WEBVTT 00:00:00.000 --> 00:00:03.120 Welcome to the Light Keepers podcast. I'm Clayton 00:00:03.120 --> 00:00:05.620 Vandiver, your Light Keeper, with a show dedicated 00:00:05.620 --> 00:00:08.240 to everyone who wants to get the most quality 00:00:08.240 --> 00:00:11.679 out of life that they can. My co -host, as always, 00:00:11.900 --> 00:00:15.279 Charlene, our very own licensed clinical social 00:00:15.279 --> 00:00:18.239 worker, certified in the state of Florida. Hey, 00:00:18.260 --> 00:00:20.820 we invite you to join the conversation this week 00:00:20.820 --> 00:00:24.920 about different levels of care and how to pay 00:00:24.920 --> 00:00:28.899 for them. And so much more on this edition. of 00:00:28.899 --> 00:01:01.619 the Light Keepers Podcast. Before we start, I'd 00:01:01.619 --> 00:01:03.780 like to invite you to please leave your questions 00:01:03.780 --> 00:01:06.040 or comments below. We always love to hear from 00:01:06.040 --> 00:01:08.780 you. Questions this week will be answered during 00:01:08.780 --> 00:01:11.400 our next show that appears online every Wednesday 00:01:11.400 --> 00:01:15.019 evening at 7 p .m. Eastern. The Light Keepers 00:01:15.019 --> 00:01:17.879 podcast is an exclusive production of A Guiding 00:01:17.879 --> 00:01:20.359 Light Incorporated. We'll tell you more about 00:01:20.359 --> 00:01:22.700 A Guiding Light at the end of the podcast, but 00:01:22.700 --> 00:01:24.519 since we don't have much time, let's get right 00:01:24.519 --> 00:01:28.480 into the conversation. Hi, Charlene. Hello. Good 00:01:28.480 --> 00:01:30.829 to have you with us again tonight. Now, we're 00:01:30.829 --> 00:01:33.489 talking about different levels of care and how 00:01:33.489 --> 00:01:37.629 our listeners and viewers can pay for them. Before 00:01:37.629 --> 00:01:40.930 we worry about how to pay for them, tell us what 00:01:40.930 --> 00:01:44.769 different levels of care are there. So there 00:01:44.769 --> 00:01:48.989 are different levels of care based on what someone 00:01:48.989 --> 00:01:53.769 is capable of doing for themselves. For example, 00:01:54.109 --> 00:02:00.129 when you have someone who is older, You can have 00:02:00.129 --> 00:02:03.170 someone who is independent, meaning they can 00:02:03.170 --> 00:02:06.430 take care of themselves. You can have someone 00:02:06.430 --> 00:02:10.830 who might need a little bit of assistance. And 00:02:10.830 --> 00:02:14.050 if this is someone who can't live on their own, 00:02:14.189 --> 00:02:16.590 this is someone who would be appropriate for 00:02:16.590 --> 00:02:19.870 what's called an assisted living facility. Someone 00:02:19.870 --> 00:02:22.210 who is appropriate for an assisted living facility 00:02:22.210 --> 00:02:25.889 is still someone who can get up on their own, 00:02:26.009 --> 00:02:29.650 meaning they're able to get out of bed. Maybe 00:02:29.650 --> 00:02:31.789 they need a little bit of help walking, maybe 00:02:31.789 --> 00:02:35.729 with a walker, or maybe even with a wheelchair, 00:02:35.870 --> 00:02:37.889 but they're able to get themselves in and out 00:02:37.889 --> 00:02:41.490 of the wheelchair on their own. Now, if you have 00:02:41.490 --> 00:02:44.830 someone who needs more assistance than that, 00:02:45.550 --> 00:02:49.050 This is someone who would most likely be best 00:02:49.050 --> 00:02:51.789 served in what's called a skilled nursing facility, 00:02:52.150 --> 00:02:56.909 which some people know of as a nursing home. 00:02:57.150 --> 00:03:00.250 Okay. Or, depending on what part of the country 00:03:00.250 --> 00:03:02.669 you live in, could also be known as an old folks 00:03:02.669 --> 00:03:07.930 home. Okay. This is a facility where someone 00:03:07.930 --> 00:03:11.310 goes that... really needs a lot of help taking 00:03:11.310 --> 00:03:13.610 care of themselves. Maybe they can't get out 00:03:13.610 --> 00:03:16.150 of bed on their own. Maybe they can't get out 00:03:16.150 --> 00:03:20.469 of bed at all. They're not able to dress themselves 00:03:20.469 --> 00:03:25.050 by themselves. Maybe they're not even able to 00:03:25.050 --> 00:03:28.129 feed themselves. Well, that sort of gets into 00:03:28.129 --> 00:03:31.139 what I was going to ask. What really determines 00:03:31.139 --> 00:03:34.020 the level of care that you'll be receiving? I 00:03:34.020 --> 00:03:38.379 mean, what qualifies you? So someone's own physical 00:03:38.379 --> 00:03:42.319 health really makes the determination, but a 00:03:42.319 --> 00:03:46.680 lot of times this level is decided by the medical 00:03:46.680 --> 00:03:50.060 community. For example, if someone goes to the 00:03:50.060 --> 00:03:55.590 hospital with an injury or with an illness, the 00:03:55.590 --> 00:03:59.189 hospital may discharge them into a skilled nursing 00:03:59.189 --> 00:04:03.729 facility for rehab. And the discharging physician 00:04:03.729 --> 00:04:07.889 determines what level of care they need. Now, 00:04:07.949 --> 00:04:11.830 I have also seen some situations where a doctor 00:04:11.830 --> 00:04:14.909 has made the decision that this person is no 00:04:14.909 --> 00:04:18.350 longer safe to care for themselves at home, and 00:04:18.350 --> 00:04:20.629 therefore they need to be discharged to live 00:04:20.629 --> 00:04:24.550 in a... nursing home or a skilled nursing facility. 00:04:25.089 --> 00:04:29.009 While this is something that I would like to 00:04:29.009 --> 00:04:32.529 discuss in greater detail in a later show, I 00:04:32.529 --> 00:04:35.509 will take a moment to point out that while a 00:04:35.509 --> 00:04:37.790 doctor may make that recommendation, ultimately 00:04:37.790 --> 00:04:40.529 it is up to the family. So if the family decides 00:04:40.529 --> 00:04:43.709 that they have adequate care at home, then they 00:04:43.709 --> 00:04:47.569 can still take that person home. But it would 00:04:47.569 --> 00:04:53.129 be the medical professional's decision that they 00:04:53.129 --> 00:04:56.029 need the level of care that they do, whether 00:04:56.029 --> 00:04:58.970 it's provided at home or in a facility. Right. 00:04:59.189 --> 00:05:01.870 Well, isn't all of this taken care of by Medicare, 00:05:02.069 --> 00:05:04.670 Medicaid, or some private insurance as far as 00:05:04.670 --> 00:05:09.279 paying? So rehab... is taken care of by Medicare 00:05:09.279 --> 00:05:13.420 and private insurance. However, those resources 00:05:13.420 --> 00:05:16.680 are very limited. Once you've received X amount 00:05:16.680 --> 00:05:21.920 of rehab, then it no longer pays for it. And 00:05:21.920 --> 00:05:26.199 at that point, the person is either discharged 00:05:26.199 --> 00:05:28.680 from the skilled nursing facility and they're 00:05:28.680 --> 00:05:33.899 able to go back home or... Depending on where 00:05:33.899 --> 00:05:37.279 their new normal is, what they're now able to 00:05:37.279 --> 00:05:39.560 do for themselves, they may need that higher 00:05:39.560 --> 00:05:42.579 level of care on a permanent basis, at which 00:05:42.579 --> 00:05:45.620 case it's either up to the individual to pay 00:05:45.620 --> 00:05:51.279 for it, or that's where you would really get 00:05:51.279 --> 00:05:53.600 into the situation of having to look at how to 00:05:53.600 --> 00:05:56.339 finance that facility or how to set up that care 00:05:56.339 --> 00:06:02.970 at home if your family cannot provide it. these 00:06:02.970 --> 00:06:06.310 levels of care and choosing what's right for 00:06:06.310 --> 00:06:08.889 them, or is it always in the hands of a professional 00:06:08.889 --> 00:06:12.970 to choose for you? Usually it is in the hands 00:06:12.970 --> 00:06:17.550 of the professional, and you may have a say in 00:06:17.550 --> 00:06:20.610 it, but that may not ultimately be the final 00:06:20.610 --> 00:06:24.250 decision. For example, say you have a loved one 00:06:24.250 --> 00:06:26.490 that needs to be discharged to a skilled nursing 00:06:26.490 --> 00:06:31.180 facility. That individual may only want to go 00:06:31.180 --> 00:06:35.980 to facility X or facility Y. If facility X and 00:06:35.980 --> 00:06:38.759 Y don't have beds available, the hospital is 00:06:38.759 --> 00:06:40.920 not going to continue to hold them. They're going 00:06:40.920 --> 00:06:44.420 to discharge them to the first place that has 00:06:44.420 --> 00:06:48.660 a bed available. And that may not be facility 00:06:48.660 --> 00:06:51.720 X or Y. It may not even be a facility in the 00:06:51.720 --> 00:06:53.920 same town, may not even be in the same state. 00:06:54.060 --> 00:06:58.240 Really? Yes. So they could actually... be sending 00:06:58.240 --> 00:07:00.660 a loved one off somewhere? What control does 00:07:00.660 --> 00:07:03.079 the family have in that situation? Unfortunately, 00:07:03.139 --> 00:07:08.079 none. Really? They can either take their loved 00:07:08.079 --> 00:07:12.439 one home and do whatever is needed to provide 00:07:12.439 --> 00:07:16.759 care at home, or they are left to the mercy of 00:07:16.759 --> 00:07:20.199 whatever facility has a bed available. Unfortunately, 00:07:20.519 --> 00:07:24.779 for example, at the height of COVID. There were 00:07:24.779 --> 00:07:30.360 no spaces and facilities, and at the time I was 00:07:30.360 --> 00:07:34.439 working in the hospital setting, and we had patients 00:07:34.439 --> 00:07:37.959 that were being discharged to other parts of 00:07:37.959 --> 00:07:42.199 the state and sometimes even out of state because 00:07:42.199 --> 00:07:44.519 that was the closest place we could find that 00:07:44.519 --> 00:07:48.139 would take them. What resources? A few weeks 00:07:48.139 --> 00:07:50.839 ago we were talking about vetting and investigating 00:07:50.839 --> 00:07:54.019 the professionals that are working with you to 00:07:54.019 --> 00:07:57.819 make sure that they're reputable and not... witch 00:07:57.819 --> 00:08:00.600 doctors. That was an interesting episode. But 00:08:00.600 --> 00:08:03.879 I'm wondering, is there a way to vet or investigate 00:08:03.879 --> 00:08:07.519 these sort of facilities ahead of time before 00:08:07.519 --> 00:08:09.660 you send a loved one there or before you go there 00:08:09.660 --> 00:08:13.040 yourself? Absolutely. And provided this is a 00:08:13.040 --> 00:08:15.819 situation that you have some control over, I 00:08:15.819 --> 00:08:19.439 would absolutely recommend checking out any facility. 00:08:20.600 --> 00:08:23.339 And I know I'm going to upset a lot of facility 00:08:23.339 --> 00:08:27.589 employees when I say this, but Make sure you 00:08:27.589 --> 00:08:30.430 take a tour of the facility. Lay eyes on the 00:08:30.430 --> 00:08:32.889 facility, but don't let them know you're coming. 00:08:33.909 --> 00:08:36.649 Okay, so an unannounced visit is a good thing. 00:08:36.970 --> 00:08:38.889 Unannounced visit is a good thing. Otherwise, 00:08:39.190 --> 00:08:41.169 they're going to have the staff on their best 00:08:41.169 --> 00:08:44.129 behavior, and they're going to have things nice 00:08:44.129 --> 00:08:46.610 and neat and clean. And for some facilities, 00:08:46.789 --> 00:08:50.399 that may be the normal. Hi, Wizzy. For other 00:08:50.399 --> 00:08:52.840 facilities, that may not be. One of our cats 00:08:52.840 --> 00:08:54.960 checking in to make sure we're covering all of 00:08:54.960 --> 00:08:57.779 this information for you. I'm curious. Is there 00:08:57.779 --> 00:09:00.860 a central website with any rankings or ratings 00:09:00.860 --> 00:09:03.840 that folks could be referred to? So Medicare 00:09:03.840 --> 00:09:07.620 does have a system. The U .S. Centers for Medicare 00:09:07.620 --> 00:09:11.559 and Medicaid Services, also known as CMS. Okay. 00:09:11.639 --> 00:09:15.039 So if you hear me say CMS, that's the Center 00:09:15.039 --> 00:09:18.080 for Medicare and Medicaid. They have a five -star 00:09:18.080 --> 00:09:21.720 quality rating system that can be researched 00:09:21.720 --> 00:09:26.620 online. And basically what they do is they have 00:09:26.620 --> 00:09:31.480 these facilities rated. Thank you. They have 00:09:31.480 --> 00:09:35.899 these facilities rated according to Medicare 00:09:35.899 --> 00:09:40.159 standards. And they have those ratings online 00:09:40.159 --> 00:09:42.980 where people can research them and look at them. 00:09:43.139 --> 00:09:46.480 But I wouldn't recommend stopping there. I would 00:09:46.480 --> 00:09:50.779 also recommend looking at reviews. Reviews are 00:09:50.779 --> 00:09:53.059 important, keeping in mind, of course, that there 00:09:53.059 --> 00:09:54.940 are some people that will complain about anything 00:09:54.940 --> 00:09:57.960 and everything. So take those reviews with a 00:09:57.960 --> 00:10:00.980 grain of salt. Fair enough. But reviews are important 00:10:00.980 --> 00:10:03.559 because these are normally left by people who 00:10:03.559 --> 00:10:06.259 have had firsthand experience. Sure. And, of 00:10:06.259 --> 00:10:09.440 course, word of mouth. If you know someone who's 00:10:09.440 --> 00:10:11.419 had personal experience, that's going to be important 00:10:11.419 --> 00:10:14.440 also. Well, now, a few years ago in the state 00:10:14.440 --> 00:10:18.940 of Florida, there was an agency. of the Department 00:10:18.940 --> 00:10:21.940 of Elder Affairs. And they were called the ombudsman. 00:10:22.019 --> 00:10:26.340 That group actually went to facilities like this, 00:10:26.460 --> 00:10:28.799 nursing homes, skilled nursing facilities, and 00:10:28.799 --> 00:10:34.139 they did surprise visits. They rated them, not 00:10:34.139 --> 00:10:37.879 raided, but rated them on their performance and 00:10:37.879 --> 00:10:40.940 cleanliness and so forth. And they really did 00:10:40.940 --> 00:10:45.240 help these facilities to... maintain standards 00:10:45.240 --> 00:10:48.019 and to do a really good job in the state of Florida. 00:10:49.039 --> 00:10:52.059 Are they still doing what they used to do? Because 00:10:52.059 --> 00:10:54.539 I haven't heard of them in a very long time. 00:10:54.820 --> 00:10:57.340 So that can vary from state to state as funding 00:10:57.340 --> 00:11:00.860 varies. That is definitely something that I would 00:11:00.860 --> 00:11:03.860 encourage someone to look into with their own 00:11:03.860 --> 00:11:07.399 state's Department of Elder Affairs, which is 00:11:07.399 --> 00:11:10.820 a good thing to look into anyway because you 00:11:10.820 --> 00:11:13.379 may want to have that information in case you 00:11:13.379 --> 00:11:17.299 need an advocate working with the nursing home. 00:11:18.879 --> 00:11:22.799 Nursing home care is important to have for those 00:11:22.799 --> 00:11:26.620 that need it, but in a lot of cases, home is 00:11:26.620 --> 00:11:28.799 going to be the best option if it's at all possible. 00:11:30.179 --> 00:11:32.120 Definitely something you would want to look into 00:11:32.120 --> 00:11:34.259 for the homes in your area. Well, I appreciate 00:11:34.259 --> 00:11:39.279 that. Oh, and I should introduce Isabelle. She's 00:11:39.279 --> 00:11:41.379 been in a few of our episodes so far, but this 00:11:41.379 --> 00:11:45.509 is her first time on camera. I guess we call 00:11:45.509 --> 00:11:47.509 her the therapy cat around the house because 00:11:47.509 --> 00:11:50.509 she knows that whenever we're working hard, she 00:11:50.509 --> 00:11:52.649 needs to be there to help us out and help us 00:11:52.649 --> 00:11:57.350 stay stress -free and cool, calm, and collected. 00:11:57.730 --> 00:12:01.809 So this is Isabelle. She likes to be in the middle 00:12:01.809 --> 00:12:03.490 of everything. And, you know, it's something 00:12:03.490 --> 00:12:05.830 we probably should do an episode about at some 00:12:05.830 --> 00:12:09.289 point because animals play such an absolutely, 00:12:09.669 --> 00:12:11.850 you know, pets are a great part of the family 00:12:11.850 --> 00:12:15.779 and they play a really important role. Absolutely. 00:12:15.799 --> 00:12:18.580 In reducing stress, in making life better. There 00:12:18.580 --> 00:12:22.220 are so many studies. There are a lot of studies 00:12:22.220 --> 00:12:26.659 that show the benefit of pet ownership, having 00:12:26.659 --> 00:12:31.159 those furry, feathered, or scaled family members. 00:12:31.440 --> 00:12:33.879 Absolutely. They have a lot of benefits to our 00:12:33.879 --> 00:12:39.710 personal health, to our emotional health. It's 00:12:39.710 --> 00:12:42.450 good to do for them. There are so many animals 00:12:42.450 --> 00:12:44.710 out there that need a family and need a home, 00:12:44.850 --> 00:12:47.970 and I'm glad she can be a part of ours. She looks 00:12:47.970 --> 00:12:51.710 great on camera, let me tell you. So we know 00:12:51.710 --> 00:12:58.409 we're going to the hospital, and what is a typical 00:12:58.409 --> 00:13:02.389 stay for the patient from admission to discharge, 00:13:02.509 --> 00:13:06.029 the entire process, before they ever get? Since 00:13:06.029 --> 00:13:07.769 we're talking about levels of care, that's really 00:13:07.769 --> 00:13:10.750 where the care often starts. It is where the 00:13:10.750 --> 00:13:15.409 care often starts, and that's something that 00:13:15.409 --> 00:13:20.549 is a topic that we really don't have time to 00:13:20.549 --> 00:13:23.610 get into today because there's a lot of great 00:13:23.610 --> 00:13:25.889 information that needs to be shared about that, 00:13:25.990 --> 00:13:28.870 starting with going to the hospital, how you 00:13:28.870 --> 00:13:31.250 get there, whether you're a trauma call or... 00:13:32.189 --> 00:13:36.110 or, you know, a walk -in admission, so to speak. 00:13:36.350 --> 00:13:38.750 We don't have time to get into all of that here 00:13:38.750 --> 00:13:41.029 today, but definitely something we should cover. 00:13:41.269 --> 00:13:42.809 Well, I'll tell you what. Why don't we make that 00:13:42.809 --> 00:13:45.110 our next episode for our listeners and our viewers? 00:13:45.549 --> 00:13:48.730 Because the hospital stay really is the first 00:13:48.730 --> 00:13:51.850 point of contact with the system for a lot of 00:13:51.850 --> 00:13:54.690 people when we're talking about levels of care 00:13:54.690 --> 00:13:58.309 and how to pay for them. Like you said, Medicare, 00:13:58.470 --> 00:14:02.299 Medicaid, private insurance. Which of these pays 00:14:02.299 --> 00:14:04.200 for some of these facilities we're talking about 00:14:04.200 --> 00:14:09.500 again? So Medicare and Medicaid will pay for 00:14:09.500 --> 00:14:12.860 rehab if you have to go to a skilled nursing 00:14:12.860 --> 00:14:17.200 facility. It will not pay anything towards assisted 00:14:17.200 --> 00:14:23.039 living, independent living, and nothing towards 00:14:23.039 --> 00:14:27.610 skilled nursing residential. And a lot of people 00:14:27.610 --> 00:14:29.809 balk at that when I tell them. I've had people 00:14:29.809 --> 00:14:31.850 get angry with me and say, you know, they've 00:14:31.850 --> 00:14:34.789 paid into the system all their lives. And that 00:14:34.789 --> 00:14:38.669 may be, but unfortunately it's important to note 00:14:38.669 --> 00:14:42.529 that asking Medicare to pay for someone to live 00:14:42.529 --> 00:14:44.750 in a skilled nursing facility would be kind of 00:14:44.750 --> 00:14:47.049 like asking them to pay for your mortgage. It's 00:14:47.049 --> 00:14:50.149 not what you've paid into it for. Ah, I see. 00:14:50.409 --> 00:14:54.100 I see. The Light Keepers podcast is an exclusive 00:14:54.100 --> 00:14:56.580 production of Animation Studios and is brought 00:14:56.580 --> 00:14:59.820 to you by A Guiding Light, a 501c3 nonprofit 00:14:59.820 --> 00:15:03.299 organization dedicated to education and information 00:15:03.299 --> 00:15:06.440 that allows informed preparation for living the 00:15:06.440 --> 00:15:09.649 very best life possible. The mission of A Guiding 00:15:09.649 --> 00:15:11.950 Light is to provide education to professionals 00:15:11.950 --> 00:15:15.429 and information for everyone else about life 00:15:15.429 --> 00:15:18.370 planning, available guidance, and counseling 00:15:18.370 --> 00:15:20.850 that helps individuals and their family navigate 00:15:20.850 --> 00:15:24.009 options that improve the quality of their remaining 00:15:24.009 --> 00:15:27.009 days. The organization is committed to training 00:15:27.009 --> 00:15:29.549 professionals through scholarship grants when 00:15:29.549 --> 00:15:32.389 needed who will help you find the best information 00:15:32.389 --> 00:15:35.750 and options to meet your planning needs that 00:15:35.750 --> 00:15:44.029 are available in your area. Thank you. Thank 00:15:44.029 --> 00:16:01.940 you. Thank you. We're so grateful for your support 00:16:01.940 --> 00:16:04.480 and sincerely hope that you will join the conversation 00:16:04.480 --> 00:16:07.899 in coming weeks. Add your questions and comments 00:16:07.899 --> 00:16:10.879 below. Speaking of that, hit the like and subscribe 00:16:10.879 --> 00:16:14.960 buttons. It's free! And turn on that notify bell 00:16:14.960 --> 00:16:18.740 so you'll catch every single episode. I'm Clayton 00:16:18.740 --> 00:16:21.620 Vandiver, your Light Keeper. We'll see you next 00:16:21.620 --> 00:16:22.080 time.