What Is The Nurse Assessment?
Your mom is in a Skilled Nursing Facility recovering from a broken hip. Everyone has decided it’s time for a move from home to a Senior Living Community. You tour a few places and they say they need to do a nurse assessment before giving you a final price. But you don’t understand as she’s in a place with doctors and nurses that have been assessing her for weeks. Why do they need another assessment? In today’s post we’re talking about the nurse assessment.
Hi and welcome to the blog. We hear this from families all the time…when we are the ones saying okay, now we need to coordinate and schedule a nurse assessment. Families respond with…wait a minute, we already have a nurse assessment from where they live now or from the skilled nursing facility. Why do we need another one?
So today we’re going to talk about the nurse assessment, the different kinds of nurse assessments, and how you pay for them.
First off, a Nurse Assessor can come to you if that’s what’s needed. Secondly, this is a requirement for any one of the services that we’re gonna talk about. I like to call it a roadmap to your loved ones’ care. You won’t be able to get a final price for the service until you have the assessment. Also, the assessments are specific to each type of service. In other words, a nurse providing an assessment for an Adult Family Home has to be licensed specifically to do that. Assessments typically take about an hour, and oftentimes are not covered by insurance, except in the case of a Medicaid assessment, or Medicaid covered In-Home Care.
Here are the types of assessments we’re going to cover:
1. Senior Living Community
2. In-Home Care
3. Adult Family Home
4. Medicaid
Before we compare the different types of assessments, let’s talk about some of the information that’s going to be required of you. First, you’re going to be required to have a doctor sign off on what’s called doctor’s orders. We’ve seen some families actually struggle a little bit with this part of the process especially if their loved one hasn’t been to the doctor in many many months or even years. In this case, you’ll need to schedule a doctor’s appointment. The doctor’s orders include diagnoses, medication and oftentimes the most recent notes or hospital stays. Most doctors are familiar with this type of paperwork.
The next thing you’ll need is a copy of your loved ones ID and insurance cards. Finally, you may have to actually pay out of pocket just for the assessment.
So let’s talk about the Senior Living Community assessment: if you’ve toured a Senior Living community, you know there’s most often a community fee, and this fee typically covers the cost of the community’s nurse assessment. Now each community is different and sometimes they won’t proceed with a nurse assessment until you’ve put down a deposit whether that’s a waitlist deposit or a deposit on an actual apartment. The assessment can be done with either of them going to your loved one. For example, at the beginning of this post we talked about if your mom was in a skilled nursing facility. The community nurse can go to that facility or many times you can bring your loved one to the community for the assessment. It really just depends where you’re at and what your needs are.
Now I have seen community assessments vary widely. Sometimes they’ll do the assessment just based on doctors information. Other times they’ll actually want to meet in person and there are many different ways that the assessment can go but generally it’s a standard list of questions and paperwork. What happens after the nurse assessment is that they’ll put the information into a computer system and the computer system is going to tell them how much time each task requires. That’s giving them a final price that they can then give to you to know how that price is managed, which is sometimes called a point system. Another style of care breakdown is called levels of care, and either way there is no way to get an exact cost until you’ve had this assessment.
For In-Home Care often the first meeting is going to be with the nurse of the In-Home Care agency and now we are talking about regulated licensed private agencies. Sometimes there’s a separate fee for the assessment and other times it’s built into the cost of In-Home Care itself. One of the cool things about In-Home Care is that they may build a binder for your loved one and it’s going to include that care plan. This is because there may be more than one caregiver providing care. It also depends on how often your loved one is receiving care so the binder will have the care plan and that way anyone that comes to provide that care is able to review it and make sure they’re doing everything your loved one needs and wants.
The Adult Family Home assessment is different from the community assessment in that most of the time you hire an independent nurse. I’ve seen the cost of this assessment vary from $400 all the way up to $1000. This is an independent nurse that you’re paying. The benefit is that this is an assessment that you only have to do one time and any of the Adult Family Homes should be able to take this assessment, so your loved one is not meeting with multiple nurses and not requiring their doctor to sign off on multiple orders. That said, there are Adult Family homes that want you to use their nurse and may not even charge you for the assessment but most of the time it’s an independent nurse that’s required.
The final type of assessment we will look at is the Medicaid assessment. Just like we said before, the only way to find out how much Medicaid is going to pay for your loved ones care is to have this nursing assessment. This is an assessment that is specific for Medicaid and during this assessment you also have to specify if you’re looking at an Adult Family Home, a Senior Living Community or In-Home Care services, because there are varying rates for each of the services that Medicaid can provide.
So when you’re looking for Senior Living or considering a specific service like In-Home Care this process can come with a lot of assessments and meetings. Wading through pages and pages of paperwork getting doctors information to each of these places for each of these assessments with your loved one possibly becoming overwhelmed by it all. It’s always a good idea to know which route you’re going to take and narrow down your choices before putting everyone through the work of that assessment. Unfortunately, like we mentioned, that means you won’t know the final cost. In fact, we have a podcast episode that talks about comparing the cost of Senior Living Communities apples to apples and getting the assessment is one step in the process. I’ll put a link to that episode below.
Whichever route you choose, the Community or the Adult Family Home, both of them have to update the assessment within 30 days of your loved one moving in and that’s because the assessment is a snapshot but they are going to get to know your loved one so well that they’ll be able to make any adjustments to that assessment. Also, don’t forget to get a copy of the assessment for your own reference. Keep it handy, review it and make sure that your mom or dad is getting everything that you believe they need. Assessments are reviewed sometimes quarterly, always annually and whenever there is a change.
The process of finding Senior Living or care can definitely be overwhelming and now you know what to expect when it comes time for that Nurse Assessment…to hopefully help make things a little more doable.
If you’d like to check out our blog post in podcast form, be sure to take a listen HERE!
Comparing the cost of Senior Living episode
