How Medicare Helps You Compare Nursing Homes
Choosing a nursing home for yourself or a loved one can be stressful. How do you know which ones are good? The Medicare Nursing Home Compare tool may shed light on the quality of nursing homes in your area.
The Medicare Nursing Home Compare tool: what is it?
Medicare.gov, the government-run website, lists details about every Medicare-certified and Medicaid-certified nursing home in the country. The Centers for Medicare & Medicaid Services (CMS) inspects nursing homes (in unannounced visits) to make sure they’re in compliance with Medicare and Medicaid standards.
The Medicare Nursing Home Compare tool tells you about such things as staffing levels, problems, and steps made to correct the problems. CMS rates each nursing home based on the information it gathers.
The Medicare Nursing Home Compare tool: what does it tell you?
You can use the Medicare Nursing Home Compare tool to find out information such as:
- Whether the nursing home participates in Medicare, Medicaid, or both. This may be important if you can’t afford a long-term stay in a nursing home. If you run out of money and have a low income, you might qualify for Medicaid to cover nursing home costs.
- Whether the nursing home is in a hospital
- Nursing home inspection results
- Per-resident staffing ratios, including registered nurses, licensed practical nurses, licensed vocational nurses, nurses’ aides, and physical therapists.
- Data about quality of resident care, such as whether residents are losing weight, getting flu shots, or experiencing pain. CMS gathers this information separately for short-term and long-term residents.
- Medication management
- How the nursing home protects residents from mental and physical abuse
- Fire safety inspections
This is not a complete list, but it gives you some idea of what the Medicare Nursing Home Compare tool can tell you about nursing homes.
The Medicare Nursing Home Compare tool: how to use it
When you visit Medicare.gov online to use the Medicare Nursing Home Compare tool, you simply type in your ZIP code or your city and state into the Location box and press Enter on your keyboard.
If you have the name of a nursing home that you’re researching, you can enter the name in a box below the Location box.
There’s a lot of other information on the Medicare Nursing Home Compare tool page on Medicare.gov. It’s worth a visit if you’re looking for a good nursing home.
Does Medicare cover nursing homes?
Medicare may cover care in skilled nursing facilities or nursing homes, but typically it’s temporary and limited coverage. Your doctor must decide it’s medically necessary for you to receive skilled nursing care. If you’re in a nursing home just for “custodial” care (such as help dressing or bathing), Medicare won’t cover your costs.
If you qualify for nursing home coverage, Medicare Part A usually:
- Covers your first 20 days at no cost
- Charges a daily coinsurance amount for days 21 through 100
- Doesn’t cover your costs for days 101 and beyond
The coverage above is for each “benefit period,” which begins the day you’re admitted to the skilled nursing facility and ends when you haven’t had skilled nursing care for 60 days in a row.
You might want to look into Medicare Supplement insurance, because some plans may cover your skilled nursing facility coinsurance for a limited time.
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