Gateway Area Chapter SPRING 2010

MS Clinical Messenger

Choosing A Nursing Home - Where to Begin?

Wendy L. Apgar, M.S., OTR/ LClinical Development Specialist

Rehab Choice IncorporatedGateway Area ChapterClinical Advisory

Committee

Committee ChairRobert Naismith, M.DBarnes-Jewish Hospital

John L. Trotter MS Center

Committee MembersElissa Held Bradford, PT

St. John’s Sports & Therapy

Mary DuParri, M.A., LPCPrivate Practice

Gerard Erker, PhDSSM Rehab

St. Mary’s Health Center

Barbara Green, M.D.St. John’s Mercy Medical Center

West County MS Center

Penny James OTR/L, MSVeteran’s Administration

Medical Center

Michelle Keating, RN, OCN, MSCNSt. John’s Mercy Medical Center

Barry Singer, M.D.Missouri Baptist Medical Center

Florian Thomas, M.D.Saint Louis University

Health Sciences Center

What to Look for When Choosing a Nursing HomeThe significant undertaking of choosing a nursing home in time of need could be overwhelming. There are numerous resources available, but where is a person to begin? Whether the individual needing nursing home services is a Medicare beneficiary or not, the website, MEDICARE The official U.S. Government Site for People with Medicare (http://www.medicare.gov/) provides a “one-stop” location to gain valuable information to assist in making important decisions.

On the home page of this website, click on Compare Nursing Homes in Your Area, which takes you to Find and Compare Nursing Homes. Once you have accessed this page, scroll down to the Nursing Home Checklist. This document outlines specific items that include critical topics for mak-ing an informed decision when selecting a nursing home to meet individ-ualized needs. It covers basic information, resident appearance, nursing home living spaces, staff, residents’ rooms, hallways, stairs ,lounges ,bath-rooms, menus and food, activities, safety and care.

Some additional questions to ask specific to individuals with MS:Are there younger residents in the facility? Do any of them have MS •or other neuro-degenerative diseases? How much experience has the facility had with MS? Are they open to having staff receive special training in this area?How elderly-focused are the activities? Is there interest in incorporat-•ing activities appealing to a younger population in terms of music, community outings, intellectually stimulating games and discussion, computer access, etc.? Do they have arrangements with vendors who can supply and repair •durable medical equipment?What health-care professionals are on staff − physical therapists, oc-•cupational therapists, social workers, etc.?What preventive care is available such as immunizations, cancer •screenings, dental care, eye care, foot care, etc?How are direct care staff assigned? Do they rotate throughout the •facility, or work on specific units?Is there individual climate control for residents’ rooms?•

To find nursing homes in a particular area and to access information specific to these homes, go to www.medicare.gov and click on the Compare Nursing Homes in Your Area button.

Search criteria can be specified to access sites for review. For example, you can use Nursing Home Compare to search and compare nursing homes by city, state, or zip code.

Efficient and effective use of the website is best achieved by taking time to read the information on each page. Step-by-step guidance for accessing vari-ous topics is provided for obtaining relevant informa-tion during the selection process.

When arriving at Nursing Home Compare, each home is rated by the Five-Star Quality Rating system. It was created to help consumers, their families, and caregivers compare nursing homes more easily and help identify areas about which questions may be asked. Nursing home ratings are taken from three sources of data, which include Health Inspections, Staffing, and Quality Measures. Detailed information is provided on this website to explain the ratings and the strengths and weaknesses of each. This information supplies a “snapshot” of the care individual nursing homes give.

The Five-Star Quality Rating is not meant to be used alone. One of the most important things to do is to visit the nursing homes being considered. Other options are to contact your Long-Term Care Ombudsman or State Survey Agency before making a decision. During a visit, take a copy of the Nursing Home Checklist, mentioned above, and talk to the nursing home staff about the information on this website. Coverage is-sues should be discussed during each visit since it will vary by site.

Information regarding eligibility for residing in a veterans’ home and qualifying for benefits for veterans can be accessed at the website, U.S. Department of Veterans Affairs (http://www.va.gov/). Listed under Veteran Services, click on Benefits Booklet to obtain information on Federal Benefits for Veterans, De-pendents and Survivors. The Veterans Administration (VA) is a very complex system. Therefore, it may be easier to call 1-877-222-8387 to speak with someone at the VA. Perseverance will be required. There may

Beverly, diagnosed in 2001

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Long-Term Care Ombudsman Resources

National Long-Term Care Ombudsman Resource Center

www.ltcombudsman.org

Illinois Department of Aging1-800-252-8966

www.state.il.us/aging/1abuselegal/ombuds.htm

Missouri Long-Term Care Ombudsman1-800-309-3282

www.dhss.mo.gov/Ombudsman/

be community-based nursing homes that have approved contracts with the VA – contact the VA for a listing.Cost ConsiderationsAgain, coverage issues should be discussed during each visit since it will vary by site. If an individual is admit-ted to a private pay facility and money runs out, s/he will typically have to move because the facility will not accept Medicaid. An individual will have to spend down her/his personal assets, excluding the house and car, to qualify for Medicaid. So timing is of the essence if an individual is in a private pay facility and will have to transition to a facility that accepts Medicaid. Long-term care insurance is tricky because it may or may not cover nursing home costs for a period of time depending on the type of insur-ance policy and the admission policy of the facility.

The 2009 MetLife Market Survey of Nursing Home, As-sisted Living, Adult Day Services, and Home Care Costs, October 2009, arrived at the following cost results.

When comparing national averages, current private room nursing home rates were $219 per day or $79,935 per year in 2009. National average rates for a semi-private room were $198 daily or $72,270 annually in 2009. As an example, daily private-pay rates for long-term (custodial) nursing home care obtained in 2009 for private and semi-

private rooms in licensed facilities throughout the United States are listed below for Missouri.MS Society ResourcesCare ManagementThe overall goal of care management is to help people with MS achieve the highest level of independence pos-sible and help caregivers cope with challenges. Care managers can provide support to individuals with MS and their families when making a decision to move into a long-term care setting. To get connected with a care manager, please call 1-800-344-4867.

Long Term Care ResourcesContact the MS Society at 1-800-344-4867 to obtain a list of additional resources (i.e., nursing homes, durable medi-cal equipment providers, attorneys, financial planners).

ResourcesProfessional Education Programs:

Psychosocial Intervention in Multiple Sclerosis: Strategies for Mental Health

Professionals Date: Friday, August 6, 2010Time: 9 a.m. – 5:30 p.m.Location: Garden Villas Retirement Commu-nity, Town & Country, MO)Cost: $50/person before July 9, $75/person after July 9, $30/studentRegistration: 1-800-344-4867, option 1

Pediatrics and MS - A Program for Health Professionals

Date: Tuesday, September 21 Time: Dinner program for health profes-sionalsDate: Wednesday, September 22Time: 8-9 a.m. Pediatric Grand RoundsLocation: Cardinal Glennon Children’s Hospital

MS: A Course for Occupational & Physical Therapists

Date: Saturday, September 25 Time: 8 a.m. - 5 p.m.Date: Sunday, September 26Time: 9 a.m. - noonLocation: Metro IL (site: TBD)Cost: $75/person before August 25, $100/person after July 9, $25/studentRegistration: 1-800-344-4867, option 1

Ongoing educationNational professional education programs/conferences: www.nationalmssociety.org g For Professionals

Publications for ProfessionalsTalking about Life Planning, Dorothy •Northrop, MSW Home Care Providers and Personal Care •AssistantsServing Individuals with MS in Adult Day •ProgramsAssisted Living for Individuals with Multiple •Sclerosis Nursing Home Care of Individuals with •Multiple Sclerosis

All can be found at nmss.org g For profession-als g Healthcare Professionals g Publications

Nursing Home Costs 2009 Semi-Private Room Private RoomLocation Low High Avg. Low High Avg.Missouri $95 $179 $134 $100 $235 $151Saint Louis $120 $179 $147 $128 $235 $176Kansas City $115 $150 $136 $120 $182 $149Rest of State $95 $165 $126 $100 $188 $138

Walk MS, 2010, Various Locations: April 10, 11, 17, 18, 22, 24 and May 1Walk MS is the signature fundraising event of the National Multiple Sclerosis Society. It is an organized front bringing us ever closer to a cure one step at a time. It’s about compassion for others. It’s about passion, drive and commitment to succeed. It’s about raising awareness for a disease that strikes individuals in the prime of their life. It’s about doing more than you have to in life to make someone else’s life that much better. Most importantly it’s about people. It’s about community, neighbors, family and friends. Walk MS season begins April 10. For a complete list of Walk MS dates and locations go to www.gatewaymswalk.org.

Optic Neuritis and MS in St. Louis, MO: April 20 Dr. Robert Naismith, Neurologist, Barnes Jewish Hospital, John L. Trotter MS Center will explain how the visual system functions and how it is affected in MS, talk about the prognosis and treatments for optic neuritis, discuss why it is important to begin MS therapy as early as possible and summarize the research being done on optic neuritis at Washington University. It will be held at the Hilton St. Louis Frontenac.

Sex Is Not A 4-Letter Word in St. Louis, MO: April 30 and in Columbia, MO: May 1 Guest speakers Dr. Frederick Foley and clinical sex therapist Heather Raznick will discuss how multiple sclerosis impacts sexual function and what can be done to improve intimacy and sexual relations. The St. Louis program will be at the Forest Park Visitor and Education Center from 6:30-9:30 p.m. The Columbia program will be at Les Bourgeois Vineyards from 6-8:30 p.m.

Spring Rendezvous in Grafton, IL: May 1-2 Take a weekend to relax and have fun with other adults living with MS at Pere Marquette Lodge in Grafton, IL. Activities for the all-adult weekend include: guest speakers on relationship building and effective communication, arts and crafts, accessible swimming, and evening entertainment. Must be 21 to attend.

Living The Symptoms of MS in St. Louis, MO: May 11 Using his book Managing The Symptoms of Multiple Sclerosis, Dr. Randall Schapiro will take people living with MS through three areas of MS management: the disease, the symptoms and the issues related to lifestyle and general wellness. He will explore all the symptoms of MS and discuss proven methods for proper and effective management. This free program, which includes dinner, will be from 6:30-9 p.m. and will be held at the St. Louis Zoo - Lakeside Cafe.

Challenge Walk MS Dean Team Automotive Walk 2010 in St. Charles, MO: June 4-6The Challenge Walk MS Dean Team Automotive Walk 2010 is a three-day, 50-mile experience that tests the strength and spirit of its participants. Challenge Walk MS makes an extraordinary difference in the lives of the 6,300 people locally and 2.5 million worldwide living with multiple sclerosis. Challenge Walk MS is not just about walking. It is about being part of the national movement of thousands of people that are doing something BIG about MS. It takes place at Saint Charles Community College. For more information or to register go to www.gatewayMSchallenge.org.

MS Clinical Messenger © 2010

Mission Statement: We mobilize people and resources to drive

research for a cure and to address the challenges of everyone affected by MS.

A newsletter published by the National MS Society.1867 Lackland Hill Parkway

St. Louis, MO 63146(314) 781-9020 or 1-800-344-4867

info@gatewaymssociety.orgPresident: Phyllis Robsham

Editor: Robert Naismith, M.D.

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