LifeQuest

267-371-1600 Admissions

FAQs

nursing-careWhat is Traditional Nursing Care?
Traditional nursing care is care delivered by skilled professionals that offers individually specialized services for residents with varying health conditions including cancer, stroke, cardiovascular disease, pulmonary disease or other medical conditions. Traditional nursing care satisfies our residents’ physical, emotional and psychological needs.

What questions should I ask at a skilled nursing facility?
The Medicare website offers resources to assist in the decision making process of finding the right skilled nursing facility for individual’s needs. The Pennsylvania Department of Health website also offers a checklist of items to ask when researching facilities.

What is the five star quality rating system for skilled nursing homes?
The rating system was developed to help individuals and their families compare skilled nursing facilities. Facilities are provided a rating for health inspections, staffing and quality measures. Those three ratings are combined to provide the overall rating for the facility.

What is a department of health survey?
Department of Health representatives review skilled nursing facilities at least yearly to determine if the care provided is quality care, which meets the requirements necessary to receive Medicare or Medicaid payments. The survey is not announced and will last several days. The review includes facility tours, general nursing care, medical record review, resident and family interviews, staff to resident ratios, housekeeping, food service, nutrition, social services and general facility operations. A report is provided upon completion of the review and any items that require improvement must be completed within the specified time period.

How do skilled nursing facilities handle doctor visits for residents?
Individuals must be seen by a physician within a few days of admission to the facility and again every 30 days for the first 90 days in the facility. After 90 days, individuals must be seen by a physician at least every 60 days. Physician visits can be scheduled as necessary for individual medical needs.

Who decides when residents are discharged to home?
Generally, discharge decisions are made jointly by the physician and the individual, along with his/her family members. Social workers will discuss the discharge plans and will assist the individual in preparing for home, a transfer to a lower level of care or transfer to long-term care. The final decision is ultimately made by the individual or their family member(s) in the event that the individual is unable to make decisions due to a medical condition.

Does LifeQuest Nursing Center have a separate Rehabilitation Unit?
Our Rehabilitation Unit is separate and has a separate entrance, which allows easy access for visitors.

Are there private rooms?
Our traditional nursing unit offers 25 private rooms.

Who pays the bill for nursing home care?
The average nursing home stay is paid as follows:

  • Medicaid – 64%
  • Medicare – 11%
  • Private Insurance (HMO) or private funds – 25%

Does Medicare pay for nursing home care?
Medicare does not pay for long-term nursing care. Medicare pays for an average of 3 to 4 weeks of care.

In order for Medicare to pay for an individual’s skilled nursing care, the individual must need the skilled service(s) and must have had a hospital stay of at least 3 days that requires additional skilled services according to their physician. Medicare coverage is discontinued when the individual no longer requires the skilled service(s), returns to the same level of health prior to the illness or injury that required the skilled service(s) or no longer shows improvement as a result of the skilled service(s).

What is the difference between Medicare and Medicaid?
Medicare is a federally administered program that guarantees health insurance for individuals aged 65 years of age or older. Medicare (Part A) will cover a maximum of 100 days (per ailment) in a skilled nursing facility. The first 20 days are fully covered by Medicare, however, the remaining 80 days require a co-payment.

Medicaid is a state and federally funded program for adults that need medical care, however, have limited income or funds to pay for it. There are medical and financial qualifications that must be met by the individual in order to receive coverage. Medicaid will only pay for skilled nursing services provided in a facility certified by the government to service Medicaid recipients. While there is no limit to the length of stay that Medicaid will cover, not all nursing homes accept Medicaid.

Does LifeQuest accept Medicaid?
Yes.

What if I have an HMO or Managed Care Insurance?
HMOs and Managed Care companies are private insurance companies and each insurance company has individual coverage terms that specifies types of services covered and length of coverage. HMOs do not pay for long-term care.

What is co-insurance and who pays it?
Co-insurance costs are paid privately by the individual toward the cost of their care. Medicare and most HMOs have co-insurance. For Medicare, the co-insurance begins on the 21st day of the individual’s stay. HMO policies differ and co-insurance fees terms vary depending on coverage. It is important for individuals to verify coverage at the time of admission to the nursing home.

What is Medicare Supplemental insurance?
Medicare supplemental insurance is a private insurance that helps pay for gaps in the Medicare coverage including deductibles and co-insurance. Most plans will help pay for skilled nursing care when that care is covered by Medicare.

How do I qualify for admission?
Medical and financial eligibility requirements must be met prior to admission. Medical eligibility is determined by a physician and financial eligibility is determined by establishing adequate personal resources and/or eligible insurance coverage. We would be happy to assist you in seeking these determinations.

What happens if you run out of resources?
If you outlive your resources, we will assist you in obtaining Medical Assistance benefits.

When are visitors allowed?
We do not restrict visiting hours. However, we ask that you kindly respect the privacy and rights of others and limit your visitation to generally accepted hours.