We know that choosing a health care company that provides proper care is not an easy task. We recommend contacting one of our highly qualified staff members to answer all questions regarding your specific health care needs. Our team will provide an evaluation and recommend all available options that will provide the best care for you and your loved ones.

This section of our Website will continuously be updated with questions and answers that are beneficial to the care you are looking for.

Thank You for visiting us online! We look forward to meeting you in person.

How will I pay for my skilled nursing stay?
Generally, if you quality for Medicare benefits, Medicare A provides payment for post-hospital care in skilled nursing facilities (SNFs) for up to 100 days during each spell of illness. A "spell of illness" begins on the first day a patient receives Medicare-covered inpatient care and ends when the patient has been discharged from skilled care for 60 consecutive days. Medicare should pay for skilled nursing care if:

• The patient was hospitalized for at least 3 days and was admitted to the SNF within 30 days of hospital discharge.
• A physician certifies that the patient requires SNF care.
• The patient requires skilled nursing or skilled rehabilitation services, or both on a daily basis.
• The skilled nursing facility is a Medicare certified facility.

If Medicare coverage requirements are met, the patient is entitled to full coverage of the first 20 days of skilled nursing care. From the 21st through the 100th day, Medicare pays for all covered services excpet for a daily co-insurance amount, which is adjusted annually. For 2009, the co-insurance for days 21-100 is $133.50/day.

In many cases, patients have insurance coverage secondary to their Medicare benefits. Depending upon the patient's plan, this insurance may cover the co-insurance amount for days 21-100. If a patient has a Medicare Advantage plan, there may be varying deductibles depending upon that plan's coverage. Each patient is responsible for services not covered by their private insurance.

Visit the Centers for Medicare and Medicaid Services for more information on eligibility requirements: http://www.cms.hhs.gov/

Medicare B generally covers outpatient therapy services if a physician orders the services. In most cases, Medicare B covers 80% of outpatient services, with secondary insurance covering the remaining 20%. Individual insurance plans have varying coverage and deductibles, patients are encouraged to research their plan's coverage.

Generally, Medicare does not pay for long term care (LTC). Medicare only covers medically skilled nursing facility or home health care. Most LTC is to assist people with support services such as activities of daily living like dressing, bathing and using the bathroom. Medicare does not pay for these types of services which are called "custodial care". Few insurance plans provide LTC coverage. People requiring LTC generally pay privately for the monthly rate or receive Medicaid. Medicaid is a State and Federal Government program that assists people with low incomes and limited assets. Visit Montana's Department of Public Health and Human Services to learn more about Montana Medicaid eligibility and application:
http://www.dphhs.mt.gov/programsservices/medicaid.shtml

Bozeman Health & Rehabilitation Center's Social Services Department and Business Office will work with each patient and their family to educate each resident on their specific coverage and assist with applying for necessary assistance.


What should I bring with me during my skilled nursing stay?
Upon admission to a skilled nursing facility, the facility will require copies of Medicare, Medicaid, Social Security and insurance cards, along with any relevant Power of Attorney or Living Will documents. Providing this information prior to or at the time of admission is helpful to the facility. Patients are encouraged to bring items from home which will make their stay more comfortable. Photos, preferred hygiene products and comfortable clothes can all help a patient to feel more "at home". Comfortable clothes are the most appropriate for therapy sessions. If a patient chooses to have the facility launder their clothing, initials should be written in permanent ink on the inside of each garment. Each resident is responsible for furnishing and maintaining his/her own clothing and other items of personal property as needed or desired. The resident may obtain, at his/her own expense, casualty insurance to cover potential damage to or loss of any resident personal property.

If the resident's personal property is not claimed or removed within 24 hours or the resident's permanent discharge, the facility places the personal property in storage until claimed. If the resident's personal property remains unclaimed for 30 days after discharge, the facility may dispose of resident property.

Resident medications, even over-the-counter medications, must be dispensed by the Nursing Department, unless specifically care-planned by the facility and the resident's physician. No drugs or medications may be brought into the facility unless they are delivered to the nurse's station. The resident understands his/her diet is medically prescribed and must be monitored by the facility. Residents must agree to consult with Nursing or Dietary staff regarding food or beverages brought into the facility.

Pet visitors are encouraged at Bozeman Health & Rehabilitation Center. For the safety of our residents, we require all pet visitors to have vaccination records on file at the facility. Residents may choose to deposit personal funds with the facility which can be withdrawn at any time. The funds are deposited into a designated trust account maintained by the facility in accordance with federal and state requirements. Every resident's funds in excess of $50.00 are kept in an interest-bearing account as required by law. The facility provides the resident or resident's authorized representative periodic account statements.


What is a Living Will?
A living will is a legal document that a person uses to make known his or her wishes regarding life prolonging medical treatments. It can also be referred to as an advance directive, health care directive, or a physician's directive. A living will should not be confused with a living trust, which is a mechanism for holding and distributing a person's assets to avoid probate. It is important to have a living will as it informs your health care providers and your family about your desires for medical treatment in the event you are not able to speak for yourself.

The requirements for a living will vary by state so you may want to have a lawyer prepare your living will. Many lawyers who practice in the area of estate planning include a living will and a health care power of attorney in their package of estate planning documents. If you need to write or update a will or trust, you can take care of your living will at the same time.

Generally, a living will describes certain life prolonging treatments. You, the declarant, indicate which treatments you do or do not want applied to you in the event you either suffer from a terminal illness or are in a permanent vegetative state. A living will does not become effective unless you are incapacitated; until then you'll be able to say what treatments you do or don't want. They usually require a certification by your doctor and another doctor that you are either suffering from a terminal illness or permanently unconscious before they become effective as well. This means that if you suffer a heart attack, for example, but otherwise do not have any terminal illness and are not permanently unconscious, a living will does not have any effect. You would still be resuscitated, even if you had a living will indicating that you don't want life prolonging procedures. A living will is only used when your ultimate recovery is hopeless.

For situations where you are incapacitated and therefore not able to speak for yourself, but your health is not so dire that your living will becomes effective, you should have a health care power of attorney or health care proxy.

Living Will Resources:
American Medical Association
(800) 621-8335
www.ama-assn.org

Health Care Decisions
(602) 222-2229
www.hcdecisions.org

Partnership for Caring
(800) 989-9455
www.partnershipforcaring.org

The U.S. Living Will Registry
(800) 548-9455
www.uslivingwillregistry.com


What is Power of Attorney?
A Power of Attorney is a document that allows you to appoint a person or organization to handle your affairs while you're unavailable or unable to do so.

General Power of Attorney - authorizes your Agent to act on your behalf in a variety of different situations.

Special Power of Attorney - authorizes your Agent to act on your behalf in specific situations only.

Health Care Power of Attorney - allows you to appoint someone to make health care decisions for you if you're incapacitated.

"Durable" Power of Attorney -The general, special and health care powers of attorney can all be made "durable" by adding certain text to the document. This means that the document will remain in effect or take effect if you become mentally incompetent.

Revocation of Power of Attorney - allows you to revoke a power of attorney document


What if I have a complaint?
Each resident has the right to express grievances without discrimination or reprisal. If the resident or the resident's representative believe(s) that the resident is being mistreated or rights have been violated by staff or another resident, the resident or resident's authorized representative will make their concerns known to the facility's Director of Nursing or Executive Director. The facility will promptly review and investigate the concern and provide a timely response to the resident and resident's authorized representative in accordance with our grievance procedure. The resident has the right to contact state representatives concerning grievance procedures.

The Long Term Care Ombudsman is an advocate for all residents of LTC facilities, especially nursing homes and personal care homes. The Ombudsman can provide information or direct assistance related to the health, safety and rights of residents.

Federal Resident Rights

STATE LONG TERM CARE OMBUDSMAN
Kelly Moorse Office on Aging/DPHHS
(406) 444-7785 or 1-800-332-2272
P.O. Box 4210
Helena, MT 59604
kmoorse@mt.gov

ASSISTANT STATE LONG TERM CARE OMBUDSMAN
Traci Clark Office on Aging/DPHHS
(406) 444-6995 or 1-800-332-2272
P.O. Box 4210
Helena, MT 59604
trclark@mt.gov


Local Ombudsman: Peggy Tombre
Serving Gallatin and Park County
Bozeman Senior Center
807 N Tracy
Bozeman MT 59715
(406) 522-8976
ptombre@montanadsl.net

Local Ombudsman: Pam Cooper
Serving Gallatin and Park County
*pending Ombudsman Certification
PO Box 1563
Bozeman, MT 59771
(406) 581-6309
pcooper@rmdc.net