Long Term Care Guide

Making decisions about the care of a loved one is often difficult. Fortunately, a broad range of services are available to older or disabled persons and their caregivers in Virginia. It is your responsibility to find the appropriate service and level of care. Checklists provided for your use at the end of each section. Comparison shopping and personal visits to long-term care facilities are highly recommended as well as calling your Local Long-Term Care Ombudsman for general complaint information. Consumers are encouraged to examine facility licensing information, which is available from the facility upon request.

NURSING HOMES

A nursing home provides nursing services on a continuous basis to persons who do not need the degree of care provided by a hospital. People who enter nursing homes require a standard of care that usually cannot be provided in the home, in the community, or in an adult care residence. The Virginia Department of Health licenses all nursing homes in Virginia. Generally, there are two levels of nursing home care: Intermediate and Skilled. Intermediate care provides assistance with eating, bathing, dressing, changing dressings, etc. Payment for intermediate nursing home care can be from private funds and Medicaid. Skilled care facilities must have a registered nurse on duty. Skilled care includes rehabilitation services and medical services that must be performed by a registered nurse. Medicare (under special circumstances and for a brief period of time), Medicaid, and private funds pay for skilled care.

Prior to nursing home admission, a community-based pre-screening team from the local health department and department of social services, which determines financial, medical, and functional eligibility, assesses persons for nursing home placement based on the Uniform Assessment Instrument (UAI). If an individual is discharged from a hospital to a nursing home, the hospital discharge planner performs the pre-screening assessment for nursing home placement. Persons who will be private pay for six months or longer do not need to be pre-screened.

ASSISTED LIVING FACILITIES

Licensed Assisted Living Facilities (ALFs) provide care for four or more persons who are mentally or physically disabled or older adults. ALFs provide room, board, supervision, and assistance with activities of daily living and instrumental activities of daily living. Licensed by the Virginia Department of Social Services, ALFs provide two levels of care: Residential and Assisted Living. Persons eligible for Residential Living require minimal assistance with daily activities while persons eligible for Assisted Living require more comprehensive services provided by ALFs. Medicaid, Medicare, and most insurances do not pay for the care received in ALFs. Payment comes from personal funds, pensions, Social Security, and for low income individuals, Auxiliary Grants from local social service departments.

Prior to admission to an ALF, an individual who needs public funding assistance is screened by a qualified assessor. Persons who are private pay are pre-screened by the facility. For questions regarding levels of care, contact the facility or the Piedmont Region Licensing Department.

HOME HEALTH CARE

Home health care refers to either health or support services provided to older and disabled persons while they live at home. Home health services are skilled nursing services ordered by a physician and supervised by a licensed nurse. Home support provides custodial care and includes personal care (bathing, dressing, etc.), and homemaking (changing bed linen, meal preparation, etc.). In Virginia the state Health Department certifies home health agencies that provide skilled services which are eligible for payment by Medicare and/or Medicaid. Home care providers in Virginia are not licensed; however, many are either accredited and/or bonded. Accredited agencies have met minimum standards developed by non-profit organizations.

HOSPICE

ADULT DAY CARE

If you have any questions please call:

LOA Ombudsman Program,

540/345-0451.

Inclusion of an agency does not imply endorsement by LOA Area Agency on Aging; exclusion of an agency does not indicate disapproval. Facilities and agencies included are those that were in operation as of August 2007.