Benjamin Franklin said it best - nothing in life is certain 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 resignation years.
Have you taken a road-trip lately? almost every highway is graced with large bill-boards providing the locations of new planned communities where couples can spend their resignation years dedicated to recreational pursuits. I doubt you will find a local newspaper that doesnt 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 gift distinct programs are being built and marketed over the state.
Nursing Homes
Is such a factory 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 positively mean. The differences however, are stunning and it is imperative to understand these differences when development choices for yourself or your loved ones.
Nursing Homes
In Virginia, a nursing home means any factory with the customary function of providing long-term nursing care, nursing services and health-related services on a persisting basis, for the medicine and sick person care of two or more non-related individuals**. Put simply, a nursing home is a factory designed for someone 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 about the medicine of residents and the supervision of resident care which are ready to residents and their families (12Vac5-360-20); (b) supply urgency medical services within 15 minutes, under general conditions (12Vac5-360-50); (c) be subject to unannounced on-site inspections of the nursing factory by State employees (12Vac5-371-60); (d) have a written business agreement with one or more physicians licensed by the Virginia Board of medicine to serve as medical director (12Vac5-371-230); and (e) each resident shall be under the care of a physician licensed by the Virginia Board of medicine (12Vac5-371-240).
In addition, residents of nursing homes are also given certain proprietary 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 factory 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 operate the daily operations of a nursing home, the greater the responsibility of the staff. These are the people who will be charged with the daily task of caring for your loved one, and development sure they are in compliancy with state and federal laws. No matter how nice and or intriguing the factory might be, the staff will make the distinction between your loved one being cared for and encouraged, or not.
A nursing home is best noteworthy for someone:
Who requires daily health care such as aid getting in and out of bed; taking medicine; or using the restroom. Who may have dementia or Alzheimers and as a result, is unable to eat and or bathe daily without reminder or assistance; Who is recovering from a fall or urgency and is therefore unable to walk, dress and or eat without aid
Assisted Living Facility
Assisted living facility means an adult care home which has been licensed by the Virginia branch of social Services to supply a level of assistance for adults who may have corporeal or mental impairments and require at least moderate aid with the activities of daily living. Within assisted living, there are two types: regular assisted living for those seniors (typically) who need aid with one or more daily activity; and laberious assisted living for someone who may be incapable of performing activities due to mental and/or severe corporeal 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 factory must: (a) supply or coordinate personal and health care services; and (b) supply 24-hour supervision.
As reflected in the table below, assisted living facilities have no obligation to supply health care and/or have health care staff ready to help your loved one. In addition, with no obligation to supply such services, there is the request as to either 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 construction 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 factory is best noteworthy 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 aid with laundry, cooking, etc. In the near future. A couple where one spouse is independent but may need aid in feeding and or providing for needs of other spouse.
Continuing Care resignation Community
In Virginia you may also see advertisements for a resignation community. They are popping up all nearby our favorite College Towns and traveler destinations.
A persisting Care resignation community provides care depending on your current needs. Like an assurance policy, the resident pays an entry fee and periodic adjustable payments, which in turn gives the resident a box of residential and healthcare services that the Ccrc is obligated to supply 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 assistance which will be provided. If you require laberious corporeal therapy or God forbid, daily aid for a Dementia patient, the Ccrc has assisted living services or nursing home services ready under your contract. persisting care contracts are regulated by the Virginia Bureau of assurance of the Virginia State Corporation Commission.
Many Ccrcs can have nursing home services ready either on-site, or at licensed facilities off-site (12Vac5-360-10). While you may be entering the resignation community as a very healthy independent and capable resident, as your needs change, so will your covenant with the community and in turn, the facilitys obligations to you.
A persisting Care resignation community factory is best noteworthy 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 distinct choices, it is very prominent to do your research:
To study assisted living facilities in Virginia, go to branch of social Services website: http://www.dss.state.va.us/facility/search/alf.cgi.
To study nursing homes, go to Medicares website: http://www.medicare.gov
And Last But Not Least
It is always best to speak to a house member of a current resident and spend time getting to know the staff, no matter what type of factory you are finding into. If finding 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 factory in Virginia.
Duty or Requirement
Nursing Home
Assisted Living
Duty to supply nursing care and or monitor residents health?
Yes
No
Doctor required to supervise residents?
Yes
No
Each resident shall be under the care of a physician 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 supervision required?
Yes
Yes
Must produce a written plan upon admission of resident?
Yes
Yes
Staff must experience criminal background check?
Yes
Yes
Monitored by Virginia center for potential health Care Services and consumer Protection
Yes
No
Monitored by branch of social Services
No
Yes
*Life expectancy increased dramatically while the past century, from 47 years for Americans born in 1900 to 77 years for those born in 2001. These same factorsimproved medical care and arresting efforts that are partly responsible for the dramatic increases in life expectancy have also produced a major shift in the prominent causes of death in the United States in the past century, from infectious diseases and acute illnesses to persisting 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 executive Code § 12Vac5-360-10.
***It is a Felony under Virginia law to operate a nursing factory without a license. See generally, 12Vac5-371-30.
Differences between Nursing Homes, Assisted Living & persisting Care resignation Communities
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