A medical assessment is the best way to determine the level of medical care you or your loved ones need. Sometimes a nursing home is the best option. One can enter a nursing home after being discharged from a hospital, from one's own home, or from another skilled nursing facility. The process of entering depends on which of these routes is followed.

Entering a Nursing Home Following Discharge From the Hospital

These are the steps to take when seniors enter a nursing home upon discharge from a hospital.

1. The caretaker or person in charge meets with the hospital social worker or discharge planner to discuss options. Bring the senior's financial information to this first meeting.
2. Depending on the senior's income, a Medicaid application will be filled out immediately. The social worker will help you with the paperwork.
3. With or without Medicaid, the social worker will then arrange for a Patient Review Instrument (PRI) Screen. A PRI is required by law and is valid for 30 days. A PRI determines the level of care and type of facility needed. In addition, the senior's hospital physician will give the social worker a patient summary.
4. The senior and caretaker choose several different nursing homes. Sometimes there's no room at the home of your choice. The social worker will help advise you. Seniors who will pay for their own care will find it easier to be admitted to the nursing home of their choice. Medicare and Medicaid insist that you select several facilities. URMC recommends that you apply to at least 10 nursing homes.
5. The social worker then sends the necessary medical information to the nursing homes selected.
6. Families and/or caregivers should be prepared to tour the chosen facilities without any delay. They may also fill out application forms if they like the facility.
7. When a bed is available in one of the selected nursing homes, the family signs a contract for care. Time is important. Usually, the senior will be transferred from hospital to nursing home within 24 hours. State and federal regulations say that if a nursing home bed is offered but not accepted by the senior, the senior and the hospital could be fined.

Entering a Nursing Home From One's Own Home or Another Senior Living Facility

These are the steps to take when seniors enter a nursing home from their own home or another senior living facility.

1. Arrange for a PRI/SCREEN. A PRI is required by law and is valid for 30 days. A PRI determines the level of care and type of facility needed. A nurse will do the PRI on a fee-for-service basis or it can be paid for by Medicaid. Call Eldersource at (585) 325-2800 for a list of agencies that can do a PRI.
2. Caretakers get a Medical Summary about the senior from the patient's physician.
3. Determine the senior's finances. Apply for Medicaid if necessary.
4. The senior and caretaker need to make realistic choices of nursing homes based on the senior's medical needs and financial resources.
5. Contact the nursing homes of your choice. URMC recommends that you apply to at least 10 nursing homes. After touring as many facilities as you can, apply to those you prefer. Complete the application and give the admissions person a copy of the senior's medical summary and PRI/SCREEN.
6. After applying, follow up. Contact the nursing home admissions coordinator once a week to check on your application.
7. If you want help finding a nursing home for a person in your care, geriatric case managers, social workers, community service organizations, and home health agencies are often very helpful.