When a home-health patient, hospice patient or an individual at home has experienced an illness or decline in condition, but an acute-care hospital stay is not required, a QLS Skilled Nursing Facility may be the right choice. We can provide a seamless transition in care and avoid unnecessary hospital readmissions and emergency room visits.
There are times when a loved one may not be up and about the way they used to be, or recent hospital stays have left them weak and unable to thrive at home. The goal of our Direct Admit program is to keep your loved one out of the hospital. Allow them to come directly to us for rehabilitation and clinical assistance to get them back home safely.
What is required for Direct Admit?
We will need to review your loved one's most up-to-date clinical information. This includes a History and Physical, as well as a Medication List. For seniors living at home, a primary care physician’s office is the best place to locate this information. If the senior receives home health services, their notes will help, too. Many times we can reach out to the physician directly for up to date information. This clinical information is what rehab facilities will use to determine if the patient meets the qualifications for skilled nursing care or long-term care. The patient’s insurance will also play a role.
Is Direct Admit covered by insurance like a regular hospital stay?
Medicare requires a 3-night inpatient stay in a hospital before admission. If the senior was recently hospitalized, they may be able to use their Medicare benefit. Managed care insurance companies typically require therapy notes before they are able to approve a patient’s admission to a skilled nursing center. Like Medicare, they will only pay if skilled care is necessary. They don’t cover long-term care expenses. Medicaid may cover this type of admission, but we would have our experts review the information for you on a case to case basis. Long-term care insurance may also help cover room and board for an older adult. Each policy is different though. We can help review a senior’s policy to see if theirs will cover long-term care.
If the senior doesn’t have any type of insurance that will cover their skilled nursing or rehab care, they will need to pay out of private resources. In this situation, a deposit check is typically required upon admission. We know this can all be tough to navigate.
If you have any questions, please
feel free
to
contact us.
We can help you walk through the process!
Don’t Stop Dreamin’ has been fulfilling dreams for residents and patients of Quality Life Services and Three Rivers Hospice since 2005. The mission of Don’t Stop Dreamin’ is to: