Picking The Right Skilled Nursing Facility
By Andrea Gallagher, CSA
President of Senior Concerns
An individual typically takes one of two paths to a skilled nursing facility: straight from the hospital or from home when they become too frail or sick to care for themselves.
In the first case, when the stay is for temporary doctor-ordered rehabilitation, the patient rarely has a say about which facility they’re transferred to. Instead, the decision is based upon bed availability, which facilities have connections to the hospital and the patient’s insurance plan.
In the second case, patients, most often seniors, do have a choice—if they do their planning and research.
Begin by figuring out which skilled-nursing facilities are covered by your Medicare plan. My parents, for example, have a Medicare HMO plan. With most HMO plans, you can go only to doctors, healthcare providers or hospitals on the plan’s list, except in an emergency.
Since my father will soon be living at a skilled-nursing facility and may need medical care there in the future, it’s important that he’s able to use his Medicare coverage plan to pay for treatment.
My parents live in New Hampshire, very close to the Massachusetts border. In their specific case, their HMO plan covers no nursing facilities in New Hampshire and only three or four in Massachusetts that are less than an hour’s drive from my parents’ home.
So the facilities covered by your insurance are your first consideration, even if you plan to pay for room and board out of pocket.
On the site, SNFs are rated on a five-star scale. Individual scores are also provided for health inspection, staffing and quality measures.
According to this tool, there are four skilled-nursing facilities in Thousand Oaks and a total of 331 beds: Mary Health of the Sick Convalescent and Nursing Homes in Newbury Park, Oakview Skilled Nursing (part of University Village) in Thousand Oaks, Thousand Oaks Healthcare Center and Windsor Terrace of Westlake Village.
Two of them—Mary Health of the Sick and Oakview—have a five-star overall rating. All four are rated four or five stars on quality and staffing measures, but Thousand Oaks Healthcare and Windsor Terrace received one star on health inspection.
The site allows you to look at the number of complaints for each facility as well as outcomes for short-stay and long-stay residents.
With insurance coverage and ratings in hand, the next step is a tour. The Medicare website has an excellent checklist to use when you go. It can be found at: www.medicare.gov/files/skillednursingfacilitychecklist.pdf.
It’s important to note that old views about nursing facilities as inhospitable and dreary are changing. Over the past several years SNFs have advanced in terms of residents’ rights, quality improvements and the overall approach to the needs and wants of residents and patients.
Many such facilities have a resident council that you may ask to visit to learn more about life in the facility.
Armed with the facts, smart seniors and their families can determine which facility is right for them.
Andrea Gallagher, CSA, is president of Senior Concerns, a nonprofit agency serving Ventura and western Los Angeles counties. For more information, visit www.seniorconcerns.org, and for comments or questions, email firstname.lastname@example.org.