What to Know Before Hiring a Long-Term Care Provider

Before making any decisions about long-term care, get as much information as you can about the different kinds of care providers and what to ask them about their services. The type of care a person may need depends on many factors, and choosing a provider is not a decision to be made hastily.1. What are my options for long-term care providers?Your options for care depend on your medical needs. Will your care be acute, temporary, or long-term? Does it involve elder care, in home care, or relocation to a facility? There are four common types of care services:In-home CareAssisted Living FacilitiesNursing Home CareAdult Day Health Care Centers2. How can I pay for long-term care and also save on cost for care services?Did you know that few, if any long-term care services are covered by Medicare or Medicaid? While health care insurance and Medicare may pay if you need skilled care for a short time to recover from an illness or injury, with few exceptions, ongoing personal care needs of day-to-day living, and long-term rehab aren’t covered.Medicaid provides financial assistance for certain short-term health services and nursing home care for those with low incomes and limited resources. A person must first use up their personal assets before they qualify for Medicaid assistance.Did you know-Most Americans are unaware of the total, sometimes hidden costs of long-term care. Many falsely assume Medicare will pay for their care. Medicare clearly states that they do not pay for any long-term care services.

For many, financing healthcare means using other financial options-savings, IRAs and 401-k plans, and other sources of income, especially if the long-term care you need is non-medical/non-skilled care with daily tasks like transportation, heavy lifting, house work, other chores, dressing, bathing, and bathroom use.3. What licenses and certifications are maintained by the care provider?Each state issues licenses and regulates care providers, and many state regulations differ. Visit the website for the Department of Health and Human Services in the state for which you’re inquiring.Make sure the provider maintains all required licenses, and inquire as to why they choose not to maintain licenses that are optional. You can find out what licenses are required or optional by contacting your Department of Health and Human Services.4. What staffing practices are in place?Understand the provider’s staffing practices. Ask if the following practices are used in hiring for all care-giving positions:Verification of professional licensure or certification, if applicableVerification of prior employment and referencesCriminal background checks (Federal and State)Skills testing, and continued educationDiscuss the experience of management staff and the turnover rate for care-giving positions. When possible, interview residents and other staff members and assess their satisfaction rates with the care site.5. How does the long-term care provider implement training and supervision?Proper staffing, training and supervision are important considerations. Be sure to ask about the training program for care-giving employees. Also ask how new employees learn the provider’s care protocols and at what point in their training are they allowed to work independently and without direct supervision. Clinical supervision of all care-giving activities should be routine and well documented. Ask about frequency of employee performance reviews. What kind of disciplinary practices are used for employees who do not meet the provider’s eligibility standards?6. How are daily care activities, health improvements and concerns monitored and addressed?A good long-term care provider will keep a daily log of activities and episodes. Maintaining a daily log to document the care provided is one way to make sure medications are taken properly and activities are included in your loved one’s daily care routine.These days, this process is often done with advanced medical software. Ask the provider if they use state of the art monitoring and incident reporting software.The caregiver will usually log-in comments about mood, energy and appetite. In your conversations with care providers, you should ask if these logs are reviewed by clinical staff personnel and what the provider might do if you have a concern with what you read in the log.

7. How will the care provider address your concerns or complaints?There should be provided a written complaint/resolution process available for your review, with options for mediation and detailed follow-through communication.Discuss the best avenues of communication and understand management’s availability for addressing immediate concerns.Learn how they will communicate with you and what they use for a response system. Many assisted living facilities and home health care organizations will be available through a call service for emergencies, and most nursing homes operate a nursing station that can be reached around the clock.8. What about rates, increases and how to terminate services?Before signing an agreement, make sure it states clearly what type of notice will be given if rates for long-term care are going to change, and how much of an increase can be made at any given time. Learn their policies for terminating and cancelling service.For home care agencies there is generally a window of time when you can cancel a single visit and not be penalized for the cost. Often there is a required period of notice to terminate services entirely with both in-home and nursing home long term care.For assisted living facilities there is generally a termination policy if a resident chooses to move elsewhere.

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