Before Moving into Convalescent Hospital

Before Moving into Convalescent Hospital

Welcoming Our Residents

The Move

When discussing the move to a convalescent center, we suggest that you discuss the advantages and disadvantages of the move with the client (patient) and with other concerned persons. It is important that the client is involved in as many of these decisions as possible. If it can be arranged, the client should be encouraged to participate in the details of the actual move, including the disposition of photographs, keepsakes, and other personal possessions. Consideration should be given to having the client bring along some personal items that he or she especially enjoys. We will help guide you in this area.

The Adjustment Period

Every new client undergoes an adjustment period where it becomes especially important to maintain a feeling of continuity with family and friends. The adjustment period may last from six to twelve weeks. By maintaining old relationships, the client’s sense of loss will be minimized.

Some experts believe that a client should be allowed to form an attachment to his or her new home before being taken out on short visits. Others recommend that you take the client on outings as soon as possible, as long as the doctor agrees and insurance coverage is not compromised. Your decision should be based on a number of individual factors, always bearing in mind the comfort and welfare of the client. The doctor and our staff are always available to help you with suggestions.

At Santa Anita Convalescent Hospital we strive to develop a sense of community in order to maintain a high-quality standard of living. This requires a cooperative effort involving clients, family members, and staff. As a friend or family member, you can assist the client by providing personal items needed by the client. Every client is encouraged to wear clothing that is clean, comfortable, attractive and appropriate for individual daily activities. This small effort help assure that each individual has positive feelings about his or her appearance.

Families can help in the following way:

Take a look at the client’s clothing and personal care items. It is important to be sure that the client has enough properly fitting clothing, that are in good condition and suitable for the client’s physical condition and activity choices. Clothing should be able to be laundered in a commercial washing machine.

Providing additional clothing and personal care items whenever needed. Each client should have enough clothing for seven days period.

It is very important to mark all articles with the client’s full name, using a permanent ink marker, large enough to be seen easily. In some cases, you may need to sew in labels. Please do not include room numbers because those sometimes change.

Report all new articles to the charge nurse or the social services person, so they can be entered on the client’s clothing list.

Should you find that an article of clothing is missing, please report it immediately to the charge nurse or to social services.

About Medicare

Medicare may help pay the client’s bill for a limited time if the following conditions are met:

The client was a patient in an acute care hospital for three full days consecutively, during the 30 days prior to admission to our facility.

The client is being treated at Santa Anita Convalescent for the same illness as in the acute care hospital.

The client requires skilled nursing care as defined by Medicare. This means a client must require the services of a licensed nurse on a daily basis for services involving feeding tubes, sterile dressing, etc. Other services, such as therapies that can only be provided on an in-patient basis, are covered for a short period of time. Assistance with bathing, feeding, dressing, toileting etc., are considered to be custodial services and are not covered by Medicare.

The Director of Nursing can provide clients and families with the probable number of days of Medicare coverage, based on Medicare’s guidelines. These projections are subject to change depending on changes in the client’s conditions. All projections should be considered as estimates rather than guarantees.

Your physician must certify that you need skilled nursing or rehabilitation care as an inpatient. The skilled care must be related to the purpose of being admitted to the hospital.

The client must have Medicare Part A coverage.

Medicare Eligibility

If you are 65 or older, you are eligible if you:

  • Receive or are entitled to Social Security or Railroad Retirement Board benefits
  • Or your spouse worked for the government for a certain period of time

If you are under 65, you are eligible if you have been getting disability for 2 years or more under Social Security.

If you have permanent kidney failure, you are eligible regardless of your age.

When Medicare Pays

The first 20 Days: When Medicare covers a client’s stay during the first twenty days, the full room and board charges are paid. If the client was in another convalescent hospital prior to being admitted to our facility, please check with our business office to determine eligibility here.

Days 21 thru 100: If Medicare covers a client’s stay for more than 20 days, the client is responsible for all daily co-insurance charges. Please contact our office for further details. Some private insurance companies will reimburse the client for this daily co-insurance charge.

* Santa Anita Convalescent Hospital does bill Medicare directly for all Medicare-covered services. When Medicare coverage ceases, the client and/or responsible party is notified.

* MEDICAL INSURANCE: We have contracts with many insurance companies, and we will bill them as a service to you. As the responsible party, you are responsible if your insurance company declines to pay for any reason.

About Medi-Cal

Santa Anita Convalescent Hospital currently participates in the Medi-Cal program. Our facility will bill Medi-Cal for services provided if the following conditions are met:

The client provides the facility with a currently approved Medi-Cal card.

The client requires skilled nursing care, as defined by Medi-Cal.

If the Medi-Cal program determines that the client is required to pay a share of the costs, the full amount of this “share of cost” must be paid to Santa Anita Convalescent Hospital in advance at the beginning of each month.

Santa Anita Convalescent Hospital will provide Medi-Cal beneficiaries with all services required by the program at no extra charge. If the client’s physician determines that certain services and/or supplies are medically necessary, but not covered under the medical program, the client is responsible for such charges.

Special Concerns

A client’s social history is very helpful to our staff professionals when assisting the client and family during the adjustment period. You can play an important role here by telling us about the client’s likes and dislikes, what foods are appreciated, his or her past interests and hobbies, talents and whatever else may be important to the client. Feel free to discuss any special request or arrangements which you feel would make the client’s stay more comfortable. Remember, we are here to help.

We realize that we cannot anticipate all your questions or respond to all your needs in these pages. Therefore, we encourage you to ask us any questions you may have so that we can make this period of transition as pleasant and beneficial as possible.

Santa Anita Convalescent Hospital provides equal services to all clients without regard to race, sex, religion or national origin. Our admission and discharge policies are available upon request.

Supplies and Services Included in the Basic Daily Rate for Medi-Cal Residents

Personal hygiene items and services, such as:

  • Denture cleaners
  • Denture adhesives
  • Dental floss
  • Oral cleansing swabs
  • Hair combs and brushes
  • Lotions Shaving soaps/creams
  • Toothbrushes and toothpaste
  • Laundry Tissue wipes S
  • Shaves
  • Shampoos
  • Periodic hair trim
  • Periodic nail trim

Commonly used items of equipment, supplies, and services used for medical and nursing care, such as:

  • Standard wheelchair (not exclusively for individual patient use)
  • Incontinence supplies

Maintenance therapies

  • Range of motion
  • Getting patients out of bed
  • Providing activities
  • Changing position in bed
  • Assisting with self-care and activities of daily living
  • Maintenance of proper body alignment and joint movement

Non-legend drugs, such as:

Aspirin, Acetaminophen and Cough Syrup

Call Santa Anita Convalescent Hospital for Daily RatesDaily Medicare rate: First 20 days paid if not previously used. Day 21 to day 100 paid after co-insurance is met. Medi-Cal: Monthly Share of Cost determined by the state. Accommodations include twenty-four-hour nursing care, complete dietary services, administration of all medications, planned and supervised activities and all other routine services. Medicare and/or Medi-Cal coverage is dependent upon the client’s eligibility for each program, based upon diagnosis, physician’s orders, prior utilization of program benefits and financial status. The client is responsible for charges for all non-covered services and non-routine items.

IMPORTANT LEGAL NOTICE

For Medi-Cal Beneficiaries & the Individuals Who Handle Their Money

Regarding the Amount of Income Determined by the California Medi-Cal Program to be Your SHARE OF COST that Must Be Paid to this Nursing Home & Your Right to Appeal Medi-Cal’s Determination

The payment of your share OF COST as determined by the California Medi-Cal Program is required by law. This obligation applies to anyone who manages uses, receives or controls the resident’s funds.

The amount of the SHARE OF COST that you must pay to this nursing home is determined by the California Medi-Cal program through the Department of Social Services. This amount is not something that this nursing home decided or controls.

If you believe that the SHARE OF COST assigned to you by Medi-Cal is not correct, you may apply for a state hearing (through the Medi-Cal office that is handling your case) for a determination as to the accuracy of the amount of your SHARE OF COST.

You must pay your assigned SHARE OF COST to this nursing home unless there is a final determination by Medi-Cal following your appeal that your amount is incorrect.

The telephone number for the Medi-Cal field office closest to this nursing home is: 626-854-4827

If you have any questions regarding this notice of your legal responsibility to pay your share OF COST, please contact this facility’s business office as soon as possible.

If you have converted from Non-Medi-Cal status to Medi-Cal coverage and you are unsure of the amount of you SHARE OF COST that you must pay to this nursing home, you may obtain an estimate of the amount by contacting the local Medi-Cal office for your county and/or, if you wish, you may also request that this nursing home assist you in obtaining information regarding the amount of your share OF COST.

If for any reason, you become ineligible for Medi-Cal benefits, you will be responsible for paying the private rates for care at this nursing home.

Willful failure to pay the share of the cost, unless exempted by law, is a misdemeanor punishable by a fine not to exceed $2500.00 or imprisonment in the county jail not to exceed 180 days or both

  • Phone:(626)-579-0310
  • Fax:(626)-350-2107

The information contained in these resources is merely the opinion of Santa Anita Convalescent Hospital is not intended as a warranty, guarantee, or to be relied upon as fact. You are encouraged to conduct your own independent investigation and research and draw your own conclusions. Please visit www.medicare.gov for more information.

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