How will my nursing home stay be paid for?

There are four basic ways in which a nursing home stay are paid.  They are:

• Medicare provides for Skilled Nursing Coverage under very specific conditions.  First, you must have a 3-night hospital stay in order to quality.  Second, your doctor must order some kind of skilled service (i.e. physical, occupational and/or speech therapies; IV medications; wound care; etc.).  Last, you must have skilled nursing days remaining in your benefit period.  Medicare can potentially pay for up to 100 days in a nursing facility – however, Medicare coverage will stop at any point during the100 day benefit period if the skilled nursing service is no longer needed.  The first 20 days of the benefit period are covered at 100% of the cost for services.  Starting on day 21 of a Medicare covered stay, there is a co-payment amount that is the responsibility of the individual.

• Private Insurance provides payment for some beneficiaries who do not qualify for Medicare coverage.  Typically, a private insurance policy requires pre-authorization or pre-certification prior to admission to the nursing facility.  The amount of payment is based on the terms of the individual policy and is usually requires that a skilled service is provided using the same criteria that Medicare uses.

• Self-Payment is when the individual does not have Medicare or Private Insurance; has a co-payment for a Medicare stay that exceeds 20 days; or no longer qualifies for payment by Medicare of Private Insurance, but is not able to return home or to another type of living (i.e. Assisted Living/Personal Care).  In this situation, the individual is responsible for paying the costs associated with staying in the nursing home.

• Medicaid is a program that pays for the stay of individuals who would normally need to self-pay for their stay, but do not have the financial resources to do so.

How do I apply for Medical Assistance?

If you need nursing care services and do not have coverage through Medicare or private insurance and do not have the financial resources to pay for your stay, a Social Worker from the facility will assist you in applying for Medical Assistance. This involves:

• An assessment by the Office of Aging to determine the appropriate level of care to meet your needs.  (This step is sometimes completed before leaving the hospital.)
• Completion of an application (available at the nursing facility) which is submitted to the State Department of Public Welfare (DPW) in Harrisburg. 
• After your application is processed, your responsible party will receive a letter arranging an appointment at the local DPW office.  They will be asked to bring certain documents to verify the amounts and locations of your assets.  Following this appointment, the state will make a decision about your Medical Assistance eligibility. 

Are you required to have a certain number of staff? 

State and federal regulations specify some basic levels of staffing that are required for nursing facilities.  Maple Farm’s staffing meets or exceeds those regulations.

Do I have to have a roommate in your facility?

Maple Farm does have several private rooms; however, there is usually a waiting list for these rooms.  Medicare pays for semi-private (two residents) rooms only.  If you are receiving Medicare coverage and wish to have a private room, you are required to privately pay the difference between the Medicare semi-private rate and the cost of the private room.

What kind of activities do you have?

There are several activities (coffee hour, sittercize, bingo, and sing along, to name a few) that happen on a daily or weekly basis.  We also have many special events, like entertainment (our “Young Frank Sinatra” is always popular), seasonal crafts, ice cream socials, and special service projects.  There are several local churches that lead worship and Bible studies on Sunday. 

How do I know that my special diet is being maintained?

When new residents are admitted to Maple Farm, their physician orders a diet based on their health needs.  We have a registered dietician that oversees the administration of physician ordered diets, and makes changes and suggestions based on individual needs.  Shortly after admission, a member of our dietary staff meets with residents and/or family members to discuss food preferences. 

What kind of clothes do I need?  How does my laundry get done?

As far as clothing is concerned, our recommendation is that residents bring and wear what is comfortable for them.  This is your home; be comfortable!   If you are participating in therapies; we recommend good sturdy shoes, and clothes that can be exercised in.  Laundry can either be done by the facility (for a minimal weekly charge) or it can be taken home and done by the family.  Either way, all articles of clothing need to be clearly labeled with the resident’s name. 

What are your visiting hours?

Visitors are welcome at anytime; however, our doors are locked after 8:00 PM to ensure the safety of our staff and residents.  There is a doorbell/intercom at the main entrance that can be utilized if you arrive after the door is locked at night.