Selecting a long term care facility (i.e., nursing home) for an aging parent or relative can be a daunting task. In Illinois, there are facilities that specialize in assisted living (e.g., help with eating) while others focus on skilled nursing or health care (e.g., physical therapy). There are different long term care coverage plans under Medicare and Medicaid, with each plan requiring different qualifiers. Long term care facilities may also carry, or not carry, certain licenses and certificates.
The Illinois Department on Public Health, as well as the Illinois Department on Aging, offer valuable tools and advice on how to select a long term care facility in the state of Illinois. To begin with, consider the needs of the aging parent or relative. Does this person require basic assistance with paying bills, shopping, and so on? Alternately, is the person in the hospital with an injury and will he or she require 24-hour care and rehabilitation? Next, find out if this person has Medicare or Medicaid insurance coverage. Both of these insurance programs pay the bills for long term care facility residents, with Medicare covering the costs for residents over the age of 65, and Medicaid covering the costs for low-income residents.
Once this information is in hand, it is time to start making some phone calls. When calling nursing homes, be sure to find out if they are self-described as “intermediate care” or “skilled nursing” facilities. These terms are important because the Medicare and Medicaid programs cover each type of facility differently. An intermediate care facility provides basic assistance with personal care as well as some health and nursing services. Medicaid, but not Medicare, may cover the costs incurred at such a facility. A skilled nursing facility provides around-the-clock nursing care and is usually covered by Medicaid if the person’s physician recommends such care. Medicare may also cover the costs incurred at a skilled nursing facility, but only if the person was first hospitalized for at least three days and his or her physician recommended skilled nursing care. Upon release from the hospital, that person is covered by Medicare for up to 100 days, after which Medicaid coverage begins if the person still requires such care.
Certification and licensing should also be considered when selecting a nursing home or assisted living facility. The Illinois Department of Public Health inspects and certifies facilities that are covered under the Medicare and Medicaid programs. Two important documents include the long term care facility license and the nursing home administrator license. Make sure that the nursing home being considered has both such licenses. Additionally, it may be helpful to check the facility’s state survey (inspection) report and find out how it met the state standards for licensing.
Click on Skilled Nursing Facilities in Illinois for a listing of long term care facilities, assisted living, and nursing homes in the state of Illinois.