who have developed unique protocols and procedures for short-term or extended care, encompassing the physical and emotional well-being of each resident.
Is the nursing staff available at all times?
Each community employs full-time, licensed nurses who oversee all aspects of care, including assessments, medication assistance and communication with family and physicians around the clock. In addition, medical centers and hospitals are easily accessible from most of our communities.
How are nurses selected by American Senior Communities?
First, ASC looks for people who have a passion for serving seniors. In addition to the medical training and licensing required, each caregiver must successfully complete a thorough reference and background check. All of our caregivers, including our licensed nurses, participate in an exclusive senior care training program.
How will I recognize if a loved one is experiencing memory challenges?
A certain amount of memory loss is considered a normal part of the aging process, but Alzheimer’s disease is not. Family members and close friends are often the first to notice changes in behavior that may indicate something more serious than what is considered normal. Although Alzheimer’s disease is the most common form of dementia, there are many different causes of memory loss. So if you think a loved one is experiencing symptoms, it’s best to visit a doctor to determine the cause and take the necessary steps after diagnosis. ASC offers seminars and support groups that can help family members recognize symptoms and become active in the treatment for their loved ones.
What happens as the Alzheimer’s disease progresses?
Alzheimer’s disease does worsen over time, but the progression varies greatly from person to person. The program in our Auguste’s Cottage is designed to follow the natural flow of the typical Alzheimer’s or dementia experience. Although there is no way to predict how fast someone will progress through the stages, our staff are specially trained in this area and are acutely aware of changes that indicate the disease is progressing. Early diagnosis and treatment can slow the progression, but expert care provided in a specialized environment, especially in advanced stages, is essential in maintaining quality of life.
Why is it so important for seniors to stay active?
Staying active isn’t just important for physical health, but for overall wellbeing. Depression can strike at any age, but for seniors, it is a common and potentially serious problem. It is believed that one in four senior adults battle feelings of depression. Elderly Depression is often undiagnosed because it is considered a normal part of aging, but staying active both physically and socially can help ensure that feelings of loneliness and isolation do not occur.
Will Mom and/or Dad be encouraged to participate in social life at American Senior Communities?
Absolutely! Our full calendar of events and activities ensures that there’s something for everyone’s taste! We ask our residents what they enjoy, and then incorporate those preferences into the activities calendar. Our Activities Directors go the extra mile to encourage all residents to participate.
Can family members participate in activities and events?
We welcome family members at any time, but especially enjoy when they take part in our community activities and social events. Our Activities Directors are happy to include family members and the residents enjoy having their loved ones join in the fun.
What types of activities are offered?
Each of our communities has a busy social calendar planned for our residents. On-site activities include things like bingo, all sorts of games, reading groups, movies, crafts, seminars on various topics, and the list goes on and on. This is in addition to the many outings to plays, movies, restaurants, casinos, parks, zoos, museums, and more. And we’re always looking for new and interesting things to add to the list!
What is Medicare and what costs does it cover?
Medicare is a federal health insurance program for people who are 65 or older, have been disabled for at least two years, or have End Stage Renal Disease.
What is Medicare Part A and Part B and what costs are covered?
There are two types of traditional Medicare coverage. Medicare Part A provides for hospital insurance for costs incurred while you are in the hospital. Medicare Part B provides medical insurance for costs of physician services, the cost of an ambulance, outpatient medical services and hospital supplies. The patient is responsible for a deductible for each of these service categories each year.
What are the qualifications to use Medicare for Skilled Nursing care?
You must have a prior Medicare-covered inpatient hospital stay of at least three days (not counting the day of hospital discharge). Your admission to a Medicare-approved Skilled Nursing facility must be within 30 days of discharge from the hospital or within 30 days of a previous Medicare-covered hospital stay. Your doctor must have certified that following your hospital stay, you require a daily skilled service provided by a licensed nurse or therapist in a nursing facility that is Medicare certified.
What are the services and supplies covered by Medicare?
Your room and board, routine nursing care, medical supplies and complex equipment, medicines and physical, occupational, speech and respiratory therapy. Oxygen and lab services are covered. Also covered are X-rays, EKGs and intravenous medications you may need. Personal convenience items, private duty nurses, custodial nursing care and the extra cost of a private room are not covered.
How long will Medicare Part A cover Skilled Nursing facility costs?
In a Medicare-certified Skilled Nursing facility, Medicare will cover 100 days per benefit period after a three-day Medicare-covered inpatient hospital stay and physician confirmation that there is a need for daily, Skilled Nursing and/or rehabilitative care in a Skilled Nursing facility. There is a co-insurance cost per day for days 21-100. This means the patient will pay for co-insurance costs through private insurance or out of pocket. Expenses beyond 100 days are not covered by Medicare Part A benefits.
What is Medicare Part C and D?
Medicare Part C is also known as a Medicare Advantage Plan. The Medicare Advantage Plan is an insurance policy offered by private insurance companies approved by the Centers for Medicare & Medicaid Services (CMS). When a person enrolls in a Medicare Advantage Plan, the plan will cover all of Part A, Part B and sometimes Part D coverage. Part D coverage is insurance coverage that subsidizes Medicare coverage for the costs of medicine.
The Medicare Advantage Plan often offers extra coverage above and beyond traditional Medicare and covers expenses for such costs as vision, hearing, dental or wellness programs. Each insurance company that offers a Medicare Advantage Plan has different rules that define which hospitals, physicians and Skilled Nursing facilities members can use. Some Medicare Advantage Plans may waive the three-day hospital stay required for inpatient skilled nursing and rehabilitation under traditional Medicare. Many Medicare Advantage Plans require that healthcare providers secure prior authorization.
American Senior Communities employs registered nurses to negotiate with the insurance companies during the prior authorization process.
What is Medicaid and what costs does it cover?
Medicaid is a federal and state-funded medical assistance program that pays for approved and needed medical care for persons who meet specific eligibility requirements. A medical assistance recipient remains eligible for nursing facility care for as long as that level of care is approved and the person continues to meet all financial and other requirements.
Who is eligible for Medicaid in the Long-Term Care setting?
Medicaid reimbursement of Intermediate and Skilled Nursing Home care costs is available to people unable to pay for nursing facility care who are age 65 or over, blind because of either central visual acuity of 20/200 or less in the better eye with the use of a corrective lens, or a visual field restriction of 20 degrees or less. You may also be eligible for Medicaid if you are disabled because of a physical or mental impairment, disease or illness which appears reasonably certain to continue a lifetime without significant improvement and which substantially impairs the ability to perform labor or services or to engage in a useful occupation.
Additionally, the individual must not have resources over the allowable limits, be a resident of Indiana, a U.S. citizen or lawfully admitted alien with permanent resident status, and not be a resident of a public institution, except one that is Medicaid certified.
State law requires that every person applying for admission to a nursing facility is prescreened to determine whether or not services are available in the community which would allow the individual to remain in the community. Failure to participate in the pre-admission screening program will result in the individual’s ineligibility for Medicaid reimbursement for the daily costs of the nursing facility for up to one year.
What are the types of medical care and services covered by Medicaid?
Nursing home services, physician services, inpatient hospital and clinic services, prescriptions, medical supplies and equipment, eyeglasses and prosthetic devices, therapy, optometry services, podiatry services, certain inpatient psychiatric care, medically-related transportation, personal items and room and board services. If an applicant is determined to be eligible for nursing facility care under the Medical Assistance program, Medicaid may pay for your medical bills incurred up to three months before the month in which the application is signed.
How is financial eligibility for Medicaid determined?
An ASC representative can assist you with this process. A variety of records with your application is needed to determine if you meet income and asset requirements. You must also have the approval of a physician certifying you need the care. Records of proof include statements showing how much you receive from Supplemental Security Income, Social Security, Veteran’s benefits, Railroad Retirement benefits, Unemployment Compensation, income from rental property and you and your spouse’s earnings and income. You will also need to provide your marriage license, Social Security number, Medicare number, Railroad Retirement number and Veteran’s claim number. You should bring your birth record, bank records, property deeds, burial trusts of pre-paid funeral arrangements, all life and medical insurance policies, documentation of all property transferred in the past five years, and records showing ages of dependent children in the home.
What are the income limits for people who are married?
The Spousal Impoverishment Protection Law applies to nursing home admissions that occurred after Sept. 30, 1989. It allows the spouse who remains at home to keep some of the couple’s income and assets while still qualifying the nursing home spouse for Medicaid.
A snapshot of the couple’s assets is taken at the time the Medicaid application is taken, which must be after 30 days of continuous institutionalization in a nursing facility or hospital. The spouse who remains at home, known as the community spouse, is allowed to keep all income that is solely in his or her name, plus half of all jointly owned income. If his or her income does not equal the minimum amount, the spouse who remains at home may keep some of the nursing home spouse’s income.
Are there exceptions made for asset restrictions?
If the community spouse has high living expenses, he or she may appeal to keep more of the nursing home spouse’s income. The nursing home spouse must contribute all of his or her remaining income towards nursing home costs except for a small amount per month for personal needs and any dollar amounts needed for health insurance premiums, taxes and medical expenses not covered by Medicaid.
What important documents should I bring?
Either prior to or during the admissions process, you must present your Medicare card, Medicaid card, Managed Care or Insurance card, Social Security card, Medicare Part D (drug benefit) card, Advanced Directives, Living Will, etc. (if applicable) and any Long-Term Care/Supplemental Insurance policies.Our admissions personnel will review all state and federal programs that you could be eligible for and explain the benefits and requirements to you. They will also explain the services available in the nursing community to assure that all of your concerns are addressed. You may also meet with a member of our business office to review any financial questions that center around your Medicare, Medicaid or Insurance policies. During the assessment process we will also review your payor sources and help you understand how billing will take place.
What if I am admitted from home?
Our goal is to provide each resident with a smooth transition into our community, while meeting the federal, state and local requirements. Our admissions director will be of great assistance to you. The first step is pre-admission screening approval.
In Indiana, the state has to give the “okay” for a person to enter the nursing community. The local Area Agency on Aging is in charge of the preadmission screening process. The state has specific criteria that a person must meet to be appropriate for placement. The client will be assessed for their medical needs for placement. Our admissions director will assist you through this process.
You also must have a physical completed by your personal physician within the last 30 days, doctor’s orders to admit you and medication orders. A chest x-ray within the last 6 months and a statement from the physician that indicates you have no communicable disease is required. Also required is a PPD, which is a skin test for tuberculosis that you must have had within the last three months.
What if I am admitted from the hospital?
Following the clinical assessment, the admissions team will work with the hospital staff to arrange placement into the Skilled Nursing community. The hospital staff will provide the medical information to ensure a smooth transition. It will be necessary for you or a family member to complete admission paperwork the day of admission.
What happens once I arrive at a nursing community?
A member of our nursing team will meet with you to gather clinical information, perform a clinical evaluation and orient you to our community. The admitting nurse will discuss a number of clinical aspects related to your diagnosis, medications and activity level. You will be assessed from head to toe to note any conditions that may need to be addressed immediately and during your stay. Also, you will be weighed periodically to maintain your weight record. Clinical interventions are focused on the special needs of our residents and are designed to promote a safe and timely discharge.
Will my family be involved?
Members of the interdisciplinary team will meet with you or your loved one shortly after admission. The team includes the therapy staff, registered dietitian and social services. They will collect important details about your diagnoses, clinical and psychosocial needs, lifestyle and discharge plan. We call this our Road to Recovery meeting and it is a goal setting meeting designed to provide a “road map” for your expected recovery. This meeting will include discussion about your nursing needs, therapy goals, expected length of treatment, psychosocial needs, discharge planning and educational needs.
What services are available at the nursing community in addition to nursing services?
For your convenience, the community may arrange providers of professional services, or you may wish to select your own providers. If you do so, please remember to bring their names, addresses and telephone numbers with you on the day of admission. These providers of professional services must comply with all applicable rules and regulations. The providers of service can include your physician who is available to visit you at the community as required by licensure/certification, your dentist, podiatrist, pharmacist, hospital professionals, and your church or clergy member.
Can I bring personal items?
We encourage you to bring personal items as space allows. All personal belongings should be labeled with your name. Any electrical item, such as lights, TVs and radios, must be checked and approved for use by our maintenance department. All clothing should have your name either on a label sewn to the garment or written on the garment in permanent ink.
What clothing should I bring?
Women should bring four or five dresses and blouses or tops; two or three sweaters, eight undergarments, pajamas, gown and robe, non-slip shoes and a coat.
Men should bring four or five pairs of slacks and four or five shirts, eight undershirts and shorts, two or three sweaters, pajamas, a robe, non-slip shoes and a coat.
Depending on which service line they will be utilizing, alternative lists of suggested items may be given.