I've been doing a little bit of reading on this subject and have discovered this is part of a very grey zone that leaves nurses in a precarious position. While a nurse is protected under good samaritan laws if she helps a stranger on the street those protections do not extend to helping someone at work. At work nurses can follow a care plan as set out by a doctor or NP, but if helping someone they are not contracted to help they place themselves in a difficult position.... suppose that the wound under that "bandaid" becomes infected or is the result of something that needed medical investigation the nurse could be sued for negligence or lose their license to practice.
This problem is exacerbated by the fact that too many IL and AL facilities are accepting residents that require a greater level of care than they are licensed to provide, both because the families are looking to avoid the higher cost of more skilled care and the management is concerned about filling every bed, so the poor nurses see people daily whose needs are greater than they can possibly accommodate.
I would assume that assisted living residents pay more than independent residents, so if nursing assistance is needed by independent residents I would expect there to be a charge. If such help is needed often, perhaps the resident would be better off with the assisted living contract.
yes, @cwillie is giving great info, when my MiL left inpatient hospice when she "stabilized" and went to a skilled nursing facility, it was a big high rise facility in downtown Orlando, it had floors for independent seniors, assisted living floors, and a wing dedicated to skilled nursing. We were fortunate to have a wonderful admissions person who explained what each level of care Could and could NOT do, at the end my husband said if she "gets a paper cut I want ya'll on it", but skilled nursing was $11k a month, and we still had hospice paying for her meds and equipment, the $11k was just for the room/bathing/food/nurses, unfortunately my MiL only stayed there for 9 days before she passed, but we were well informed.
I would advise approaching the admissions coordinator and asking about the varying levels of care that are or are NOT offered, and make of list of things you would like to be covered and if that facility is not able to provide them, can they provide you a list of nearby facilities that will.
BettyRae, what is it you want the nurses to do? Of course they can help with nursing duties, but if it is more than a one time thing then you are expected to pay extra for care. And if you are looking for assistance with things that are not nursing you will need to ask housekeeping or maintenance staff, or some places have a concierge.
My mom just moved to an IL facility that is set up more like an AL facility. It is all one building, not separate apartment buildings; so her neighbor is literally in the room right next to hers. They have a common dining area, where they get 3 meals a day, weekly housekeeping, etc that is included in monthly rent.
For an additional charge, she has home health that comes 3 times a day to give meds and check blood sugars, and they can provide assistance with bathing, etc if needed. I think the RN has to be the one to actually give the insulin injections, or if the elder can inject themselves, the aide can draw up the dosing and basically do everything BUT give the injection. Oral meds are kept in a locked box that only the aides/nurse can access. The home health office is housed in the building so there are aides and a nurse there for most of the day, like 6am-7pm I believe. She has a life alert pendant in case there is an emergency and she needs immediate medical assistance.
In some cases, health insurance will pay for skilled nursing and PT assistance through home health, but mom's insurance said they don't pay for medication management, so she does have to pay the extra charge for that per month. Found out insurance will pay for PT a certain amount per month and weekly skilled nurse visits to do assessment, check vitals, etc.
The one mom is in is owned by Holiday Management. You might check to see if there is one in your area if you think something like that might be a good fit. From what they told me, they own senior facilities in many parts of the country.
At Moms independent living facility the staff wasn’t allowed to put hands on the residents. There were no nurses, no CNAs. If she fell, they’d have to call 911, couldn’t pick her up. Assisted living is a little more hands-on but not much. Even they told me if she fell and “it didn’t look like she was hurt” they could pick her up but really weren’t supposed to. The 1 nurse there would probably put a bandaid on her. So you need to define independent vs assisted ( they are not the same) and what the contract says. This was NY, maybe every state is different. Mom got lots more individual help at her independent living apt with an additional home health aid than she could have at assisted living.
Please DONT CALL THEM NURSES, it’s an insult to those of us who actually are. They are “caregivers.” My mother’s place had a single LPN overseeing several “med techs.” They didn’t provide care and had to call the ambulance if someone fell.
This problem is exacerbated by the fact that too many IL and AL facilities are accepting residents that require a greater level of care than they are licensed to provide, both because the families are looking to avoid the higher cost of more skilled care and the management is concerned about filling every bed, so the poor nurses see people daily whose needs are greater than they can possibly accommodate.
I would assume that assisted living residents pay more than independent residents, so if nursing assistance is needed by independent residents I would expect there to be a charge. If such help is needed often, perhaps the resident would be better off with the assisted living contract.
We were fortunate to have a wonderful admissions person who explained what each level of care Could and could NOT do, at the end my husband said if she "gets a paper cut I want ya'll on it", but skilled nursing was $11k a month, and we still had hospice paying for her meds and equipment, the $11k was just for the room/bathing/food/nurses, unfortunately my MiL only stayed there for 9 days before she passed, but we were well informed.
I would advise approaching the admissions coordinator and asking about the varying levels of care that are or are NOT offered, and make of list of things you would like to be covered and if that facility is not able to provide them, can they provide you a list of nearby facilities that will.
For an additional charge, she has home health that comes 3 times a day to give meds and check blood sugars, and they can provide assistance with bathing, etc if needed. I think the RN has to be the one to actually give the insulin injections, or if the elder can inject themselves, the aide can draw up the dosing and basically do everything BUT give the injection. Oral meds are kept in a locked box that only the aides/nurse can access. The home health office is housed in the building so there are aides and a nurse there for most of the day, like 6am-7pm I believe. She has a life alert pendant in case there is an emergency and she needs immediate medical assistance.
In some cases, health insurance will pay for skilled nursing and PT assistance through home health, but mom's insurance said they don't pay for medication management, so she does have to pay the extra charge for that per month. Found out insurance will pay for PT a certain amount per month and weekly skilled nurse visits to do assessment, check vitals, etc.
The one mom is in is owned by Holiday Management. You might check to see if there is one in your area if you think something like that might be a good fit. From what they told me, they own senior facilities in many parts of the country.
https://www.agingcare.com/articles/difference-between-independent-living-and-assisted-living-168142.htm
See All Answers