1. We review the medical records to determine if we can meet their medical needs:
A. Physician Orders: When someone is interested in coming to the nursing home, we start with Physician Orders stating that the person needs nursing home care. The orders spell out how we are to care for the individual – for example: do they need physical, occupational, or speech therapy, do we need to check their blood pressure, do we need to check their blood sugars and how often. The orders should list their current medications and any routine lab work. Everything we do is under the order of a physician, so this is the starting point.
B. History and Physical: Additionally, we need a current history and physical (H&P). While the Physician Orders tell us how to care for the person today; the H&P tell us what to look out for. For example, they have a history of high blood pressure, or congestive heart failure. This information assists our medical team in caring for your loved one.
2. Then we discuss the financial needs.
A. Private Pay: Are you paying private pay? Do you want a private room?
B. Medicare: If you have had a hospital stay within the past 30 days, we can review to see if you are eligible for skilled care and check your insurance coverage for you.
C. Medicaid: If you are not able to fully pay private pay, then we can check to see if you meet both
i. Medical Necessity, and
ii. Financial Neccissity