If you are seeking home care for your loved one in Texas and not sure where to begin the search.. email Carol@WorkingCaregiver.com, visit our website WorkingCaregiver.com, or visit our Senior Services Network in Texas for home care or other concerns dealing with aging or seniors in Texas.
A Texas hospice team consists of a doctor, a nurse, a social worker, a therapist if needed, a counselor and an aide to provide custodial care. Help with activities of daily living is provided at home or in a Medicare approved hospice facility. Custodial care is always a part of a hospice plan of care and Medicare routinely pays for these services.
I’m not aware of a custodial nursing home in Texas. All nursing homes are by definition skilled care facilities because they have nurses who are skilled care providers. Also, I believe, that not all states license intermediate care facilities which might provide less than 24 hour registered nursing care. “Skilled care patients” in nursing homes are referred to as such because they are receiving payment from Medicare or sometimes payment from private health insurance plans. Practically all nursing home residents have medical needs but Medicare and other insurance plans will only pay for patients that have certain acute medical needs where recovery is anticipated. Patients with chronic medical problems are typically not covered by Medicare but would be covered by Medicaid.
There’s a lot of confusion about ”skilled nursing care” which may come from Medicare. To be a certified Medicare nursing home and receive payments from Medicare a nursing home must meet the Medicare definition of a “skilled nursing facility”. This means there must be registered nurses on duty 24 hours a day, there must be a doctor on call at all times and there must be ambulance service to a local hospital. Medicare may also require additional staffing and facility arrangements to receive certification. It is unfortunate that the word “skilled” is used in this definition. All nursing homes whether they meet the definition of a “skilled nursing facility” or not provide services from a nurse, doctor or therapist and this meets the medical definition of skilled care.
Some states have adopted the same federal criteria for licensing their nursing homes. ”Skilled” definition is the only option for a nursing home. But in some states facilities with lesser services can receive different licensing classes. These might be called intermediate care facilities or “small nursing homes”. If you need help understanding these terms or need help locating a quality skilled care facility in Texas email Carol@WorkingCaregiver.com, WorkingCaregiver.com.
