My father, 93, is in a group home in Arizona. It is not licensed for
skilled care. I am being told that he needs skilled care and should be
moved. However, I am also being told that he can stay where he is if I
pay additional money each month. This isn't ringing 'true' with me.
How can I be sure that he needs to be moved for skilled care or if the
facility is looking for more money?

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Clarification of Question by jane101248-ga on 04 Feb 2005 11:35 PST

To clarify: I am fine with paying additional funds for additional
care. That makes perfect sense. What I'm looking for is help in
determining what 'skilled care' entails. I don't want to move him
unless it's absolutely necessary since I'm sure it will be devistating
for him. However, this facility is telling me that they can NOT keep
him because he needs skilled care, then saying to me that they CAN
keep him if I pay more, even though they aren't licensed for skilled
care. Without a medical background, how can I determine his care needs
accurately? He either needs skilled care or he doesn't. I'm
frustrated. His Dr says he's slowly failing which is to be expected -
yet his blood pressure, heart rate, blood sugar, kidney function etc
etc is all within normal ranges. I don't want to move him if I don't
have to. I'm willing to pay additional funds. I'm just concerned that
I'm hearing two different stories from this facility as to his care
needs. I want to make the best decision for him. Thank you!

Hi, Jane

93 is a great age, especially for a man.

Sadly, as we get older, we usually do need more care.

It is reasonable to expect that his carers will seek reimbursement for
any extra care that they are providing.

You may find that it is more attractive to leave your father where he
is (and where presumably he is happy) rather than move him elsewhere.

In any event, any new home may wish to reassess his fees from time to
time consistent with his changing requirements.

Mike

Skilled care is probably defined by the state of Arizona which
presumably licenses these facilities.  This facility may be licensed
as a skilled care facility but chooses to limit how many skilled care
patients it takes on.  Prior to paying more money, I would assure
myself that they are licensed to provide skilled care and in fact have
the employee staffing that can provide that care.

You can probably go online State of Arizona and find out that
information. Some states are sophisticated enough to have advocates
for patients and families  and have complied a a list of skilled care
facilities that are rated based on quality of care.  You may be able
to compare costs of several facilities.  If I were you, I would revamp
my question to perhaps have researchers find out if this facility is
licensed and what services its licensed to provide.  Check out
advocate groups for long term care facilities in Arizona.  Also it
never hurts to see if this facility has ever been sanctioned about it
delivery of care services?   What you want to make sure is that your
93 year old parent is in the most appropriate affordable licensed
facility you can find.

There are numerous levels of care provided by Assisted living and
Skilled nursing facilities. Each level requires specific state
licensure and the fees would escalate with the nursing hours required
for the patient. However, the name of the game in this industry is
"heads in the beds"  most operators will try to keep all patients in
their own facility as long as possible, sometimes at the expense of
the patient.To pay privately for services that the patient could get
covered under the medicare program would drain the patients resources
unecessarily. Those funds may be sorely needed down the road.