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Medicare Beneficiaries Can Compare Nursing Homes With Improved Medicare.gov Tool

Medicare.gov is making it easier for those considering a nursing home for their loved one.

The government website that serves as the home base for Medicare added some new improvements to the “Nursing Home Compare” tool found on Medicare.gov.

The recent improvements include:

  • Higher thresholds of standards for evaluating nursing home staffing levels
  • Improved measures for differences in quality between nursing homes
  • New abuse alerts that let beneficiaries know about nursing homes that received citations for potential issues related to abuse

What is the Nursing Home Compare tool?

The searchable online database includes all nursing homes in the U.S. that are certified by Medicare and Medicaid. The Medicare.gov website and the Nursing Home Compare tool are provided by the Centers for Medicare & Medicaid Services (CMS).

Users simply need to enter the location or name of a nursing home in order to see detailed information including the home’s quality of care and staffing. The feature can be used to compare nursing homes in a particular area before finalizing a decision on where you or your loved ones would like to live. 

The tool also alerts users if a nursing home a history of poor care and may require increased oversight and enforcement.

Medicare and nursing home overage

Medicare rolled out the new research tool despite not offering significant coverage for nursing home care.

A nursing home may provide permanent custodial care such as dressing, eating and bathing. Custodial care is not covered by Medicare if it’s the only type of care you need.

However, Medicare does offer coverage for skilled nursing facility stays. A skilled nursing facility (SNF) provides temporary care to treat a specific medical need or allow for recovery outside of a hospital.

In order for a skilled nursing facility stay to be covered by Medicare, a patient must enter a skilled nursing facility approved by Medicare within 30 days of a hospital stay that lasted at least three days. The care received in the skilled nursing facility must be for the same condition that required the hospital stay.

The items and services that may be covered by Medicare in a skilled nursing facility include:

  • Semi-private room
  • Meals
  • Skilled nursing care
  • Physical therapy
  • Occupational therapy
  • Speech-language pathology services
  • Medical social services
  • Medications
  • Medical supplies and equipment
  • Ambulance transportation
  • Dietary counseling
  • Swing bed services

The first 20 days of a skilled nursing facility stay require no coinsurance. Days 21 through 100 require a coinsurance payment of $176 per day in 2020, and the beneficiary is responsible for all costs after 100 days.

These coinsurance requirements may be covered in full by any one of the 10 standardized  Medicare Supplement Insurance (Medigap) plans that are available in most states. 

Medicare Advantage plans may cover long-term care

While Medicare Advantage plans don’t typically care nursing home stays, some Medicare Advantage plans may cover specialized types of home care, such as hospice and respite care, certain home health services, home meal delivery and improvements that can be made in your home such as bathroom grab bars.

You can learn more about your Medicare Advantage plan options by calling to speak with a licensed insurance agent. You can also compare plans online for free, with no obligation to enroll.

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