Most states offer a Medicaid Program for individuals who meet financial eligibility and medical need criteria. Please contact your State’s Department of Human Services Income Support Division (local Medicaid office) to see if you or your loved one meets criteria for assistance. Most individuals fear that they may loose their home or all of their income and assets if they apply for assistance. There are laws and regulations in each state that provides Medicaid to protect home or homestead and to protect spouse from poverty. There are also attorney’s that specialize in Elder Law that can help you protect your income and assets and plan for transition to State Medicaid Assistance when you or your loved ones resources become exhausted.

Nursing homes generate income from providing rehabilitation services to keep financially afloat. They check to see that they will make a profit from providing patient services they need. That means that everything patient needs in way of treatments, therapy and medications must be covered by your insurance before they agree to accept a patient from a hospital.

The nursing home will also want to get an understanding of patient’s cognitive status and psycho/social-well-being to see that they are appropriate for their facility unless they have a contract with discharging hospital. Keep in mind that not all nursing homes are adapted to serve all types of patients. If you or loved one has some behavioral issues, related to dementia, Alzheimer’s disease or psychiatric problems they may not be accepted for admission. You may need to find a nursing home that specializes for those types of paient needs.

Understanding your insurance benefits and your needs will get you services you require for a successful rehabilitation stay.

Once you make selection Discharge Planner will check for bed availability at that nursing home. The nursing home may send out their nurse liaison to hospital to assess resident and make sure that nursing home can provide care and has appropriate equipment for patient as well as get needed information to verify that patient has met Medicare criteria for a skilled rehabilitation stay and to obtain information to verify payer source. This information is then passed on to nursing home’s Admissions Coordinator to review. Once it has been decided that nursing home will accept patient Discharge Planner is contacted. The Discharge Planner will obtained necessary physicians orders to discharge patient to nursing home and make transportation arrangements. As a courtesy to nursing home sometimes Discharge Planner will fax orders on to Admissions Coordinator so receiving nurse can verify equipment needed and order medications required for patient. Otherwise, orders come with patient.

While at nursing home Admissions Coordinator is verifying payer source. If payer source is traditional Medicare they will verify days available that Medicare will pay for. If, an HMO is payer source they will obtain required authorization, level of care and days authorized to provide care. The Admissions Coordinator will disseminate all hospital information to Interdisciplinary Team of nursing home to prepare to receive patient.

By time patient arrives at nursing home room should be ready with all of necessary equipment needed. The Admissions Coordinator will have an agreement ready for patient or responsible party to review and sign. Once in nursing home patient is referred to as a “Resident”. The nursing home is a different environment. It’s not a hospital, nor home for a skilled patient.