Monday, June 4, 2012

Differences between Nursing Homes, Assisted Living & chronic Care resignation Communities

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Benjamin Franklin said it best - “nothing in life is inescapable except death and taxes” but with daily advancements in science, technology and condition care, Americans are living longer than ever before*. This blessing however, has created a unique dilemma for modern American families: How to plan for and get ready for one's relinquishment years.

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Have you taken a road-trip lately? approximately every highway is graced with large bill-boards providing the locations of new planned communities where couples can spend their relinquishment years dedicated to recreational pursuits. I doubt you will find a local newspaper that doesn’t have at least one ad promoting the amenities found at a local assisted living facility. Try to crusade for “nursing homes in Virginia” on the Internet and thousands of web pages will appear. Each and every day new facilities gift distinct programs are being built and marketed across the state.

Is such a factory right for you and your family? If so, which facility? We often hear the terms “retirement community,” “nursing home,” and “assisted living facility” but rarely reconsider what these terms authentically mean. The differences however, are astonishing and it is imperative to understand these differences when manufacture choices for yourself or your loved ones.

Nursing Homes

In Virginia, a nursing home means any factory with the traditional function of providing long-term nursing care, nursing services and health-related services on a persisting basis, for the treatment and outpatient care of two or more non-related individuals**. Put simply, a nursing home is a factory designed for someone who needs less care than a hospital, but requires daily condition care assistance.

The Virginia branch of condition licenses such facilities and has established guidelines regulating various aspects of their operations, programs, and staffing needs, etc***. For example, a nursing home must: (a) have written policies and procedures about the treatment of residents and the administration of resident care which are available to residents and their families (12Vac5-360-20); (b) supply emergency healing services within 15 minutes, under general conditions (12Vac5-360-50); (c) be subject to unannounced on-site inspections of the nursing factory by State employees (12Vac5-371-60); (d) have a written trade with one or more physicians licensed by the Virginia Board of treatment to serve as healing director (12Vac5-371-230); and (e) each resident shall be under the care of a physician licensed by the Virginia Board of treatment (12Vac5-371-240).

In addition, residents of nursing homes are also given inescapable possession as defined by Virginia Code §32.1-138. See http://leg1.state.va.us/cgi-bin/legp504.exe?000+cod+32.1-138. Nursing homes are the most regulated and structured residential options for our Seniors requiring some level of daily condition care. If the factory provides care through Medicare and Medicaid programs, it is deemed a "Certified nursing facility" (Virginia Code §32.1-123; Virginia Code §32.1-127) and must be in yielding with both federal and state laws.

Of course, the more rules and regulations that define and operate the daily operations of a nursing home, the greater the accountability of the staff. These are the population who will be charged with the daily task of caring for your loved one, and manufacture sure they are in yielding with state and federal laws. No matter how nice and or entertaining the factory might be, the staff will make the variation in the middle of your loved one being cared for and encouraged, or not.

A nursing home is best mighty for someone:

Who requires daily condition care – such as aid getting in and out of bed; taking medicine; or using the restroom. Who may have dementia or Alzheimer’s and as a result, is unable to eat and or bathe daily without reminder or assistance; Who is recovering from a fall or emergency and is therefore unable to walk, dress and or eat without aid
Assisted Living Facility

“Assisted living facility” means an adult care house which has been licensed by the Virginia branch of communal Services to supply a level of aid for adults who may have corporeal or mental impairments and require at least moderate aid with the activities of daily living. Within assisted living, there are two types: regular assisted living for those seniors (typically) who need aid with one or more daily activity; and arduous assisted living for someone who may be incapable of performing activities due to mental and/or severe corporeal impairment (12Vac30-120-450).

The Virginia branch of communal Services licenses assisted living facilities but does not regulate in the way the branch of condition regulates nursing homes. While there are Virginia guidelines regulating aspects of assisted living facilities, they are limited: An assisted living factory must: (a) supply or coordinate personal and condition care services; and (b) supply 24-hour supervision.

As reflected in the table below, assisted living facilities have no compulsion to supply condition care and/or have condition care staff available to sustain your loved one. In addition, with no compulsion to supply such services, there is the inquire as to whether or not they owe a duty to warn or treat residents with illnesses or diseases that could be transmitted from other residents.

While a nursing home will have many nurses on staff and doctors hired to monitor the residents, assisted living is more analogous to an apartment construction or college dorm where laundry and food services are provided and residents are on their own for the rest of the day.

An assisted living factory is best mighty for someone:

Who is basically independent but may not be able or willing to get ready their own food or drive to doctors’ appointments; Someone who wants to scale back and anticipates needing aid with laundry, cooking, etc. In the near future. A couple where one spouse is independent but may need aid in feeding and or providing for needs of other spouse.
Continuing Care relinquishment Community

In Virginia you may also see advertisements for a relinquishment community. They are popping up all nearby our beloved College Towns and traveler destinations.

A persisting Care relinquishment society provides care depending on your current needs. Like an assurance policy, the resident pays an entry fee and periodic adjustable payments, which in turn gives the resident a package of residential and healthcare services that the Ccrc is obligated to supply at the time these residential and condition care services are required. For example, if upon entering, all you want is help with your meals, that is the only aid which will be provided. If you require arduous corporeal therapy or God forbid, daily aid for a Dementia patient, the Ccrc has assisted living services or nursing home services available under your contract. persisting care contracts are regulated by the Virginia Bureau of assurance of the Virginia State Corporation Commission.

Many Ccrcs can have nursing home services available whether on-site, or at licensed facilities off-site (12Vac5-360-10). While you may be entering the relinquishment society as a very salutary independent and capable resident, as your needs change, so will your compact with the society and in turn, the facility’s obligations to you.

A persisting Care relinquishment society factory is best mighty for someone:

Who is basically independent but anticipates the need for daily condition care for themselves or a spouse in the near future; Someone who is physically disabled and would be unable to care for themselves or a spouse if the disability grew worse. With at least three very distinct choices, it is very foremost to do your research:

To study assisted living facilities in Virginia, go to branch of communal Services website: http://www.dss.state.va.us/facility/search/alf.cgi.

To study nursing homes, go to Medicare’s website: http://www.medicare.gov

And Last But Not Least

It is always best to speak to a family member of a current resident and spend time getting to know the staff, no matter what type of factory you are looking into. If looking and researching is not enough, then reconsider the chart below – a comparison of the legal duties of a nursing home compared to the legal duties of an assisted living factory in Virginia.

Duty or Requirement

Nursing Home

Assisted Living

Duty to supply nursing care and or monitor resident’s health?

Yes

No

Doctor required to supervise residents?

Yes

No

Each resident shall be under the care of a physician licensed by the Virginia Board of Medicine?

Yes

No

Must have nurses on staff?

Yes

No

Must offer rehabilitative services?

Yes

No

Must have ongoing consultation from a registered dietitian or dietitian on staff?

Yes

No

24 Hour administration required?

Yes

Yes

Must construct a written plan upon admission of resident?

Yes

Yes

Staff must endure criminal background check?

Yes

Yes

Monitored by Virginia center for potential condition Care Services and consumer Protection

Yes

No

Monitored by branch of communal Services

No

Yes

*Life expectancy increased dramatically during the past century, from 47 years for Americans born in 1900 to 77 years for those born in 2001. These same factors—improved healing care and prevention efforts— that are partly responsible for the dramatic increases in life expectancy have also produced a major shift in the foremost causes of death in the United States in the past century, from infectious diseases and acute illnesses to persisting diseases and degenerative illnesses.” The State of Aging and condition in America 2004, published by the center for Disease Control, available at http://www.cdc.gov/aging/pdf/State_of_Aging_and_Health_in_America_2004.pdf.

**See generally, Virginia Code §32.1-123, as amended and Virginia executive Code § 12Vac5-360-10.

***It is a Felony under Virginia law to operate a nursing factory without a license. See generally, 12Vac5-371-30.

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