Don't know which facility to choose? CMS created the Five-Star Quality Rating System to help consumers, their families, and caregivers compare nursing homes more easily.
A quality rating system that gives each nursing home a rating of between 1 and 5 stars. Nursing homes with 5 stars are considered to have much above average quality and nursing homes with 1 star are considered to have quality below average. A separate rating for each of the following three sources of information:
Health Inspections – The health inspection rating contains information from the last 3 years of onsite inspections. This information is gathered by individuals who go onsite to the nursing home and follow a specific process to determine the extent to which a nursing home has met Medicare's minimum quality requirements. The most recent survey findings and More than 200,000 onsite reviews are used in the health inspection scoring nationally.
Staffing – The staffing rating has information about the number of hours of care on average provided to each resident each day by nursing staff. This rating considers the difference in the level of need of care of residents in different homes.
Quality Measures (QMs) – The quality measure rating has information on 10 different physical and clinical measures for nursing home residents. This information is collected by the nursing home for all residents and the QMs offer information about how well nursing homes are caring for their residents' physical and clinical needs.
More than 12 million assessments of the conditions of nursing home residents are used in the Five-Star rating system. To help you find the nursing home that is priced in your range and offers quality service for your aging elder.
Thursday, January 28, 2010
Saturday, October 10, 2009
Hospital Care Checklist: Medicare Checklists
Hospital Care is important and it is better to ask questions before a life threatening problem. Here is a checklist you can use to find the hospital care that fits your Medicare plans.
Ask your doctor or health care provider
1) Which hospitals do you work with?
2) Which hospital has the best care and results for my conditions?
3) How were your other patients treated at that hospital?
4) Why do you recommend this hospital for my hospital care? What are you basing your recommendation on? Why is this the best hospital for me?
Find out if the hospital:
5) Is accredited (voluntarily met national health and safety standards) by a national organization.
6) Checks and improves its quality of care? Ask how problems with care are handled.
7) Is conveniently located for you. Can you and your family get there easily for planned or emergency care?
8) Has convenient visiting hours and other rules that are important to you and your family.
9) Is clean. Visit the hospital and look around. Do the rooms look comfortable?
10) Does the hospital have rooms that offer privacy?
Check with your insurance company or health plan to see whether you:
11) Have to go to a certain hospital for non-emergency care or whether you can choose your hospital.
12) Have to pay a different amount depending on which hospital you use.
Ask your doctor or health care provider
1) Which hospitals do you work with?
2) Which hospital has the best care and results for my conditions?
3) How were your other patients treated at that hospital?
4) Why do you recommend this hospital for my hospital care? What are you basing your recommendation on? Why is this the best hospital for me?
Find out if the hospital:
5) Is accredited (voluntarily met national health and safety standards) by a national organization.
6) Checks and improves its quality of care? Ask how problems with care are handled.
7) Is conveniently located for you. Can you and your family get there easily for planned or emergency care?
8) Has convenient visiting hours and other rules that are important to you and your family.
9) Is clean. Visit the hospital and look around. Do the rooms look comfortable?
10) Does the hospital have rooms that offer privacy?
Check with your insurance company or health plan to see whether you:
11) Have to go to a certain hospital for non-emergency care or whether you can choose your hospital.
12) Have to pay a different amount depending on which hospital you use.
Compare Hospital Care Tool: Medicare Supplement
Hospital Compare Tool
In this tool you will find information on how well hospitals care for patients with certain medical conditions or surgical procedures, and results from a survey of patients about the quality of care they received during a recent hospital stay. This information will help you compare the quality of care hospitals provide when choosing Medicare options. Talk to your doctor about this information to help you, your family and your friends make your best hospital care and Medicare decisions.
Hospital Compare was created through the efforts of the Centers for Medicare & Medicaid Services (CMS), the Department of Health and Human Services, and other members of the Hospital Quality Alliance: Improving Care Through Information (HQA).
When it comes to Medicare and Hospital Care doing research can save your life.
In this tool you will find information on how well hospitals care for patients with certain medical conditions or surgical procedures, and results from a survey of patients about the quality of care they received during a recent hospital stay. This information will help you compare the quality of care hospitals provide when choosing Medicare options. Talk to your doctor about this information to help you, your family and your friends make your best hospital care and Medicare decisions.
Hospital Compare was created through the efforts of the Centers for Medicare & Medicaid Services (CMS), the Department of Health and Human Services, and other members of the Hospital Quality Alliance: Improving Care Through Information (HQA).
When it comes to Medicare and Hospital Care doing research can save your life.
Sunday, October 4, 2009
Information about Replacing a Medicare Card
The Medicare card looks like a red, white and blue card.
What You Should Know
- Your Medicare card will arrive in the mail in about 30 days.
- It will be mailed to the address Social Security has on file for you.
- If you need proof that you have Medicare sooner than 30 days, you also can request a letter which you will receive in about 10 days.
- If you need proof immediately for your doctor or for a prescription, visit your nearest Social Security office.
If You Have Moved
- If you have moved and have not reported this to Social Security, you will need to report this change to them before we can process your request.
- If you have moved and have reported this to Social Secuirty recently, you will need to contact them before we can process your request.
How to block access to your personal information
If you want to prevent online and automated telephone access to your personal information, you can block access to your personal information.
Sunday, September 27, 2009
Medicare Part B Explained
The second part of the Medicare program is called Medicare Part B.
Medicare Part B Premiums
Most people have to pay a premium for Medicare Part B. The premium is usually deducted from a Social Security, Railroad Retirement or Civil Service Retirement check. The Medicare Part B premium can also be paid every quarter or through the electronic payment option. Medicare Premiums will be based on income beginning January of 2007.
What is Medicare Part B?
Medicare Part B is a medical insurance provided by the federal government to eligible beneficiaries. The coverage provided by Medicare Part B includes medically necessary doctor's services, outpatient care, and most other services that Medicare Part A does not cover.
What does Medicare Part B Cover?
Medicare Part B covers many services, tests, and preventive treatments that are common among health care patients. However Medicare Part B is still not a 100% insurance coverage plan. Medicare Part B helps cover only the medically necessary services including tests, labs, screenings, exams, lab tests, screening, bone mass measurement is covered every two years, lab Services such as blood tests or urinalysis,colorectal cancer screenings to find any pre-cancerous growths, annual fecal occult blood test, flexible sigmoidoscopy (every four years), screening colonoscopy (every ten years), or barium enema (every four years).
Diabetic screenings are covered by Medicare Part B if you have high blood pressure, dyslipidemia, obesity, or high blood sugar. Diabetic supplies covered include monitors, test strips, lancet devices, and therapeutic shoes. Diabetic self-management training is covered if prescribed by your doctor.
Cardiovascular screenings to help prevent heart attack or stroke are covered by Medicare Part B. A screening consists of testing your triglyceride, lipid, and cholesterol levels every five years.
Doctor, Hospital and Home Health Care
Home health services include only medically necessary part-time care and services such as skilled nursing care, physical or occupational therapy, home health aide service, speech language pathology, and medical social services. Medicare Part B also includes certain home use medical equipment such as wheelchairs, hospital beds, walkers, oxygen equipment, and other medical supplies.
Chiropractic services will be covered by Medicare Part B if it is to correct one or more of the bones that has moved out of place in your spine subluxation. Ambulance services are covered by Medicare Part B if any other form of transportation would endanger your health. Blood that you receive during an outpatient visit or another Part B covered service. Clinical trials may be covered by Medicare Part B if it will help to diagnose, prevent, or treat diseases.
Ambulatory surgery center fees are covered by Medicare Part B for approved services. Emergency room services for bad injuries, severe illness, or any time you believe your life is in danger. Doctor services do not include routine physical exams except the one time "Welcome to Medicare" exam.
Eyeglass coverage is limited to one pair of glasses and standard frames after cataract surgery.
Preventive Shots
Flu shots are covered by Medicare Part B one time per year during flu season.
Three hepatitis B shots are covered by Medicare Part B if you are at medium or high risk.
Additional services covered by Medicare Part B include hearing and balance exams,mammograms, dialysis, pap tests or pelvic exams, mental health care, medical nutrition therapy, hospital services, occupational therapy, outpatient surgery service and supplies, limited prescription drugs, practitioner services, physical therapy, prosthetic devices, and transplant services.
Medicare Part B Premiums
Most people have to pay a premium for Medicare Part B. The premium is usually deducted from a Social Security, Railroad Retirement or Civil Service Retirement check. The Medicare Part B premium can also be paid every quarter or through the electronic payment option. Medicare Premiums will be based on income beginning January of 2007.
What is Medicare Part B?
Medicare Part B is a medical insurance provided by the federal government to eligible beneficiaries. The coverage provided by Medicare Part B includes medically necessary doctor's services, outpatient care, and most other services that Medicare Part A does not cover.
What does Medicare Part B Cover?
Medicare Part B covers many services, tests, and preventive treatments that are common among health care patients. However Medicare Part B is still not a 100% insurance coverage plan. Medicare Part B helps cover only the medically necessary services including tests, labs, screenings, exams, lab tests, screening, bone mass measurement is covered every two years, lab Services such as blood tests or urinalysis,colorectal cancer screenings to find any pre-cancerous growths, annual fecal occult blood test, flexible sigmoidoscopy (every four years), screening colonoscopy (every ten years), or barium enema (every four years).
Diabetic screenings are covered by Medicare Part B if you have high blood pressure, dyslipidemia, obesity, or high blood sugar. Diabetic supplies covered include monitors, test strips, lancet devices, and therapeutic shoes. Diabetic self-management training is covered if prescribed by your doctor.
Cardiovascular screenings to help prevent heart attack or stroke are covered by Medicare Part B. A screening consists of testing your triglyceride, lipid, and cholesterol levels every five years.
Doctor, Hospital and Home Health Care
Home health services include only medically necessary part-time care and services such as skilled nursing care, physical or occupational therapy, home health aide service, speech language pathology, and medical social services. Medicare Part B also includes certain home use medical equipment such as wheelchairs, hospital beds, walkers, oxygen equipment, and other medical supplies.
Chiropractic services will be covered by Medicare Part B if it is to correct one or more of the bones that has moved out of place in your spine subluxation. Ambulance services are covered by Medicare Part B if any other form of transportation would endanger your health. Blood that you receive during an outpatient visit or another Part B covered service. Clinical trials may be covered by Medicare Part B if it will help to diagnose, prevent, or treat diseases.
Ambulatory surgery center fees are covered by Medicare Part B for approved services. Emergency room services for bad injuries, severe illness, or any time you believe your life is in danger. Doctor services do not include routine physical exams except the one time "Welcome to Medicare" exam.
Eyeglass coverage is limited to one pair of glasses and standard frames after cataract surgery.
Preventive Shots
Flu shots are covered by Medicare Part B one time per year during flu season.
Three hepatitis B shots are covered by Medicare Part B if you are at medium or high risk.
Additional services covered by Medicare Part B include hearing and balance exams,mammograms, dialysis, pap tests or pelvic exams, mental health care, medical nutrition therapy, hospital services, occupational therapy, outpatient surgery service and supplies, limited prescription drugs, practitioner services, physical therapy, prosthetic devices, and transplant services.
Medicare Part A Explained
One part of the Medicare program is called Medicare Part A. Most people do not have to pay a premium for Medicare Part A because the individual paid Medicare taxes while working.
What is Medicare Part A?
Medicare Part A is a type of hospital insurance provided by Medicare. The coverage provided by Medicare Part A includes inpatient care in hospitals, nursing homes, skilled nursing facilities, and critical access hospitals. Medicare Part A does not include long-term or custodial care.
Private insurance companies handle the claims for the Medicare Part A plan that act as agents for the federal government in processing and paying Medicare claims.
What does Medicare Part A Cover?
Medicare does not cover everything, nor does it cover the total cost for many of the covered services or medical supplies. Coverage amounts are based on which Medicare plan you have. Medicare Part A helps cover only the medically necessary services below:
Blood Transfusions
This is blood that you receive during a covered stay in a hospital, critical access hospital, or a skilled nursing facility.
Hospital Stays
Medicare Part A covers hospital stays, which includes a semi-private room, meals, general nursing, and some hospital services and supplies. Inpatient care in critical access hospitals and mental health care are also covered. Hospital stays must be at least 3 days. The time begins the first midnight after admission and does not include any hours on the discharge date.
Nursing Home or Skilled Nursing Facility
Nursing home or skilled nursing facility stays must be related to diagnosis during a hospital stay. A nursing home or skilled nursing facility stay includes a semi-private room, meals, and rehabilitative and skilled nursing services and care.
The coverage is limited to a maximum of 100 days in a benefit period. The first 20 days are paid in full, and the remaining 80 days will require a co-payment. Medicare Part A will not cover long-term care, non-skilled, daily living, or custodial activities.
Home Health Services
Home health services include medically necessary part-time care and services including skilled nursing care, physical or occupational therapy, home health aide service, and medical social services. It also includes certain home-use medical equipment and other medical supplies.
Hospice Care
Hospice care is for the terminally ill who have six months or less to live. Coverage includes pain relief and symptom control drugs, medical and support services, grief counseling, and other services. Care is provided by a nearby, Medicare-approved Hospice caregiver who will visit you at your home. Medicare does not cover many of the services that are provided to patients who receive Hospice assistance.
Whatever health care and Medicare insurance coverage you choose, make sure you have a clear understanding of all the Medicare options, Medicare coverage and Medicare premiums.
What is Medicare Part A?
Medicare Part A is a type of hospital insurance provided by Medicare. The coverage provided by Medicare Part A includes inpatient care in hospitals, nursing homes, skilled nursing facilities, and critical access hospitals. Medicare Part A does not include long-term or custodial care.
Private insurance companies handle the claims for the Medicare Part A plan that act as agents for the federal government in processing and paying Medicare claims.
What does Medicare Part A Cover?
Medicare does not cover everything, nor does it cover the total cost for many of the covered services or medical supplies. Coverage amounts are based on which Medicare plan you have. Medicare Part A helps cover only the medically necessary services below:
Blood Transfusions
This is blood that you receive during a covered stay in a hospital, critical access hospital, or a skilled nursing facility.
Hospital Stays
Medicare Part A covers hospital stays, which includes a semi-private room, meals, general nursing, and some hospital services and supplies. Inpatient care in critical access hospitals and mental health care are also covered. Hospital stays must be at least 3 days. The time begins the first midnight after admission and does not include any hours on the discharge date.
Nursing Home or Skilled Nursing Facility
Nursing home or skilled nursing facility stays must be related to diagnosis during a hospital stay. A nursing home or skilled nursing facility stay includes a semi-private room, meals, and rehabilitative and skilled nursing services and care.
The coverage is limited to a maximum of 100 days in a benefit period. The first 20 days are paid in full, and the remaining 80 days will require a co-payment. Medicare Part A will not cover long-term care, non-skilled, daily living, or custodial activities.
Home Health Services
Home health services include medically necessary part-time care and services including skilled nursing care, physical or occupational therapy, home health aide service, and medical social services. It also includes certain home-use medical equipment and other medical supplies.
Hospice Care
Hospice care is for the terminally ill who have six months or less to live. Coverage includes pain relief and symptom control drugs, medical and support services, grief counseling, and other services. Care is provided by a nearby, Medicare-approved Hospice caregiver who will visit you at your home. Medicare does not cover many of the services that are provided to patients who receive Hospice assistance.
Whatever health care and Medicare insurance coverage you choose, make sure you have a clear understanding of all the Medicare options, Medicare coverage and Medicare premiums.
Saturday, September 26, 2009
7 Steps to Medicare Eligibility: Step 7 Get Ready
What should I do now to get ready?
1) Apply for supplemental Medicare insurance if you think you might qualify. If you make less than $16,245 ($21,855 for a couple), you should apply for extra help with costs.
2) Record the names and costs of your current drugs.
3) Talk with your doctor about your drugs. Ask which ones are on the Medicare plans’ drug lists, called formularies. If your drugs are not on the Medicare formularies, ask if the formulary has a drug you can take instead—and how you should switch over to this drug.
4) If you need help with Medicare, ask your family or friends to help you.
1) Apply for supplemental Medicare insurance if you think you might qualify. If you make less than $16,245 ($21,855 for a couple), you should apply for extra help with costs.
2) Record the names and costs of your current drugs.
3) Talk with your doctor about your drugs. Ask which ones are on the Medicare plans’ drug lists, called formularies. If your drugs are not on the Medicare formularies, ask if the formulary has a drug you can take instead—and how you should switch over to this drug.
4) If you need help with Medicare, ask your family or friends to help you.
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