Tag Archives: Nursing Homes

Alternatives to Nursing Homes

A Special Guest Blog Entry by Amanda Duncan of St. Paul’s PACE Program

Nursing home care is traditionally a permanent residence for, mostly elderly, people who are too sick or frail to live at home or at a temporary care facility. Most of us have a stereotyped image in our mind of a nursing home: an institutional setting filled with sad, bored, little old people.  It doesn’t have to be like this. There are many great nursing homes as well as alternatives to nursing home care.

In fact, there are a wide variety of care options available depending on the type of care required by the individual. Options range from home and community care programs, to non-medical assistive living communities, to board and care homes  — designed for people who can’t live on their own but don’t need a nursing home, to continuing care retirement communities that provide different levels of service depending on residents’ individual need.

An innovative alternative, that covers all these options, is called Program of All-Inclusive Care for the Elderly, or PACE.  The PACE program features a comprehensive medical and social service delivery system using and interdisciplinary team approach in an adult day health center that is supplemented by an in-home and referral services in accordance with participants’ needs. The goal is to allow seniors to remain in their home while receiving the comprehensive medical and social services they need.

In furtherance of the program goal, and at a minimum, PACE programs provide services provided  at a PACE center including, but not limited to: Primary Care Doctors, medications and medication management, clinic services, primary care services, social services, restorative therapies, personal care and supportive services, nutritional counseling, recreational therapy and more.

PACE care teams strive to keep patients healthy and active – and living independently. By utilizing an adult day care setting and transporting seniors from their homes to the center PACE staff are able to make sure that seniors are receiving all the medical care they require, in addition to providing classes and social interaction.  St. Paul’s PACE in San Diego occupies a 7,000 square foot center which includes a large main room for seniors to socialize, participate in classes and eat lunch. Additionally, the facility has a physical therapy room, and a clinic staffed with full-time doctors and nurses.

Participants of PACE receive services as needed, many receive home care support with a combination of time at the day center where they receive physical therapy, clinic visits and time with specialists such as eye doctor, dentist, podiatrist, ear doctor and therapist – of course as needed.  PACE in California has received a waiver which allows for them to provide many specialty services to seniors which have been cut from the Medi-cal budget.

Full-time care, either in-home or in a care center environment can be expensive. Obviously cost comes into play when deciding which option is best for the individual as well as their budget. We would all like to see our loved-ones, or ourselves, at an upscale continuing care retirement community. Given the state of the economy, and the number of baby boomers soon to be looking for elder care, that scenario is not always possible.  Home health care, depending on the extent of services required, can also be cost prohibitive which is where a program like PACE can be good fit.   Those who qualify for PACE services are over 55 years of age, live in the designated PACE service area, are able to live safely in their home environment and must be approved  by the State as nursing home level of need.  PACE receives payments from Medicare and Medi-cal.  Most PACE participant’s have Medi-CAL.

Regardless of which type of senior care is chosen, it is critical for individuals and their families to be aware of all the options. For those with minor limitations an in-home care situation might make the most sense. But, innovative programs like PACE, if it is available, might take that care to the next level without the expense of continuing care retirement community.


A Visit to Chaparral House in Berkeley

I had the pleasure of visiting Chaparral House, an Aging Services member, earlier this week. It’s a cozy, skilled nursing community located creekside and in a quiet residential area. The campus is lush, green and bursting with flowers everywhere. It’s quite lovely.

They have an incredibly robust volunteer program, as well as thriving intergenerational programs. Organic gardens on campus are tended by local Montessori students and an organization that teaches children about sustainable growing and healthy cooking. Chaparral House also has a very busy activities calendar, with something available to residents at almost all hours of the day. Activities range from Laughter Yoga (which I’ve been inspired to learn more about!) to spiritual engagement, art, sandbox therapy and more – just a tremendous variety.

It was a treat to be able visit such a tight knit community that thrives on their values, philosophy, community connections, and embraces the ideals of culture change.

Study Finds Not-for-profit Nursing Homes Provide Better Care than For-profits

A recent study published in the British Medical Journal has found that nonprofit nursing homes provide better care than their for-profit counterparts. Continue reading

CMS Announces Final Rule that will Result in an Average 1.1% Rate Reduction

The Centers for Medicare and Medicaid Services (CMS) has just issued its final rule regarding the SNF rate recalibration. According to CMS, “the FY 2010 recalibration of the CMIs results in a reduction in payments to nursing homes of $1.050 billion, or 3.3 percent.  However, this decrease would be largely offset by this fiscal year’s update to Medicare payments to skilled nursing facilities.  The update—an increase of 2.2 percent or $690 million for FY 2010—is based on the change in prices of a ‘market basket’ of goods and services included in covered skilled nursing facility stays.  The percentage increase in the market basket is used to compute the update factor annually.  The combination of the market basket increase and the recalibration of the CMIs yields the 1.1 percent reduction.”

It is important to note that this changes reflects an average rate decrease October 1 by 1.1%.  Each facility’s situation will be different. You are encouraged to use the CMS Skilled Nursing Facility PC Pricer to see how you will be affected.

For more information, contact Lori Costa at lcosta@aging.org or (916) 469-3377.