What Are the Steps to Entering a Nursing Home?

You and your family have had the nursing home conversation and decided that it’s time to find the right care facility that fits your needs. That process can look very different depending on your needs and the nursing home you apply to enter; however, there are a few key general steps for preparing to enter a nursing home. Not only can these steps improve your admission experience, they can ensure a seamless transition into the right nursing home or senior care facility.

Why Are You Entering a Nursing Home?

This is perhaps the most important question you’ll ask yourself when deciding to admit yourself into a care facility. Knowing why you want, or need, the additional care or help will define the type of care facility you should look into. For example, if you’re still pretty active and only need a little assistance with things like maintenance and yardwork, or if you just want a centralized suite of services, an independent living community should be at the top of your list. If you need more specific medical care than what would be presented somewhere like that, you may want to look into skilled nursing facilities.

Knowing why you want, or need, the additional care or help will define the type of care facility you should look into.

Meeting with your doctor to discuss your particular medical needs can be a great way to answer this question, as well as other questions that you may have about senior care facilities.

Pre-Application Preparation

When it comes to moving from your home into a nursing home for the foreseeable future, preparation is key. First and foremost, research several different types of care facilities and locations so that you have a few options to choose from. Even if the reason you’re looking at care facilities favors one type of place, it’s still worth looking into others, so you know all of your options. Once you begin to narrow them down, you’ll be able to visit your top picks, which will allow you to investigate the properties to make sure they have the amenities you need. Our “What to Look for When Choosing a Senior Care Facility” post breaks down the questions you should ask and ways you can differentiate between facilities.

Once you begin to narrow down your options, visit them to make sure they have the amenities you need.

While all this is going on, you should begin preparing your home and property for the eventual move. In some cases, a lien may be placed on the home after you’ve entered into a care facility. This lien would be used to pay for the costs you incur during your stay. There are ways that you can transfer or sell your home in order to prevent it from being used to pay for costs, but that may influence other factors, like your Medicaid eligibility.

In addition to having a plan for your property, you should also have a plan for your assets. If you have a larger home, downsizing into an assisted living facility may require a yard sale to help get rid of some things you don’t need anymore. You likely won’t have as much space to yourself in your care facility, so prioritizing what you take with you is important.

Financial Decisions and Financial Aid

When you start looking into your nursing home options, your finances will rarely be far from your mind. Nursing homes of any type can be expensive, even with insurance coverage. Finding some way to pay for these facilities is essential to a successful application. So, before you even pick up the application, it’s worth sitting down and figuring out how you’ll be able to afford it.

If you’re enrolled in Medicare, you may receive some coverage for medically necessary facilities like skilled nursing facilities (and can get a get a Medigap plan for extra coverage), but not for day-to-day care and senior living communities like assisted living facilities. That said, Medicaid will usually help pay for most types of care facilities, which can help make some of the costs more affordable for seniors.

You may want to pick up long-term care insurance, which can help bring down your out-of-pocket costs.

When it comes to Medicare coverage at a care facility, medical costs are often covered, but anything considered long-term care or daily living assistance is not. To help cover these costs, you may want to pick up long-term care insurance, which can pair with both Medicare and Medicaid to help bring down your out-of-pocket costs. If this is an option you’re interested in, be sure to read the specifics carefully to ensure the coverage fits your needs.

Besides insurance, you can help fund a stay at a care facility much like you’d fund your retirement, either via personal savings, getting an annuity, or some other strategy.

Applying, Screenings, and Pre-Admission Assessments

Once you’ve found the nursing home you want to move into, prepared your assets, and outlined your finances, it’s time to apply for admission. The application process can be specific to each nursing home, but generally, there will be a staff member who will help walk you through their individual process. If there aren’t any openings at that time, you may be asked to join a waiting list. Some facility waiting lists require a deposit, unless your stay is covered by Medicaid or Medicare. That said, wait list policies can differ from facility to facility. If you’re placed on a waiting list, be sure to read the fine print to understand the specific rules of that facility.

Preadmission screening and resident reviews establish your medical needs, cognitive health, finances, and family situation.

A key part of the application process is a preadmission screening and resident review. Sometimes called preadmission assessment or patient review instrument (PRI) screening, these tests will seek to establish your medical needs, your cognitive health, your finances, and your family situation. These screenings are important to establishing and personalizing your care and may also be used to determine Medicare and Medicaid eligibility or necessity. Meeting with your doctor and getting your own medical history and doctor files may also help speed this process along.

If your application has been successful, it may be tempting to sign the admission paperwork and start moving in immediately. You should reject this urge, though. Any legal paperwork should always been read carefully and reviewed thoroughly. It may even be wise to have an attorney look over the contract or paperwork before signing and handing it in. Remember, that paperwork establishes your costs, care, and considerations throughout your stay. Don’t sign it unless it works for you.

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Entering into a nursing home or senior care facility can be a tough choice. Making sure that the process is as smooth and painless as possible can go a long way toward easing you into these new living circumstances. You can achieve this through proper preparation, research, and planning. This all goes to show that moving into a nursing home doesn’t have to be the hassle it sometimes can become.

Further Reading

Centers for Medicare & Medicaid Services — Nursing Home Toolkit: Nursing Homes — A Guide for Medicaid Beneficiaries’ Families and Helpers