Admissions Process
Moving to a Licensed or Certified Nursing Home
Older Ohioans who wish to move to a Medicaid-certified nursing facility must get approval from a PASSPORT office before they can be admitted. The approval, often called a Pre-Admission Review, is a federal requirement to ensure that nursing home residents who need specialized mental health or MR/DD services are identified upon admission. Council on Aging of Southwestern Ohio is the PASSPORT office for Butler, Clermont, Clinton, Hamilton, and Warren Counties.
A social worker or registered nurse from Council on Aging can conduct the Pre-Admission Review. Contact Pre-Admission Review at Council on Aging of Southwestern Ohio at 513-345-8622.
Paying for Nursing Home Care
Medicare
While Medicare covers some skilled nursing care, it is not a long-term care program. Medicare covers up to 100 days of nursing home care, but only in limited situations. To qualify for this benefit, an individual must need daily skilled care (seven days a week of nursing care or five days a week of rehabilitative care). Moreover, the individual must have been hospitalized for at least three days and must be admitted to the nursing home within 30 days of discharge from the hospital. Medicare pays days 1 through 20 at 100%. For days 21 through 100, however, a co-payment is required for the individual.
Private Pay
Most people who enter nursing homes begin by paying for their care out of their own pocket. As their resources are depleted over a period of time, they may eventually become eligible for Medicaid. Some insurance companies will allow you to use your life insurance policy to pay for long-term care. Ask your insurance agency how this works.
Medicaid
A joint Federal and State program that pays for certain health services and nursing home care for older people with low incomes and limited assets. If you qualify, you may be able to get help to pay for nursing home care or other health care costs. If you qualify for both Medicare and Medicaid, most health care costs are covered. It is important to note that not all nursing homes accept Medicaid payments. Be sure to check with your nursing home of choice to ensure they accept Medicaid and to determine if they have a Medicaid bed available.
Long-Term Care Insurance
This type of private insurance policy can help pay for many types of long-term care, including both skilled and non-skilled care. Long-term care insurance can vary widely. If you have long-term care insurance, check your policy, or call the insurance company to find out if the care you need is covered. If you are shopping for long-term care insurance, find out which types of long-term care services and facilities the different policies cover. Also, check to see if your coverage could be limited because of a pre-existing condition.
Veterans Benefits
The Veterans Administration may provide assistance for nursing home expenses for some veterans. Assistance may also be available for children and surviving spouses of veterans. In order to receive these benefits, you must choose a nursing home that is under contract with the Veterans Administration.
Contact the local VA office for information:
Cincinnati VA Medical Center
513-861-3100
Information from Council on Aging Website: http://www.help4seniors.org
Admissions into Nursing Facility
The admissions process can often seem like an overwhelming task. At Lincoln Crawford, we look forward to providing you and your family with the support and information necessary to ease this transition. We hope to simplify the process by offering a wealth of information on a variety of topics, such as levels of care, hospital impatient days that allow Medicare to assist in covering you stay, how to apply for Medicaid and information regarding Respite Admissions, which allow a care-giver to take a rest from their care-giving role.
The Basic Process:
- Referral for admissions into Nursing Center
- Doctors Orders
- Assessment is done either in the hospital or at your home. If you are coming from the community, just give us a call.
- Ohio Department of Aging requires anyone entering into a nursing facility, regardless of their length of stay, to have either a Hospital Exemption or Pre-Admission Screening form completed. This is done by either a hospital Social Worker/Case Manager or a community Social Worker through Council on Aging. If you are coming from the Community, call Council on Aging at 721-1025 to request a long-term consultation.
- Verification of Insurance; see notes from Council on Aging for paying for your Nursing Home stay. At Lincoln Crawford we will assist you in verification and give you information on applying for Medicaid.
- Once review and accepted we will be able to receive you into Lincoln Crawford to help you with your short or long term care.
- Upon Admission, a full application packet will be completed with the resident, family, or Power of Attorney/Guardian.
- Call us today for Admissions or assistance at 513-821-2044.
