Skilled Nursing Facilities Definition

Skilled nursing facilities are establishments for the elderly or disabled who needs tender loving care. They provide a home for the elderly when they need around the clock care by skilled nurses. The skilled nursing facilities also provide therapy and rehabilitation for the disabled. This helps the elderly and disabled live more comfortable lives. Skilled nursing facilities provide twenty-four hour, seven days a week expert care for those in need of constant care. This type of facility is for those who need short or long term care. These facilities offer help for a loved one when they have a temporary or permanent health issue, and they are not able to get the kind of care they need at home. A skilled nursing facility is good for the very sick, or for those who need to recover from a serious accident or surgery. They may need specialized therapy that they could get in this type of facility. The skilled nursing facilities will give them medical treatment that their doctor prescribes, as well as help them with their physical needs like taking a bath, eating, and even walking. This facility is a home away from home, where you get expert nursing care.

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Skilled Care Definition

Skilled care is a type of intermediate care in which the patient or resident needs more assistance than usual, generally from licensed nursing personnel and certified nursing assistants. This care is not the same as long-term care in which a resident may not need the services of a licensed nurse on a daily basis. The resident/patient does need longer-term care than what the acute care hospital services can provide. Reasons may include long-term IV therapy, IV line access and care, chemotherapy, physical therapy, long-term wound care rehabilitation, respiratory treatments, nutritional therapy with feeding tubes, and continuous positive motion machines to exercise limbs in which prosthetic joints have been inserted. According to Medicare, there are a certain number of allowable “skilled care” days in each billing year that are covered. Skilled care can be offered in a wide variety of facilities, such as a “skilled” unit in an acute care hospital, a LTAC (Long-Term Acute Care) rehab unit or hospital, and sometimes at the patient’s own home provided for by Home Health nursing staff. The term refers to the level of care a patient needs and not the facility in which it is provided, acute care being the highest level, skilled care at the intermediate level and chronic care or long-term care being the lowest level of care.

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Progressive Neurological Condition Definition

Progressive neurological disorders are conditions that get worse as time goes on. These types of illnesses usually impact the person for their entire life. Types of diseases include Parkinson’s disease, multiply sclerosis, and motor neuron disease. In geriatrics the most common form of a progressive disease is Alzheimer’s. The main culprits for degenerating disease can be defective brain cells. The conditions can sometimes be genetic. The use of illegal substances and alcohol can also damage brain cells, as well as toxic or chemical environments. Once brain cells have been damaged they cannot be repaired.

When the need for assisted living is necessary there are many facilities well trained in providing care for those suffering from progressive neurological disorders. Since damaged brain cells are permanent an experienced facility will concentrate on creating a comfortable environment for the patient. Treating the patients conditions are done best by helping to relieve and reduce the severity of symptoms.

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Palliative Care Definition

Palliative care is a special type of care offered to patients who are at the end of their lives. The most common type of palliative care is Hospice. Hospice care takes place in a person’s home rather than in the hospital.

Hospice does not focus on treating the medical problem an individual suffers from. Instead, palliative care is given. This means that the hospice nurse is there to lend support to the patient and family and to manage the pain and other symptoms that are affecting the patient. The goal of the hospice nurse is to make the patient as comfortable as possible during their last days of life. There are many other professions involved with hospice to provide patients with the best care and concern at the end of their lives.

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Program of All Inclusive Care for the Elderly (PACE) Definition

Program of All Inclusive Care for the Elderly or PACE is a therapeutic program which offers individual support to people enrolled with the idea of enabling them to live independently in their communities. The requirements for PACE are simple, a person of ages fifty-five or older, is located within an area supported by the program, meet the state’s nursing facility level care after a screening and be able to live safely in a community. The service offers transportation to the care center three times a week where individuals meet with doctors, nurses and other health care professionals to help with their needs.

If medication is suggested by a health care professional the cost is covered under the PACE program. Payment for the program is monthly per person and remains the same price throughout the entirety of the contract year. As well as monthly payment, a premium may be required, which is dependent on qualification for Medicaid and Medicare.

The overall goal of the program is to enable elderly individuals to remain living within their community for the longest time possible without being brought into assisted living homes. The program is open ended and those enrolled in it may leave at any time and resume their prior Medicaid or Medicare program.

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Medicare Supplemental Insurance Definition

Medicare supplemental insurance is a government-funded insurance program designed for people 65 years and older or for people who are disabled. Also called medigap there are five parts to this insurance: basic, part A, part B, part C and part D. Basic Medicare insurance covers the basics, so there are some things the insurance will not cover. It will not cover any kind of in-home, assisting or nursing home care nor will it cover certain illnesses. It will cover some prescription medication but it will not cover all of it. Part A covers hospital care. It pays for a semi-private room, food, tests and doctors’ fees too. This may or may not cost anything. To get the other three will cost extra. They require paying for deductibles, enrollment fees every month and co-insurance payments. Plan B covers outpatient care. It covers doctors and therapy including purchasing canes, walkers, scooters, wheelchairs, and limbs. Plan C covers HMO, PPO and other organization related to it. Plan D covers prescription drugs. Depending on the insurance plan picking any one of these four will have the person covered pay the deductible and Medicare paying the rest OR Medicare will pay for all of it.

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Medicare Savings Program Definition

A Medicare savings program is a special program offered through Medicaid to help pay for a patient’s Medicare premiums. These programs are typically based on income levels and help to cover both medical costs and prescription drugs. Medicare savings programs will typically cover part B Medicare premiums and also helps with other out-of-pocket expenses. There are four types of Medicare savings programs that one might qualify for. These are Qualified Medicare Beneficiary or QMB, Specified Low-Income Medicare Beneficiary, or SLMB, Qualified Individual, or QI and Qualified Disabled and Working Individual, or QDWI. In order to qualify for any of these Medicare savings programs, the patient must meet certain income and asset requirements. These requirements will determine which of the four types of programs the patient will be eligible for.

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Medicaid Spend Down Definition

Medicaid spend down is a type of deductible. When you receive Medicaid coverage, your income and other assets will be evaluated to determine the amount of coverage you will be qualified for. In some cases, you will be assigned a spend down amount. This means simply that you will need to pay this amount of money out of pocket before you will have Medicaid coverage for your prescriptions and other medical care. This is not a yearly amount that must be met, but a monthly payment. Many people think in terms of the typical insurance coverage that carries a yearly family deductible or personal deductible that, once met, does not need to be reached again until the following year. However, with Medicaid, the spend down amount, or deductible amount, must be met every month before the coverage is available.

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Medicaid Gap Definition

The Medicaid gap is for Medicare health insurance consumers who need extra health insurance than what’s usually covered under traditional Medicaid. Medicare is affordable health insurance for the deaf, elderly, and disabled. The amount of elderly people needing Medicare is growing by the day, so Medicaid gap health insurance is becoming a bigger and bigger reality for a lot of elderly consumers. The Medicaid gap particularly covers some of the costs that Medicare doesn’t cover. Elderly consumers have to have Medicare health insurance to be approved for Medicaid gap health insurance.

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Medicare Defnition

Medicare is a governmental health program meant to ensure that a certain social group can never be denied affordable health care. The program is offered in Canada, Australia, and the United States. In the United States, Medicare benefits are extended to those citizens having reached or exceeded the age of 65. Other candidates include those under 65 who are permanently disabled with a physical detriment or a debilitating congenital disability. In general, the plan works by paying for 80% of the Medicare approved cost of any given health care cost, often including tests, office visits and certain prescription drugs. The remaining 20% is then paid either out of pocket by the Medicare patient or by a supplemental insurance plan obtained and paid for by the patient.

Medicare was established in the United States in 1965. Before that time just 51% of citizens over age 65 had medical benefits and more than 30% of that group lived at or below the poverty level.

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