Below are 5 things to look out for when signing a Nursing Home Agreement.

1.Responsible Party Contract.By law, your parent is the only person responsible for any bills from a care facility. Some facilities, try to get an adult child and/ or another relative or friend to sign on as a “responsible party.”Look for this term and ask for it to be removed from the contract. Many facilities have a separate agreement that you would sign so make sure you do not sign it!

2.Government Aid. Most facilities do accept Medicare or Medicaid but the contract should explicitly state whether the facility takes either or both. It’s illegal for a facility that participates in these programs to force your parent to pay privately for a period of time before accepting her as a Medicare or Medicaid resident. Medicare has strict guidelines on who receives those benefits for a nursing home stay.

3.Deposits.Deposits can only be required of privately paying residents. Residents using Medicare or Medicaid can’t be required to pay a deposit.

4.Personal Property Inventory Checklist. The agreement should list what your parent or loved one is bringing into the facility. make sure you add everything! The nursing home will be cleaning their room and doing laundry. It’s better to be on the safe side.

5.Discharge Notification. Make sure the contract states how much notice your parent must give before leaving, and how long the facility will save her spot if she needs temporary hospitalization.

Below is the list of the worst states for nursing homes. This study was done last December by th federal government. The latest government statistics show that the 10 states below have the lowest percentages of five-star homes. Louisiana, ranked at the bottom with only nine five-star homes. The average proportion of five-star homes for all states is 11.9 percent.

State Total % With
5 Stars
1. Louisiana 284 3.2%
2. Georgia 357 6.2%
3. Oklahoma 311 7.1%
4. Tennessee 316 7.3%
5. West Virginia 130 7.7%
6. Kentucky 286 8.7%
7. Indiana 504 8.9%
8. Missouri 507 9.1%
9. Texas 1,113 9.3%
10. Ohio 948 9.9%
10. Utah 91 9.9%

Below is the list of the top states for nursing homes. This study was done last December by th federal government. They began giving nursing homes overall ratings from one star (lowest) to five stars (highest). The new U.S. News “America’s Best Nursing Homes” rankings take the data another step further. The government’s latest statistics show that the 10 states below have the largest percentages of five-star homes. Alaska is at the top, but it has a small number of homes; three fewer five-stars would have dropped the state off the list. The average for all states is 11.9 percent.

State Total % With
5 Stars
1. Alaska 15 33.3%
2. Hawaii 46 28.3%
3. Delaware 45 26.7%
4. New Hampshire 78 23.1%
5. Maine 109 19.3%
6. Connecticut 241 19.1%
7. Alabama 232 18.1%
8. Massachusetts 433 18.0%
9. Rhode Island 85 17.6%
10. Vermont 40 17.5%

According to U.S. News and World Report’s America’s Best Nursing Homes rankings alaska has the largest percentage of five-star rated facilities in the United States, while Louisiana has the lowest. The list expands on information from the Centers for Medicare & Medicaid Services’ Nursing Home Compare Web site, which houses the new “five-star” rating system.

The CMS five-star system rates nursing homes on three criteria: health inspection performance, nurse staffing levels, and quality performance and improvement measures. The U.S. News system creates a multi-tiered approach to deciphering the CMS model. Nursing home search results are grouped based on the number of CMS stars received in each of the three categories, and allow for combined searches. For example, users can search for a CMS five-star rated facility in a certain state or zip code, then refine the search to show only religious facilities or facilities with only Medicare residents, according to the magazine.

Facilities that receive five stars in all three CMS categories are placed on an honor roll. There are currently 27 facilities on the list and information is updated quarterly. You can view the full list at:http://health.usnews.com/sections/health/best-nursing-homes/index.html.

Medicare beneficiaries who require assistance with three or more activities of daily living account for up to one-quarter of all Medicare Part A and B spending. This despite the fact they constitute only 7% of the Medicare population, according to a new analysis.

These beneficiaries consume roughly $18,902 each—nearly 4.5 times as much as beneficiaries without disabilities, a new report from Avalere Health finds. Post-acute care services and some other Medicare services that transition beneficiaries from acute to long-term care settings may be soaking up Medicare funds, according to the report. Palliative and hospice care services, both covered by Medicare, experienced significant increases in length of stay between 2000 and 2005 for Alzheimer’s and dementia patients. This suggests that these services are filling a gap in long-term care for demanding beneficiaries.

Avalere Health conducted the study on behalf of The SCAN Foundation.

According to a new U.S. Census Bureau report, Nursing homes and residential care facilities continued to receive most of their funding from Medicaid in 2007. The entitlement program handed out $59 billion to them.

Medicaid provided at least $20 billion to continuing care retirement communities in 2007, which was up 10.1% from 2006. Homes for the elderly that do not have on-site nursing care facilities also saw a revenue increase of 7.1% up to $14.5 billion, according to the Census Bureau figures. Overall healthcare and social assistance revenue increased by 6.8% to $1.66 trillion in 2007.

While overall revenues were up, emergency relief services saw a 13.2% cut, dropping the amount of funding received to $6.9 billion. Figures were compiled from the results of the 2007 Service Annual Survey: Health Care and Social Assistance, which estimates revenues for healthcare providers and related businesses with paid employees.

Source: US Census Report

About 22 percent of the nation’s nearly 16,000 nursing homes received the federal government’s lowest rating in a new five-star system unveiled Thursday, while 12 percent received the highest ranking possible.

A home could obtain up to five stars based on criteria such as staffing and how well they fared in state inspections. The lowest ranking possible was one star. Such a simple rating for so complex a task as caring for the elderly has led to much anxiety in the nursing home industry.

Kerry Weems, acting administrator for the Centers for Medicare and Medicaid Services, said the agency was merely taking existing data already on the agency’s Web site and making it easier for patients and families to evaluate a nursing home. He said it can be difficult for people to understand all the aspects of an inspection.

“This should help consumers in narrowing their choices, but nothing should substitute for visiting a nursing home when making a decision,” Weems said.

Officials also see the new rating system as a way to challenge nursing homes to improve the care they provide to nearly 1.5 million patients nationwide.

“Transparency is key when it comes to nursing home quality,” said Sen. Herb Kohl, D-Wis.

Under the new system, five stars means a nursing home ranks “much above average,” four star indicates “above average,” three means “about average,” two is “below average” with a one indicating “much below average.” The rankings will be updated quarterly. The industry is already questioning their validity.

To nursing home operators, the five-star system is a great idea whose time has not yet come.

The system “is poorly planned, prematurely implemented and hamhandedly rolled out,” said Larry Minnix, president and chief executive officer of the American Association of Homes and Services for the Aging, an industry trade group.

The ratings are based on three major criteria: state inspections, staffing levels and quality measures, such as the percentage of residents with bed sores. The nursing homes will receive stars for each of those categories as well as for their overall quality.

Consumer groups like the concept, but agreed there are some potential problems with the data. For example, the staffing data is self-reported just before state surveys and is widely recognized as unreliable.

“From a consumer viewpoint, it’s not stringent enough,” said Alice H. Hedt, executive director of the National Citizens’ Coalition for Nursing Home Reform. “It’s basically taking information already available on Medicare’s Nursing Home Compare Web site and pulling it into an easier system for consumers to use, and that is a good thing.”

Hedt said consumers should consider the star ratings, but not solely rely on them when comparing facilities. Her organization also warned that nursing homes may appear in the ratings to give better care than they actually do.

“Our initial reaction is that consumers should probably avoid any facility with a one- or two-star rating and even a three-star rating unless people they trust convince them that the rating is inaccurate or unfair,” she said.

But, in Indiana, eight nonprofit nursing homes have reported getting one star for staffing even though they have some of the highest staffing levels in the state, said Jim Leich, president and chief executive officer of the Indiana Association of Homes for the Aging.

The Jennings Center for Older Adults in Garfield Heights, Ohio, got four stars for its nursing home, said Martha Kutik, the center’s president and CEO. Still, she’s worried that the rating system relies on surveys that measure cracks in the ceiling but not patient and family satisfaction.

“Any system that’s going to measure quality for consumers should keep satisfaction high on the list,” Kutik said.

Weems acknowledged that satisfaction levels are an important criteria.

“That’s something we would like to do in the future,” Weems said.

CMS used three year’s worth of inspections to rate nursing homes based on an annual survey designed to measure how well homes protect the health and safety of their residents. The measurement for staffing reports the number of hours of nursing and other staff dedicated per patient each day. The measurement for quality looks at 10 areas, including the percent of patients with bed sores after their first 90 days in the nursing home and the number of residents whose mobility worsened after admission.

States with the highest percentage of nursing homes with a one-star ranking were: Louisiana, 39.6 percent; Georgia, 32.4 percent; Virginia, 32.4 percent; and Tennessee, 30.9 percent.

States with the highest percentage of homes with five stars were: Delaware, 30.2 percent; Alaska, 26.7 percent; New Hampshire, 24.4 percent; and Hawaii, 23.9 percent.

Industry officials said surveys conducted in some states are stricter than others, so they cautioned against using the new ratings to conclude that one state’s nursing homes were better than another’s.

A new Medicaid regulation gives states “unprecedented flexibility” in configuring their Medicaid programs. Exempted from the rule are nursing home residents, Medicare beneficiaries and medically frail individuals who have freedom of choice in participating in coverage offerings.
The rule, which was issued by the Centers for Medicare & Medicaid Services Wednesday, allows states to place Medicaid beneficiaries in alternative benefit packages called “benchmark plans.” These plans are models states can use in designing their programs. They could carry benefits of a standard Blue Cross/Blue Shield provider plan under the Federal Employees Health Benefit Plan, or state employee coverage, as two examples.
The final rule incorporates some comments that the American Health Care Association made following the release of the proposed rule last February, according to Janice Zalen, senior director of special programs for the American Health Care Association. It states more explicitly that enrollment in a benchmark plan is optional for exempt individuals and they may opt out at any time, she said. AHCA was concerned that two states, which received approval to offer benchmark benefits, did not properly inform elderly people that inclusion was optional.

1. Daily Living Plan: Make sure the assisted living or senior living facility offers lots of activities that allow residents to be active. They should include great socializing events, exercise classes, educational seminars, religious services, and outings.
2. Medical Staff: Check to see who the resident geriatrician is and what credentials the nurses have. There should be an ambulance service and a quality hospital nearby with the patients’ medical charts. Also check to see that menus are approved by a nutritionist;
3. Talk to residents!!!!: Ask current residents for their opinion on the facility and services. You can get the best information for the residents! The will tell you the good and the bad of the place.
4. Room Accomidations and Facility Basics: Make sure the facility has showers with moveable showerheads, handrails, good lighting, emergency electricity generators, emergency help buttons and adequate personnel.

Approximately 3.8 million seniors reside in some type of aging services facility, according to the American Association of Homes and Services for the Aging. They live in roughly 17,000 nursing homes, 39,500 assisted-living facilities, 2,250 continuing care retirement communities, and other senior housing units.

The distressed housing market, and a deepening recession threaten a huge decline in the senior housing indusrty . Across the spectrum of senior housing; life-care communities, assisted living facilities, and nursing homes people at all levels of income are dealing with financial challenges.

Primary residences are the greatest source of wealth for most retirees, and the sale of those homes is the most common way to generate retirement-community entrance fees, which range from $100,000 at the low end, upwards of $500,000 and much more at the highest-end communities.

Income from pensions and investments is a major source of monthly maintenance payments across the spectrum of senior housing. Financial support from children and other family members often enables retirement home occupants to make ends meet.