Benjamin Franklin said it best - “nothing in life is clear 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 modern American families: How to plan for and prepare 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 crusade for “nursing homes in Virginia” on the Internet and thousands of web pages will appear. Each and every day new facilities contribution separate programs are being built and marketed over the state.
Nursing Home
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 verily mean. The differences however, are striking and it is imperative to understand these differences when production choices for yourself or your loved ones.
Nursing Homes
In Virginia, a nursing home means any factory with the former function of providing long-term nursing care, nursing services and health-related services on a continuing basis, for the rehabilitation and sick person care of two or more non-related individuals**. Put simply, a nursing home is a factory designed for man who needs less care than a hospital, but requires daily health care assistance.
The Virginia division of health licenses such facilities and has established guidelines regulating discrete aspects of their operations, programs, and staffing needs, etc***. For example, a nursing home must: (a) have written policies and procedures concerning the rehabilitation of residents and the supervision of resident care which are available to residents and their families (12Vac5-360-20); (b) furnish crisis medical services within 15 minutes, under normal conditions (12Vac5-360-50); (c) be branch to unannounced on-site inspections of the nursing factory by State employees (12Vac5-371-60); (d) have a written agreement with one or more physicians licensed by the Virginia Board of rehabilitation to serve as medical 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 clear 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 compliance 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 responsibility of the staff. These are the citizen who will be charged with the daily task of caring for your loved one, and production sure they are in compliance with state and federal laws. No matter how nice and or appealing the factory might be, the staff will make the dissimilarity 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 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 crisis and is therefore unable to walk, dress and or eat without assistance
Assisted Living Facility
“Assisted living facility” means an adult care house which has been licensed by the Virginia division of group Services to furnish a level of assistance for adults who may have corporeal or reasoning impairments and wish 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 arduous assisted living for man who may be incapable of performing activities due to reasoning and/or severe corporeal impairment (12Vac30-120-450).
The Virginia division of group Services licenses assisted living facilities but does not regulate in the way the division 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) furnish or coordinate personal and health care services; and (b) furnish 24-hour supervision.
As reflected in the table below, assisted living facilities have no enforcement to furnish health care and/or have health care staff available to aid your loved one. In addition, with no enforcement to furnish such services, there is the request 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 construction or college dorm where laundry and food services are provided 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 prepare 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 concentrate 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 continuing Care withdrawal 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 container of residential and healthcare services that the Ccrc is obligated to furnish 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 wish arduous corporeal therapy or God forbid, daily assistance for a Dementia patient, the Ccrc has assisted living services or nursing home services available under your contract. continuing care contracts are regulated by the Virginia Bureau of assurance of the Virginia State Corporation Commission.
Many Ccrcs can have nursing home services available whether on-site, or at licensed facilities off-site (12Vac5-360-10). While you may be entering the withdrawal community as a very wholesome independent and capable resident, as your needs change, so will your ageement with the community and in turn, the facility’s obligations to you.
A continuing Care withdrawal 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 separate choices, it is very important to do your research:
To explore assisted living facilities in Virginia, go to division of group 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 factory you are looking into. If looking 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 furnish 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 supervision required?
Yes
Yes
Must build a written plan upon admission of resident?
Yes
Yes
Staff must experience criminal background check?
Yes
Yes
Monitored by Virginia town for ability health Care Services and buyer Protection
Yes
No
Monitored by division of group 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 factors—improved medical care and prevention efforts— that are partly responsible for the dramatic increases in life expectancy have also produced a major shift in the important causes of death in the United States in the past century, from infectious diseases and acute illnesses to continuing diseases and degenerative illnesses.” The State of Aging and health in America 2004, published by the town for Disease Control, available 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 administrative Code § 12Vac5-360-10.
***It is a Felony under Virginia law to control a nursing factory without a license. See generally, 12Vac5-371-30.
Differences between Nursing Homes, Assisted Living & chronic Care seclusion Communities
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