According to the National Center for Assisted Living (NCAL), there are 28,000 assisted living facilities in the United States, housing over one million residents. More than 15,500 skilled nursing facilities housing over 1.35 million residents.
In the past generation, there has been an increase in assisted living facilities and residents. Firstly, They admit a resident to an assisted living or skilled nursing facility. And they are evaluated to determine the type of services they will require.
Assisted Living Facilities VS Skilled Nursing Facilities and the level of care provided.
Assisted Living
Level One low level of care. Thereupon a resident can meet most of their own needs. And they are related to Activities of Daily Living (ADL’s). But it also includes bathing, grooming, getting in and out of bed, walking, climbing stairs, eating, and dressing.
2. Level Two intermediate or moderate. Because the resident may require assistance with bathing, grooming, getting in and out of bed, walking, climbing stairs, eating. and dressing. At level two, the resident may require a setup for some or all ADL’s. So includes them and making sure the resident has all the supplies needed to meet their needs.
3. Level Three high level of care. So this point, the resident usually requires extensive care with ADL’s. The care staff will give the resident a shower or bath. They will assist with picking out clothes, grooming, walking with a device (walker or cane). But the resident begins to decline, he or she will meet the criteria for skilled nursing care.
Skilled Nursing
In like manner, the Nursing Home Level of Care (NHLOC) determines if a person is eligible for nursing home Medicaid. Uniquely, the eligibility requirements vary from state to state. And the resident usually requires extensive assistance with ADL’s will be long-term care.
Suppose the resident does not meet the criteria. Then he or she could be referred to an assisted living or home with home health care.
Medicare short-term rehabilitation, residents have been hospitalized for a three-day qualifying stay in the hospital. It may require additional services. Although, before he or she is ready to go home. In most cases, Medicare will pay 100% for the first 20 days, 80% for 80 days with a co-payment.
The business office manager will explain the insurance details to the resident and/or the family. Short-term rehab entails physical, occupational, and speech therapy. Foremost, the short-term resident’s goal is to return home.
Assisted Living Facilities VS Skilled Nursing Facilities payor source
Most assisted living facilities are private pay. And the resident pays for services from his or her personal resources. In many cases, residents may have a long-term care insurance policy to pay full or partial benefits. As well as, if the resident is a veteran, he or she could have military benefits that can assist with his or her care. Assisted living care may cost around $4,000 a month.
Equally important, skilled nursing care will accept Medicaid if you meet the Medicare three-day qualifying stay, private pay, and self-pay insurance requirements. Skilled nursing private pay cost is around $8,000 a month. Although, this does not include a private room.
Assisted Living Facilities VS Skilled Nursing Facilities and the different types of environments
Assisted Living Facilities have private rooms with a full bath and sitting area. A formal dining hall where the residents have select menus. The staff gives the residents a menu the day before, and the residents choose what they would like for all three meals.
The select menu lists two types of meat, four vegetables, two starches, two desserts, two kinds of bread, soup of the day, and salad.
Residents have the right to eat in their room or go out to eat. Upon admission, the director should go over medical needs and dietary restrictions. Equally, the facility should have food likes and dislikes, dietary lifestyle, food allergies, and weight management goals.
Furthermore, the assisted living has a gym where the residents can work out independently, an activities room, and a beauty\barber shop. Typically, assisted living has a bus or van to transport residents to and from doctor’s appointments and shopping.
Skilled Nursing Facilities
Skilled Nursing Facilities have private rooms. But the resident is responsible for the extra cost. Most rooms have anywhere from two to four residents in a room with a half bath.
Additionally, they offer a bathhouse that has a few shower stalls and a whirlpool tub. Skilled Nursing Facilities have a bath schedule. Residents are taken to the bathhouse every other day and receive a bed bath when they are not on the schedule for the bathhouse. Before the resident’s dietary needs they discuss with the doctor, nursing, speech therapist, and dietary manager.
If the team decides as to what type of diet each resident requires. Another key point, if a resident requires a puree diet, no added salt, and has food allergies, they list this information on the dietary meal sheet. With this in mind, your dietary cook and aide check the meal sheet to ensure a resident does not receive the wrong diet.
Whenever the menu is posted outside the dining room, residents are offered an alternative if he or she does not like the meal for the day. For this reason, They encourage residents to eat in the dining room for added social interaction.
Altogether, the residents have a beauty\barber shop and an activity room. Activities are designed to meet the needs of the residents. Higher functioning residents may go out to eat or to the movies.
Medium-functioning residents may want to put puzzles together or watch an old movie.
Lower functioning residents require one on one which may consist of conversation. After they paint their nails. You can also incorporate a large event to include all residents, including singing, dances, and other activities.
Assisted Living Facilities VS Skilled Nursing Facilities and outside services
Assisted Living Facilities have contracts with hospice services that entail support for the family, comprehensive comfort, and attempts to cure the disease.
Respite care is used by a family who has a loved one living at home but can not be alone. Under the circumstances, if the family wants to go on vacation, they can send their loved one to an assisted living for respite care. The resident can stay a few days to a few weeks depending on insurance type or private pay.
Skilled Nursing Facilities have many choices when it comes to hiring Hospice services. In 2018, there were 4,639 hospice agencies, and this continues to grow, according to https://www.statista.com. Skilled nursing will also provide respite care. Families who are full-time care providers need a break. It is important for their social and mental wellbeing.
Assisted Living Facilities VS Skilled Nursing Facilities medication management
Assisted Living Facilities provides medication management. A care provider such as a resident attendant or certified nursing assistant has a cart with the patient’s medications. In any event, he or she will go to the resident’s room and assist them with their daily medications. Assisted living is only required to have one Registered Nurse on staff for eight hours. In the event if there is an issue with a resident’s medication, the nurse will contact his or her primary care provider.
Skilled Nursing Facilities are different; federal and state guidelines require a Licensed Practical Nurse or Registered Nurse to give medications to residents. Including all prescription and over-the-counter medications. This requires Skilled Nursing Facilities to meet a PPD. It includes all nursing staff in this number. It gives you the number of hours of care per resident per day.
Points often overlooked, within the number of nursing staff, you have Licensed Practical Nurses, Registered Nurses, Certified Nursing Assistants, Director of Health Services, Assistant Director of Health Services, Wound Care Coordinator, and Minimum Data Set Coordinator.
Skilled Nursing Facilities have a Medical Director who meets with the staff once a month and makes rounds to check on residents. If there is an issue with a resident, they can contact the Medical Director, making recommendations.
Assisted Living Facilities VS Skilled Nursing Facilities family involvement
Notably, in Assisted Living Facilities, the residents are independent and do not require one with family members. The residents make their own decisions, pay their bills, and handle other businesses. In the case the resident wants family involvement, it is completely up to them.
Meanwhile, in Skilled Nursing Facilities, most residents have family members who oversee their affairs. The facility may require the family to obtain a Durable Power of Attorney to make decisions, sign paperwork, and take care of bills.
Assisted Living Facilities VS Skilled Nursing Facilities pros and cons
Assisted Living Facilities pros
a. Lower cost than skilled nursing
b. No need to maintain a home or worry about yard work.
c. The staff and facility will adapt to the changing needs of the residents.
Assisted Living Facilities cons
It does not offer services for some medical conditions and moderate dementia.
In most cases, the cost is private pay and the will you all his or her resources such as savings, retirement, the sale of a home, and other property.
The amount of time you can be away from the facility may be restricted.
Skilled Nursing Facilities pros
1.24/7 care from highly trained staff.
2. Active social life, making friends, participating in different activities.
3. Schedules, structure, and stability.
Skilled Nursing Facilities cons
a. Expensive.
b. Inability to have the freedom they did at home.
c. Horror stories from one-star facilities.
Assisted Living Facilities VS Skilled Nursing Facilities reasons for moving into one
Assisted Living Facilities
Mismanagement of medication, if you forget to take your medication, or you get the medications confused.
Living alone, if you find yourself lonely and a decrease in social interaction.
If you find it more difficult to take care of your ADL’s
Meal preparation can be difficult when you get older; proper nutrition is important.
If you are prone to falls and lack of balance, this is a safety issue.
If you can no longer drive to appointments and do not have a family, Assisted Living can help with appointments.
Skilled Nursing Facilities
a. Peace of mind, you no longer need to worry about your needs being met.
b. Spiritual and social support. Through daily activities and spiritual or religious services, you gain social interaction.
c. You will receive three balanced and nutritional meals a day, plus snacks.
d. In-house speech, physical, and occupational therapy for those who qualify and a restorative program for others
Assisted Living Facilities VS Skilled Nursing Facilities housekeeping
In assisted living and skilled nursing facilities, housekeeping is a service that is included in the monthly cost. As we get older, it becomes more difficult to do household chores such as dusting, sweeping, and mopping. Daily housekeeping tasks can cause joint and muscle pain, making it more difficult for your loved one to maintain at home.
Firstly, Assisted Living Facilities and Skilled Nursing Facilities hire individuals who specifically work in housekeeping. The housekeeping team members ensure the facility as a whole has been cleaned and sanitized daily. Most facilities have a housekeeping checklist; seasoned housekeepers know the routine.
Without delay, a few things that are done daily include dusting, sweeping, mopping, vacuuming, cleaning the bathrooms, emptying the trash, and cleaning fixtures. Keeping the resident’s living space clean, odor-free, safe, and sanitary is important. Important to realize, a clean environment can cut down the number of air-borne illnesses.
In conclusion, you and your loved ones have options when they can no longer live alone. The first step would be to have him or her assessed to see if he or she meets the criteria for assisted living or skilled nursing. Once you know what type of placement he or she requires; Then you can start your research.
Next, visit the facilities, check for the cleanliness of the building and its parking area. At the same time, look at other residents. Are they clean, brush hair, do you smell foul odors?
Also, consider scheduling an appointment there for lunch. Hence, this will help determine the quality of meals. Generally speaking, facilities have a quality rating system between one and five stars, with five being the best. This information is available at all facilities, usually located at the main office.