31. Nursing Homes in New York City and Choices

Senior Hug helps you in Making the right choice when looking for Nursing Homes in New York City.

This includes the boroughs of Queens, Brooklyn, the Bronx and Manhattan.

Sometimes, decisions about where to care for a family member need to be made quickly, for example, when a sudden injury requires a new care plan. Other times, a family has a while to look for the best place to care for an elderly relative.

Lets look at the defintion of a Nursing Home…

What Is a Nursing Home?

A nursing home, also known as a skilled nursing facility, is a place for people who don’t need to be in a hospital but can no longer be cared for at home. This can include people with critical injuries or serious illnesses, or those needing care after surgery.

Most nursing homes have aides and skilled nurses on hand 24 hours a day. Talk to your healthcare provider to find out if a nursing home is the best choice for you or a member of your family.

Nursing homes can be:

Hospital-like. This type of nursing home is often set up like a hospital. Members of the staff give medical care, as well as physical, speech, and occupational therapy. There can be a nurses’ station on each floor. As a rule, one or two people live in a room. A number of nursing homes will let couples live together. Things that make a room special, like family photos, are often welcome.
Many nursing homes have visiting doctors who see their patients on site. Other nursing homes have patients visit the doctor’s office. Nursing homes sometimes have separate areas called “Special Care Units” for people with serious memory problems, like dementia.
Tips to Keep in Mind

If you need to go to a nursing home after a hospital stay, the hospital staff can help you find one that will provide the kind of care that’s best for you. Most hospitals have social workers who can help you with these decisions. If you are looking for a nursing home, ask your doctor’s office for some recommendations. Once you know what choices you have, it’s a good idea to:

Consider. What is important to you—nursing care, meals, physical therapy, a religious connection, hospice care, or Special Care Units for dementia patients? Do you want a place close to family and friends so they can easily visit?

Ask. Talk with friends, relatives, social workers, and religious groups to find out what places they suggest. Check with healthcare providers about which nursing homes they feel provide good care. Use their suggestions to make a list of homes that offer the types of services you want.

Call. Get in touch with each place on your list. Ask questions about how many people live there and what it costs. Find out about waiting lists.

Visit. Make plans to meet with the director and the nursing director.
Medicare and Medicaid certificationHandicap accessResidents who look well cared forWarm interaction between staff and residents

Talk. Don’t be afraid to ask questions. For example, you can ask the staff to explain any strong odors. Bad smells might indicate a problem; good ones might hide a problem. 

You might want to find out how long the director and heads of nursing, food, and social services departments have worked at the nursing home. If key members of the staff change often, that could mean there’s something wrong.

It is important to always do some deligent research about the particular nursing homes that you have planned for your loved ones.

30. Picking the right Nursing Home in New York City

Picking the right Nursing Home in New York City

Senior Hug helps you Pick the right Nursing Home for your loved ones.   Senior Hug has a directory of the Nursing Homes that are within New York City.  We try to help both the elders and their families find the right Nursing Home that fits their needs and the level of care that they want.

Your mom, dad or another close relative needs a nursing home. Finding the right facility, with a constant level of skilled care, is a serious undertaking. Bad nursing homes neglect, steal from and even abuse residents.

Good ones help them live happy, dignified lives despite being in poor health and may even help them improve enough to move to assisted living or return home. Here are some tips on how to pick the right place.

Check the Ratings

A good place to begin narrowing your nursing home options is with the feds – specifically, Medicare’s Nursing Home Compare feature. The Centers for Medicare and Medicaid Services (CMS), part of the U.S. Department of Health and Human Services, rates nursing homes based on comprehensive annual health inspections, 18 measures of residents’ quality of life and staffing levels.

The ratings are updated about once a year or whenever someone files a complaint against a nursing home with the state regulatory agency.

CMS gives each nursing home a rating from one to five stars. Avoid facilities with one or two stars, which indicate serious problems with residents’ care; look for ones with four or five stars. Then, review the detailed ratings for each facility. A home might have five stars overall, but just two stars for quality measures (which reflects treatment of specific conditions).

You can also use the nursing home search tool from ProPublica, an independent non-profit organization that conducts investigative journalism in the public interest, to search CMS reports on nursing home deficiencies. The site will help you uncover specific problems cited during nursing home inspections.

Once you have a preliminary list, call each facility to find out if it has beds available and to ask how much it charges for care, making sure to get detailed figures based on your loved one’s actual needs. If there is no availability or the cost does not fit your budget, there’s no use researching that home further.
Flaws in the Ratings

Ratings can give you a general idea of which facilities might be best and which to avoid, but they aren’t perfect. The New York Times in August 2014 reported on how nursing homes were able to game the star rating system, since they actually supplied the data for staff levels and quality measures; only the annual health inspection ratings were based on independent observations.

This means a facility could have a five-star rating, despite numerous complaints and even lawsuits over the quality of care. In January 2015, CMS introduced improvements to the two self-reported measures.

 

Digging Deeper

Families for Better Care, a Tallahassee, Fla.-based non-profit advocacy group, says your next step should be to contact your local long-term care ombudsman. Under this government-mandated program, ombudsmen regularly visit and advocate on behalf of nursing home residents. Ask your ombudsman for complaint data on the nursing homes on your list. You can even talk to the specific person who has visited each facility.

Other possible sources of recommendations include doctors, elder law attorneys, elder advocacy groups, members of religious organizations or clubs you or your loved one belongs to, friends and coworkers. Make sure their recommendations are based on recent experience, as nursing home conditions can change.

Hospital discharge planners, on the other hand, “may or may not be good sources, given their interest sometimes in just moving patients out of the hospital,” says Eric Carlson, directing attorney at Justice in Aging, a national organization that fights senior poverty.

 

Get Referrals

If the whole process of finding a reputable nursing home seems like more than you can manage, consider a placement service. These services can recommend facilities, take you on tours and help you negotiate a contract. “We review the care and violation histories of the communities we refer to, every single time, before we do a tour, as the violation histories can change dramatically in a short period of time,” says Haley Gray, owner of CarePatrol of the Triangle, in North Carolina.
Because of this potential conflict of interest, you should research the placement service’s reputation and independently verify any information the placement service gives you. Make your own, unannounced visits to the facilities you’re considering.

Also keep in mind that there may be excellent facilities available that the placement service will not refer you to because they are not contracted with that facility and therefore won’t earn any commission for sending you there.
Ask Questions

During your visit, ask about the staff-to-patient ratio and how that ratio changes throughout the day and over the weekend. Ask about – and try to observe – how long it takes staff to respond to patients’ requests for assistance. Visit during meal time to see if the food is appetizing and observe how staff interacts with patients of varying needs.

Always try to be vigilant in asking questions or in trying to get as much information as you want.

Drop by unannounced, and, if you make more than one visit, try going at different times of day. In a good, secure facility, you probably won’t get far, but it can be significant to see how long it takes a stranger’s presence to register. And a place should be ready to give you a tour any time; the more impromptu, the more of a real-life perspective you’ll get.

Ask how many hours of physical and occupational therapy residents receive daily, and ask staff how long they’ve worked there Also consider staff morale; if the workers seem unhappy to be there, that could indicate an underlying problem with the nursing home. Also ask staff what they’d like to see improved about the home.

29. Paying for a Nursing Home in New York City

Paying for a Nursing Home in New York City is one of the major issues and concerns.

How can I pay for nursing home care?

Nursing Home can be quite expensive especially Nursing Homes in New York City.  It can have a huge impact on your wallet and your financial situation.

There are many ways you can pay for nursing home care. Most people who enter nursing homes begin by paying for their care out-of-pocket.

As you use your resources (like bank accounts and stocks) over a period of time, you may eventually become eligible for Medicaid.

Medicare generally doesn’t cover long-term care stays (room and board) in a nursing home. Also, nursing home care isn’t covered by many types of health insurance. However, don’t drop your health care coverage (including Medicare) if you’re in a nursing home.

Even if it doesn’t cover nursing home care, you’ll need health coverage for hospital care, doctor services, and medical supplies while you’re in the nursing home.

There are several other ways you can pay for nursing home care:

You can use your personal money and savings to pay for nursing home care. Some insurance companies let you use your life insurance policy to pay for long-term care. Ask your insurance agent how this works.

If you qualify for Medicaid, you may be able to get help to pay for nursing home care costs. Not all nursing homes accept Medicaid payment.

Check with the nursing home to see if it accepts people with Medicaid, and if it has a Medicaid bed available. You may be eligible for Medicaid coverage in a nursing home even if you haven’t qualified for other Medicaid services in the past.

Sometimes you won’t be eligible for Medicaid until you’ve spent some of your personal resources on medical care. You may be moved to another room in the Medicaid-certified section of the nursing home when your care is paid by Medicaid. To get more information on Medicaid eligibility requirements in your state, call your Medicaid office.

There are many Important things to know about Medicaid,n and how it can affect you financially when choosing the right Nursing home especially in New York City.

 

Paying for care

You may have to pay out-of-pocket for nursing home care each month. The nursing home will bill Medicaid for the rest of the amount. How much you owe depends on your income and deductions.

Your home

The state can’t put a lien on your home if one of these is true:

There’s a reasonable chance you’ll return home after getting nursing home care.

You have a spouse or dependents living there

This means they can’t take, sell, or hold your property to recover benefits that are correctly paid for care while you’re living in a nursing home in this circumstance.

In most cases, after someone who gets Medicaid nursing home benefits passes away, the state must try to get whatever benefits it paid for that person back from their estate.

 

 

Your assets

Most people who are eligible for Medicaid have to reduce their assets first. There are rules about what’s counted as an asset and what isn’t when determining Medicaid eligibility.

Also, states are required to let married couples protect a certain amount of assets and income when one spouse is in an institution (like a nursing home) and one isn’t.

A spouse who isn’t in an institution may keep half of the couple’s joint assets, up to a maximum of $119,220 in 2016, as well as a monthly income allowance. For more information, call your Medicaid office. You can also call your local Area Agency on Aging to find out if your state has any legal services where you could get more information.

Transferring your assets

Transfers for less than fair market value may subject you to a penalty that Medicaid won’t pay for your nursing home care for a period of time. How long the period is depends on the value of the assets you gave away.

There are limited exceptions to this, especially if you have a spouse, or a blind or disabled child. Generally, giving away your assets can result in no payment for your nursing home care, sometimes for months or even years.
Long-term care insurance

This type of private insurance policy can help pay for many types of long-term care, including both skilled and non-skilled care. Long-term care insurance can vary widely. Some policies may cover only nursing home care. Others may include coverage for a whole range of services, like adult day care, assisted living, medical equipment, and informal home care.

If you have long-term care insurance, check your policy or call the insurance company to find out if the care you need is covered. If you’re shopping for long-term care insurance, find out which types of long-term care services and facilities the different policies cover.

Also, check to see if your coverage could be limited because of a pre-existing condition. Make sure you buy from a reliable company that’s licensed in your state.

Federal employees, members of the uniformed services, retirees, their spouses, and other qualified relatives may be able to buy long-term care insurance at discounted group rates.

28. Nursing Home Coverage and costs

Nursing Home Coverage and costs

Nursing Homes can be one of the most expensive things that you can spend money on during the later years.

Nursing homes in new york city can especially be more costly and expensive compared to others.

A nursing home is first and foremost a home. It will be the most important place for your loved ones within that Nursing Home.

More than that, it provides skilled nursing care, rehabilitative care, medical services, personal care, and recreation in a supervised and safe environment.

Finding the right nursing home for a loved one may be the most difficult decisions a person makes. However, family involvement does not end when a loved one enters a nursing home; the family assumes a crucial new role to make sure the home’s staff others provides good care.

Looking for the right Nursing Home especially in the state of New York can be very difficult.

Talk with the loved one who will be living there. This will help in adjusting to the major life change about to occur.

Interact with other family members and ask for help in locating the best nursing home.

Communicate with doctors, nurses, or any other health professionals or social workers who care for your loved one.

Talk with some nursing home employees, especially assistants since they give most of the care.

Contact the long-term care ombudsman and discuss the right nursing home for you and your loved ones.

A long-term care ombudsman represents people who live in nursing homes. He or she investigates problems and complaints, and is a trusted source of information. Ombudsman volunteers make regular visits to nursing homes and can usually provide information about how well they are organized and run.

Note that ombudsman programs are not allowed to recommend one nursing home over another. However, they can provide important information such as the latest state inspection reports and the number and types of complaints received. The long-term care ombudsman can also give advice on what to look for when visiting nursing homes.

About a third of nursing home residents pay all of their nursing home costs from their own funds.

 

What it Costs

Most people already know nursing home care can be expensive. Although the average cost is more than $50,000 a year and climbing, it can vary widely depending on where you live. Employee health insurance does not pay for nursing home care. About a third of nursing home residents pay all of their nursing home costs from their own funds. Extended nursing home care can eat up your or your loved one’s savings quickly many people exhaust their finances after just six months.

A fraction of them or just about 5 percent` buys long-term care insurance, which covers the cost of a nursing home or other extended care. Medicare, the federal health insurance program for older persons and some younger ones with disabilities, pays for short-term nursing home stays.

So what about the rest? The greatest share of residents, about two-thirds, pay for their care with money from Medicaid, a federal and state health insurance program for people with low incomes.

Medicaid picks up the cost of nursing home care once people have used almost all of their savings spouses are allowed to keep some assets including income, savings, and their home.

However, Medicaid will only pay for nursing home care that is provided at a facility certified by the government.

Eligibility for Medicaid varies by state, so if you think a loved one may need care years from now, you should gather information as soon as possible. Learning early about the requirements ensures the care comes quickly when you or your loved one need it.

 

27. How prevalent is Nursing Home Abuse

Nursing Home Abuse

Placing our loved ones in a Nursing Home can be a hard thing to do, therefore it is always important to make sure that we are not placing our loved ones in the wrong Nursing Home that puts their well being in danger.

A congressional report showed that an examination of nursing home records conducted over a two-year period showed that nearly 1 in 3 nursing homes were cited for violations that had the potential to cause harm and almost 10 percent of all nursing homes have violations that caused actual harm, serious injury or placed them in jeopardy of death.

A survey of nursing home residents showed that up to 44 percent of nursing home residents reported that they had been abused at some time in residency and nearly all of those surveyed (95%) had seen another resident neglected.

This can be a quite a depressing statistic

Due to reports like these, legislatures in all 50 states have passed anti-elder-abuse laws but nursing home abuse continues to occur.

Nursing home abuse can involve:

Physical Abuse is a condition or event that causes physical harm. Physical abuse may be intentional such as hitting or pinching or it may be due to neglect including overuse of restraints and lack of physical care.

Sexual Abuse is unwanted sexual attention or exploitation. This includes sexual attention given to a patient who is unable to express his or her wishes or is cognitively compromised such as the patient with dementia.

Psychological Abuse is not easily identified but can include yelling, criticizing, humiliating or otherwise shaming the patient. Patients who are experiencing psychological abuse may exhibit behavioral changes.

Financial Exploitation occurs a caregiver takes advantage of access to a patients financial matters, steals or otherwise compromises the patient’s financial status. This could include direct theft, theft from banking accounts or applying for credit in the patient’s name.

Neglect is often unintentional and a result of inadequate staffing. Neglect occurs when a patient’s needs are not taken care of such as personal hygiene care or when the patient is not provided food, clothing or water.

Neglect can contribute to a number of medical conditions such as bed sores, skin infections, malnutrition and dehydration.

Resident to Resident Abuse occurs when one resident is allowed to abuse another. Resident to resident abuse may be physical, sexual or psychological. Nursing home patients should be protected from other residents.

25. History of New York City and Nursing Homes

History of Nursing Homes and New York City

Finding the right nursing home for your loved ones in NYC can be one of the hardest things to do.

What Is a Nursing Home

A nursing home, also known as a skilled nursing facility, is a place for people who don’t need to be in a hospital but can no longer be cared for at home. This can include people with critical injuries or serious illnesses, or those needing care after surgery.

Most nursing homes have aides and skilled nurses on hand 24 hours a day. Talk to your healthcare provider to find out if a nursing home is the best choice for you or a member of your family.

Nursing homes can be:

Hospital-like. This type of nursing home is often set up like a hospital. Members of the staff give medical care, as well as physical, speech, and occupational therapy. There can be a nurses’ station on each floor. As a rule, one or two people live in a room. A number of nursing homes will let couples live together. Things that make a room special, like family photos, are often welcome.

Household-like. These facilities are designed to be more like homes, and the day-to-day routine is not fixed. Teams of staff and residents try to create a relaxed feeling. Kitchens are often open to residents, decorations give a sense of home, and the staff is encouraged to develop relationships with residents.

Combination. Some nursing homes have a combination of hospital-like and household-like units.

Many nursing homes have visiting doctors who see their patients on site. Other nursing homes have patients visit the doctor’s office. Nursing homes sometimes have separate areas called “Special Care Units” for people with serious memory problems, like dementia.

Tips to Keep in Mind

If you need to go to a nursing home after a hospital stay, the hospital staff can help you find one that will provide the kind of care that’s best for you. Most hospitals have social workers who can help you with these decisions. If you are looking for a nursing home, ask your doctor’s office for some recommendations. Once you know what choices you have, it’s a good idea to:

Consider. What is important to you—nursing care, meals, physical therapy, a religious connection, hospice care, or Special Care Units for dementia patients? Do you want a place close to family and friends so they can easily visit?

Ask. Talk with friends, relatives, social workers, and religious groups to find out what places they suggest. Check with healthcare providers about which nursing homes they feel provide good care. Use their suggestions to make a list of homes that offer the types of services you want.

Call. Get in touch with each place on your list. Ask questions about how many people live there and what it costs. Find out about waiting lists.

26. The Era of Nursing Homes in New York City

Whe did Nursing Homes start sprouting all around New York City.

What Is a Nursing Home?

A nursing home, also known as a skilled nursing facility, is a place for people who don’t need to be in a hospital but can no longer be cared for at home. This can include people with critical injuries or serious illnesses, or those needing care after surgery.

Most nursing homes have aides and skilled nurses on hand 24 hours a day. Talk to your healthcare provider to find out if a nursing home is the best choice for you or a member of your family.

Nursing homes can be:

Hospital-like. This type of nursing home is often set up like a hospital. Members of the staff give medical care, as well as physical, speech, and occupational therapy. There can be a nurses’ station on each floor. As a rule, one or two people live in a room. A number of nursing homes will let couples live together. Things that make a room special, like family photos, are often welcome.

Household-like. These facilities are designed to be more like homes, and the day-to-day routine is not fixed. Teams of staff and residents try to create a relaxed feeling. Kitchens are often open to residents, decorations give a sense of home, and the staff is encouraged to develop relationships with residents.

Combination. Some nursing homes have a combination of hospital-like and household-like units.

Many nursing homes have visiting doctors who see their patients on site. Other nursing homes have patients visit the doctor’s office. Nursing homes sometimes have separate areas called “Special Care Units” for people with serious memory problems, like dementia.

Tips to Keep in Mind

If you need to go to a nursing home after a hospital stay, the hospital staff can help you find one that will provide the kind of care that’s best for you. Most hospitals have social workers who can help you with these decisions. If you are looking for a nursing home, ask your doctor’s office for some recommendations. Once you know what choices you have, it’s a good idea to:

Consider. What is important to you—nursing care, meals, physical therapy, a religious connection, hospice care, or Special Care Units for dementia patients? Do you want a place close to family and friends so they can easily visit?

Ask. Talk with friends, relatives, social workers, and religious groups to find out what places they suggest. Check with healthcare providers about which nursing homes they feel provide good care. Use their suggestions to make a list of homes that offer the types of services you want.

Call. Get in touch with each place on your list. Ask questions about how many people live there and what it costs. Find out about waiting lists.

24. Nursing Homes and Malpractice lawsuits in New York City

Nursing Home abuse can be a very big issue.

New York City Nursing Homes

Placing our loved ones in a Nursing Home can be a hard thing to do, therefore it is always important to make sure that we are not placing our loved ones in the wrong Nursing Home that puts their well being in danger.

A congressional report showed that an examination of nursing home records conducted over a two-year period showed that nearly 1 in 3 nursing homes were cited for violations that had the potential to cause harm and almost 10 percent of all nursing homes have violations that caused actual harm, serious injury or placed them in jeopardy of death.

A survey of nursing home residents showed that up to 44 percent of nursing home residents reported that they had been abused at some time in residency and nearly all of those surveyed (95%) had seen another resident neglected.

This can be a quite a depressing statistic

Due to reports like these, legislatures in all 50 states have passed anti-elder-abuse laws but nursing home abuse continues to occur.

Nursing home abuse can involve:

There are plenty of different types of abuses that can be placed within various types of categories, some being more worse that others. 

Physical Abuse is a condition or event that causes physical harm. Physical abuse may be intentional such as hitting or pinching or it may be due to neglect including overuse of restraints and lack of physical care.

Sexual Abuse is unwanted sexual attention or exploitation. This includes sexual attention given to a patient who is unable to express his or her wishes or is cognitively compromised such as the patient with dementia.

Psychological Abuse is not easily identified but can include yelling, criticizing, humiliating or otherwise shaming the patient. Patients who are experiencing psychological abuse may exhibit behavioral changes.

Financial Exploitation occurs a caregiver takes advantage of access to a patients financial matters, steals or otherwise compromises the patient’s financial status. This could include direct theft, theft from banking accounts or applying for credit in the patient’s name.

Neglect is often unintentional and a result of inadequate staffing. Neglect occurs when a patient’s needs are not taken care of such as personal hygiene care or when the patient is not provided food, clothing or water.

Neglect can contribute to a number of medical conditions such as bed sores, skin infections, malnutrition and dehydration.

Resident to Resident Abuse occurs when one resident is allowed to abuse another. Resident to resident abuse may be physical, sexual or psychological. Nursing home patients should be protected from other residents.