Benjamin Franklin said it best - “nothing in life is unavoidable except death and taxes” but with daily advancements in science, technology and health care, Americans are living longer than ever before*. This blessing however, has created a unique dilemma for contemporary American families: How to plan for and put in order for one's withdrawal years.
Have you taken a road-trip lately? approximately every highway is graced with large bill-boards providing the locations of new planned communities where couples can spend their withdrawal years dedicated to recreational pursuits. I doubt you will find a local newspaper that doesn’t have at least one ad promoting the amenities found at a local assisted living facility. Try to quest for “nursing homes in Virginia” on the Internet and thousands of web pages will appear. Each and every day new facilities contribution different programs are being built and marketed across the state.
Nursing Homes
Is such a premise right for you and your family? If so, which facility? We often hear the terms “retirement community,” “nursing home,” and “assisted living facility” but rarely consider what these terms nothing else but mean. The differences however, are astonishing and it is imperative to understand these differences when making choices for yourself or your loved ones.
Nursing Homes
In Virginia, a nursing home means any premise with the traditional function of providing long-term nursing care, nursing services and health-related services on a chronic basis, for the rehabilitation and sick person care of two or more non-related individuals**. Put simply, a nursing home is a premise designed for man who needs less care than a hospital, but requires daily health care assistance.
The Virginia branch of health licenses such facilities and has established guidelines regulating varied aspects of their operations, programs, and staffing needs, etc***. For example, a nursing home must: (a) have written policies and procedures with regard to the rehabilitation of residents and the management of resident care which are ready to residents and their families (12Vac5-360-20); (b) contribute emergency healing services within 15 minutes, under general conditions (12Vac5-360-50); (c) be subject to unannounced on-site inspections of the nursing premise by State employees (12Vac5-371-60); (d) have a written business agreement with one or more physicians licensed by the Virginia Board of rehabilitation to serve as healing director (12Vac5-371-230); and (e) each resident shall be under the care of a doctor licensed by the Virginia Board of rehabilitation (12Vac5-371-240).
In addition, residents of nursing homes are also given unavoidable possession as defined by Virginia Code §32.1-138. See http://leg1.state.va.us/cgi-bin/legp504.exe?000+cod+32.1-138. Nursing homes are the most regulated and structured residential options for our Seniors requiring some level of daily health care. If the premise provides care through Medicare and Medicaid programs, it is deemed a "Certified nursing facility" (Virginia Code §32.1-123; Virginia Code §32.1-127) and must be in compliancy with both federal and state laws.
Of course, the more rules and regulations that define and control the daily operations of a nursing home, the greater the accountability of the staff. These are the population who will be expensed with the daily task of caring for your loved one, and making sure they are in compliancy with state and federal laws. No matter how nice and or enthralling the premise might be, the staff will make the divergence in the middle of your loved one being cared for and encouraged, or not.
A nursing home is best excellent for someone:
Who requires daily health care – such as assistance getting in and out of bed; taking medicine; or using the restroom. Who may have dementia or Alzheimer’s and as a result, is unable to eat and or bathe daily without reminder or assistance; Who is recovering from a fall or emergency and is therefore unable to walk, dress and or eat without assistance
Assisted Living Facility
“Assisted living facility” means an adult care home which has been licensed by the Virginia branch of social Services to contribute a level of aid for adults who may have bodily or thinking impairments and require at least moderate assistance with the activities of daily living. Within assisted living, there are two types: regular assisted living for those seniors (typically) who need assistance with one or more daily activity; and oppressive assisted living for man who may be incapable of performing activities due to thinking and/or severe bodily impairment (12Vac30-120-450).
The Virginia branch of social Services licenses assisted living facilities but does not regulate in the way the branch of health regulates nursing homes. While there are Virginia guidelines regulating aspects of assisted living facilities, they are limited: An assisted living premise must: (a) contribute or coordinate personal and health care services; and (b) contribute 24-hour supervision.
As reflected in the table below, assisted living facilities have no compulsion to contribute health care and/or have health care staff ready to support your loved one. In addition, with no compulsion to contribute such services, there is the examine as to whether or not they owe a duty to warn or treat residents with illnesses or diseases that could be transmitted from other residents.
While a nursing home will have many nurses on staff and doctors hired to monitor the residents, assisted living is more analogous to an apartment building or college dorm where laundry and food services are in case,granted and residents are on their own for the rest of the day.
An assisted living premise is best excellent for someone:
Who is basically independent but may not be able or willing to put in order their own food or drive to doctors’ appointments; Someone who wants to scale back and anticipates needing assistance with laundry, cooking, etc. In the near future. A merge where one spouse is independent but may need assistance in feeding and or providing for needs of other spouse.
Continuing Care withdrawal Community
In Virginia you may also see advertisements for a withdrawal community. They are popping up all around our popular College Towns and traveler destinations.
A chronic Care withdrawal community provides care depending on your current needs. Like an guarnatee policy, the resident pays an entry fee and periodic adjustable payments, which in turn gives the resident a package of residential and healthcare services that the Ccrc is obligated to contribute at the time these residential and health care services are required. For example, if upon entering, all you want is help with your meals, that is the only aid which will be provided. If you require oppressive bodily therapy or God forbid, daily assistance for a Dementia patient, the Ccrc has assisted living services or nursing home services ready under your contract. chronic care contracts are regulated by the Virginia Bureau of guarnatee of the Virginia State Corporation Commission.
Many Ccrcs can have nursing home services ready whether on-site, or at licensed facilities off-site (12Vac5-360-10). While you may be entering the withdrawal community as a very healthy independent and capable resident, as your needs change, so will your contract with the community and in turn, the facility’s obligations to you.
A chronic Care withdrawal community premise is best excellent for someone:
Who is basically independent but anticipates the need for daily health care for themselves or a spouse in the near future; Someone who is physically disabled and would be unable to care for themselves or a spouse if the disability grew worse. With at least three very different choices, it is very foremost to do your research:
To explore assisted living facilities in Virginia, go to branch of social Services website: http://www.dss.state.va.us/facility/search/alf.cgi.
To explore nursing homes, go to Medicare’s website: http://www.medicare.gov
And Last But Not Least
It is all the time best to speak to a house member of a current resident and spend time getting to know the staff, no matter what type of premise you are seeing into. If seeing and researching is not enough, then consider the chart below – a comparison of the legal duties of a nursing home compared to the legal duties of an assisted living premise in Virginia.
Duty or Requirement
Nursing Home
Assisted Living
Duty to contribute nursing care and or monitor resident’s health?
Yes
No
Doctor required to supervise residents?
Yes
No
Each resident shall be under the care of a doctor licensed by the Virginia Board of Medicine?
Yes
No
Must have nurses on staff?
Yes
No
Must offer rehabilitative services?
Yes
No
Must have ongoing consultation from a registered dietitian or dietitian on staff?
Yes
No
24 Hour management required?
Yes
Yes
Must institute a written plan upon admission of resident?
Yes
Yes
Staff must feel criminal background check?
Yes
Yes
Monitored by Virginia center for quality health Care Services and consumer Protection
Yes
No
Monitored by branch of social Services
No
Yes
*Life expectancy increased dramatically during the past century, from 47 years for Americans born in 1900 to 77 years for those born in 2001. These same factors—improved healing care and stoppage efforts— that are partly responsible for the dramatic increases in life expectancy have also produced a major shift in the foremost causes of death in the United States in the past century, from infectious diseases and acute illnesses to chronic diseases and degenerative illnesses.” The State of Aging and health in America 2004, published by the center for Disease Control, ready at http://www.cdc.gov/aging/pdf/State_of_Aging_and_Health_in_America_2004.pdf.
**See generally, Virginia Code §32.1-123, as amended and Virginia menagerial Code § 12Vac5-360-10.
***It is a Felony under Virginia law to control a nursing premise without a license. See generally, 12Vac5-371-30.
Differences in the middle of Nursing Homes, Assisted Living & lasting Care withdrawal Communities