Nebraska Department of Insurance
THE NEBRASKA HEALTH INSURANCE INFORMATION, COUNSELING, AND ASSISTANCE (NICA) PROGRAM
MARCH 2000 NICA NEWS
THIS AND THAT
Assisted Living Search
www.senioralternatives.com
This website will search the state and city that you are interested in and find a complete list of Assisted Living facilities. Assisted Living, the largest growing type of housing, provides a special combination of residential housing, personalized suppor-tive services and healthcare designed to meet the individual needs of those requiring help with activities of daily living, but do not need the skilled medical care provided in a nursing home.
Although the variety of services and level of care will vary, most communities provide assistance with dressing, grooming, bathing, and other daily activities. Assistance with medications differs according to state regulations; this is reflected on each community listing page by either "supervision, administration, or monitoring." Meals, laundry, and housekeeping are usually provided within private and semi-private rooms in a residential setting.
Assisted Living Communities can be free standing, part of a Continuing Care Com-munity that provides independent, assisted and nursing care, affiliated with a nursing home, or often are specialized services brought into independent retirement communities.
There are a variety of names in different parts of the country: Board and Care, Resi-dential Care Facilities, Community Based Retirement Facilities, Personal Care, Adult Living Facilities, Adult Foster Care and more. However, the generic term throughout the country is "Assisted Living."
Most Assisted Living Communities accept private pay only; however, in some states there is assistance with payment. This type of information is best determined on an individual basis.
Communities that offer more than one level of service are indicated on each community listing page by reference and link to additional listing page providing information on another level.
HOME HEALTH CARE
On October 1, 2000, Medicare will begin paying all Home Health Agencies (HHAs) under a new prospective payment system. The proposed system includes the following:- Medicare would pay HHAs for each covered 60-day episode of care. Beneficiaries could receive an unlimited number of episodes of care.
- Medicare would pay HHAs at a higher rate to care for those beneficiaries with greater needs.
- HHAs would receive additional payments (called "outlier" payments) for individuals with unusual needs resulting in significantly higher costs than the specified payment.
- National payment rates would be used with adjustments for area wage differences and the intensity of care required by each beneficiary.
- HHAs payments for each 60-day episode would include skilled nursing and home health aide visits, covered therapy, medical social services and supplies.
- Medicare would pay HHAs separately for medically necessary durable medical equipment.
- Payment rates would be adjusted to reflect significant changes in a patient's condition during each Medicare-covered episode of care.
- Medicare would require HHAs to provide at least 5 visits to beneficiaries to receive the full payment for each episode of care. (For fewer visits, a different method of payment will be used to determine the appropriate amount.)
Medicare has paid hospitals and nursing homes under a prospective payment system since 1983 and 1998 respectively. According to the Balanced Budget Act, HCFA must also implement prospective payment systems for hospital outpatient services and for rehabilitation hospitals. We'll see these developments in the future.