ElderPerfect a leading publisher on senior healthcare across the United States, today announced the recipients of the Best Hospices for 2020. These awards are designed to recognize providers based on their ability to consistently deliver excellence in the areas of Health Inspections, Quality of Residence Care, Penalties and Staffing. We’ve identified 3,788 facilities that meet our top rating. This report marks the Gold Standard in terms of care for seniors.
Standard vs. Best Facilities
Every year, the government assigns inspectors to conduct a formal review of hospice facilities for regulatory purposes to meet the mandates outlined for Medicare and Medicaid, this aims to measure and improve the safety of residents across providers. Facilities may also be inspected when complaints are submitted or based on a reported incident. When noncompliance is identified, the facility is served a citation that indicates which regulation that was identified, along with the severity of the incident. hospice facilities are subsequently required to execute a program of resolution in order to meet compliance. Some scenarios require enforcement actions to be applied, such as a civil monetary penalty or withholding of payment(s), to incentivize resolution in a timely manner.
Facilities are applied 2 types of penalties due to non-compliance / accumulation of incidents. Civil penalties are monetary fines that may be applied to a facility based on citations / infractions identified during a review. The severity of a penalty is defined primarily by the size and frequency of the infraction.
Quality of Residence Care
There are 3 types of resident care ratings, but for this exercise, we primarily focused on the overall quality measure rating. The quality measures (QMs) include 17 data points that are derived from clinical information reported by the respective hospice facilities and also from Medicare claims data submitted for payment. Ratings are calculated for the QM domain using the 4 most recent quarters for which data are available. A hospice facilities receives points contingent on performance on each measure (weighting distribution is not equal).
Staffing research is submitted regularly by the facility and is adjusted for the requirement of the facilities residents. For each of registered nurse staff and total staffing, a 1 – 5 rating is applied according to definitions established for each category. These ratings are subsequently combined to assign an overall staffing rating. As an example, to get an overall staffing rating of 5 stars, nursing homes must earn a rating of 5 stars for both registered nurses and total staffing. hospice facilities could also be assigned a 1 star rating should they not have a registered nurse on-site daily, and do not submit staffing data, or which the data cannot be verified.
Future of Senior Care
From 2010 to 2020, the United States needed to add 400,000 Registered Nurses along with 500,000 Nurse Aides to keep up with the demand. This increase has subsequently impacted the pay on staff, which impacts the costs to residents. Other factors that are impacting the overall costs of healthcare include the amount of overtime registered by facilities with relatively low volumes of staff available.
Occupancy over the next decade for senior care facilities is expected to grow due to the “baby boomer” generation reaching the maturity of 65 by 2030.
Since Medicare does not provide a long-term care component. When conditions are met, Medicare offer limited coverage (100 days of coverage per benefit period) for applicants. Considering that long-term care is not covered, the program will not pay for assisted care related costs. This is why financial planning for extended care should take place long before the requirement surfaces. Some insurance, such as employer-provided or private health insurance plans can reduce the cost of extended care. However, if these policies aren’t in place before a serious event occurs, they tend to not become available to potential recipients.
Should you find an immediate requirement for nursing care and don’t have an insurance plan available, there are still options to help reduce the burden. In 2019, a private room cost an average of $102,200 per year, or $8,516 per month (according to medicare.gov). A semi-private room was only 12% less at around $90,155 per year. Geography has a major part to play and the state-by-state price guide can be found at the link below.