What is the visitation policy?
Residents enjoy and appreciate frequent visits by family and friends. General visiting hours are daily from 8am to 8pm, however, we will accommodate family visits at any time. If this schedule is not convenient for family or friends, or if there is a need to visit a resident at a time other than regular times, please contact your nurse so alternate arrangements may be made.
We recognize the benefit of children visiting the residents and we encourage this. For the safety and comfort of all residents, please ensure children are under the supervision of an adult throughout the visit.
Pets also hold an important place in many of our residents’ lives. We encourage families to include the family pet when visiting a resident. Please make sure they are on a leash at all times.
For the health and well-being of our residents, please refrain from visiting if you have, or are showing the signs of, any infectious disease.
Payment Related Information
Can I private pay for my loved ones care?
If you will be paying for your care on a private pay basis, you must pay the Basic Rate in full and in advance each month. In addition, you must pay for all charges upon receipt of an invoice, as well as any applicable co-payments incurred during the preceding month that are billed under Parts A and B of the Medicare program. A complete list of items and services that may be provided by the campus and their corresponding charges will be given to you during your admission paperwork process.
Do I need to provide proof of Health Insurance?
At the time of admission to BrookHaven all residents must provide information regarding their health insurance coverage, if applicable. At this time, the campus makes a copy of any insurance cards, including prescription cards. You must notify the Business Office of any changes in health insurance coverage so we can continue to provide services in an efficient manner. You are responsible for maintaining medical and health insurance and for completing claims with respect to medical expenses.
What is Medicare?
Medicare is a federal health insurance program for people 65 and over and certain disabled people under 65. It does not provide a comprehensive long term care component. Medicare covers only those skilled nursing facility services rendered to help a beneficiary recover from an acute illness or injury. Medicare is administered by the government’s Center for Medicare and Medicaid Services (CMS) and is divided into two parts: Hospital Insurance (Part A); and Medical Insurance (Part B).
What is Medicare Part A?
Skilled nursing facility coverage falls under Part A of Medicare and is very limited. If certain conditions are met, Medicare only pays fully for the first twenty (20) days of care in a skilled nursing facility (SNF). For the 21st through the 100th day, the Resident must share, or co-pay, for the cost of care by paying a daily coinsurance rate which changes yearly.
The following conditions must be met in order for Medicare to pay for SNF care:
- You must have been admitted for at least three (3) consecutive days in the hospital. When determining if this qualification has been met, the day of admission will be counted as a hospitalized day; however, the day of discharge will not be counted.
- Your admission to the SNF must have occurred within thirty (30) days after your discharge from the hospital.
- A physician must have certified that you need SNF services for the same or related illness for which you were hospitalized.
- You must require continuous skilled nursing care or skilled rehabilitation services (as defined by the federal government) on a daily basis. That is, the services you require must be so inherently complex that they can only be performed utilizing the skills of professional or technical personnel, or furnished under their direct supervision.
If any of the foregoing conditions are missing, then Medicare Part A will NOT pay for your stay at our campus.
If you meet the requirements of coverage for Medicare Part A benefits, you may elect to request Medicare payment, or you may refuse to request Medicare payment and pay for your services via some other source.
If you do not meet the requirements of coverage for Medicare Part A benefits either at the time of admission or readmission or at any point thereafter, you will be issued a Medicare Benefit Denial Letter. This letter will explain why BrookHaven believes your services will not be covered, and that a bill will not be submitted to Medicare, unless specifically requested to do so.
What is Medicare Part B?
Medicare Part B may help pay for covered services that you receive from your doctor while at BrookHaven, if you have chosen to participate in the Part B medical insurance program.
If you have exhausted your Part A coverage for a spell of illness, Part B may also cover a portion of services received at BrookHaven, such as physical and occupational therapy. Please note, however, Medicare imposes financial limitations (“caps”) on how much physical, occupational, and speech therapy a beneficiary can receive in a calendar year. There are certain exceptions to the caps, but to the extent the exceptions do not apply, you will be responsible for paying all therapy you receive if you exceed your cap.
Under the Part B program, you must pay an annual premium and a deductible for all Part B services, including physician services, after which Medicare pays 80 percent of the fee screen for covered services.
If you have any questions regarding Medicare coverage, please contact the Business Office.
What is Medicaid?
Medicaid is a joint federal-state program designed to provide health care assistance to low income people. Eligibility for Medicaid is made by the government based on certain criteria, such as a very low number of resources. If approved for Medicaid, the government will pay for certain covered items.
What is covered by Medicaid?
Medicaid does not pay for all services and supplies you may want
A common misconception is that Medicaid pays completely for all services and supplies that a resident receives in a nursing facility. This belief is not true. Medicaid only pays for the following services and supplies:
- Routine nursing care
- Room & Board
- Medically related Social Services
- Housekeeping & Laundry
- Routine personal hygiene items
- Medical Supplies
- Central Supplies
- Physical Therapy
- Occupational Therapy
- Speech Therapy
- Nutritional Therapy
- Oxygen & Oxygen Supplies
- Certain Medications
- Laboratory Services
- Radiology Services
- Physician Services
Thus, if you wish to purchase items or services such as personal care/comfort items (including, without limitation, private telephone expenses, beauty/barber services, television, radio, newspapers, novelties and confections, etc.) you will need to purchase these with your own money. Medicaid provides a minimal monthly allowance in order to purchase these types of items, which is referred to as your Personal Needs Allowance (PNA).
Medicaid does not pay for the full cost of services and supplies you receive.
Another common misconception is that Medicaid pays 100% of the charges for services and supplies that you receive. This is not true. When determining your eligibility, the government will look at all of your income, assets and resources to come up with an amount that if believes you should be able to contribute to your care on a monthly basis. This “personal liability amount” is then deducted from the payments that Medicaid makes to BrookHaven for your care.
You are responsible for paying BrookHaven the personal liability amount each month. Since under the Medicaid program all of your income must be used to pay for the services and supplies you receive at BrookHaven, we have found that it is administratively easier for you and us to assign that income directly to BrookHaven. That is, since you would have to sign over all checks that you receive to BrookHaven each month anyway, it is easier and more efficient to have those checks come directly to us in the first place. If you do this, then all of your basic care will be paid for and you will not have to worry about making monthly payments for Basic Services.
How do I apply for Medicaid?
Notification for Advance Planning. You must notify BrookHaven when your resources reach $15,000. In addition, If you do not have monthly income sufficient to pay for the cost of care and services, then you must apply for Medicaid or promptly make other arrangements to pay for your continued stay at BrookHaven when your resources reach $5,000.
Improper Transfers. When applying for Medicaid, the government may examine all transfers of property and resources that you have made (or were made on your behalf) and all trusts created for the previous five (5) years, to determine if any improper transfers were made.
The government presumes any transfer of property or resources in the look-back period is improper if the transfer made you Medicaid-eligible, divested you of proceeds that would be available if the property were sold, or if you transferred incoming producing property or resources. If an improper transfer of your resources was made, then you will not be eligible to receive Medicaid assistance for a designated period of time. Examples of improper transfers could include: the transfer of your house, care and other personal property, the transfer of your bank accounts, stocks or bonds, the transfer of real estate, and the creation of certain trusts.
In the event your eligibility for Medicaid benefit is denied, interrupted or terminated for any reason, including due to the government’s determination that improper transfers of resources were made, then you must make alternative arrangements to ensure BrookHaven is paid. If you fail to pay your changes in full in this circumstance, your Admission Agreement may be terminated and you may be discharged from BrookHaven.
Continued Payment to Facility During Application Process. A common misconception is that once an application for Medicaid is made, you do not have to continue to pay for the care we provide. This is not true. The filing of an application does not excuse you from continuing to make payment to us in accordance with the terms of your Admission Agreement. This is why it is important to begin the application process early.
All Income Sources & Medicaid
If you are (or will become) a recipient of Medicaid benefits, then all of your income must be turned over to BrookHaven to pay for your care. For example, you may be currently receiving Social Security benefits and/or a recipient of Supplement Security Income (SSI) for which you (or a representative payee on your behalf) receives payments from the Social Security Administration (SSA). If you are receiving such benefits, then since the total amount of Social Security and/or SSI payments must be paid over to BrookHaven for your care, we ask that these payments be made directly to BrookHaven.
Please contact the Business Office Manager for an appointment to obtain more specific information regarding Medicaid and its application process.
What is a Personal Needs Account?
A personal Needs Account (“PNA”) for residents can be arranged through the Business Office. A PNA is an account or petty cash fund that holds the money of a resident and that BrookHaven manages for the resident. A PNA is intended for the use by the resident for the purchase of items or services of their choice. The PNA should have a sufficient balance to cover expenses and at no time can the account have a negative balance.
When are late fees assessed?
If any charge or fee is not paid within 10 days of when such payment is due, interest will be charged to the unpaid balance.
What are the financial responsibilities of a Representative?
During the term of your residency, you made need assistance in arranging for payment for the services provided. Upon admission to our facility, you identified a person who has legal authority to act on your behalf to satisfy your financial obligations under your admission agreement if you choose not to, or unable to, meet those obligations. The Representative is not responsible for paying your care from his/her own resources, but rather is only responsible to pay for your care from your income, resources and assets. You will be primarily responsible for making payments to our facility until such time as you assign the responsibility for making payment to your Representative or until you can no longer make payments on your own behalf; at such time, the Representative shall become primarily responsible for making such payments from your income/asset resources.
Services Related Information
What is covered with Nursing Services?
Nursing and nurse’s aides work in BrookHaven seven (7) days a week, twenty-four (24) hours. These staff are assigned to provide reasonable nursing and personal care as is customary in a nursing home. Thus, while staff are always present in BrookHaven, they are not always providing care to you. The services you have purchased pursuant to your Admission Agreement are not one-to-one, seven days a week, twenty-four hours per day services. If you would like such extraordinary nursing services, you may contract for such services separately. (See the section on “Private Duty Personnel” in this Handbook for more information.)
What is your policy on Tuberculosis Testing?
All new residents who have not had previously known significant tuberculin tests and do not have a history of past active disease will have a 2-step tuberculin test performed upon admission unless there is documentation that has been performed within a ninety (90) days preceding admission. Those person with positive tuberculin skin tests will have an admission chest x-ray. If a resident is exposed to a known case of tuberculosis, he/she shall have a single tuberculin skin test repeated, and if there is evidence of conversion, shall have a chest x-ray performed within thirty (30) days. If the chest x-ray does not reveal active tuberculosis, the physician will document the patient is receiving appropriate preventative treatment or treatment is contraindicated.
What is your policy on selecting an attending physician?
BrookHaven does not employ medical doctors for the purpose of providing attending physician services for our residents. Thus, you may choose an attending physician of your choice so as long as such physician is licensed in the State of Ohio and meets all of our credentialing requirements.
If you do not designate an attending physician, if such physician is not available, or if such physician is not appropriately licensed or credentialed, we will assign an attending physician to you – until such time as you make a different choice.
The physician visits are scheduled at least once every thirty (30) days during the first ninety (90) days following admission and at least every sixty (60) days thereafter. If you need assistance in obtaining a physician, please contact your social worker.
What dental services are provided?
For the convenience of our residents, BrookHaven has identified a dentist(s) who is licensed to practice dentistry in the State of Ohio, and who is willing to make periodic visits to BrookHaven to provide dental treatment based upon the needs of our residents. You may elect to make arrangements to use the services of either this dentist(s) or another dentist of your own choosing. If you choose another dentist, he/she must be licensed in the State of Ohio and meet all of our credentialing requirements.
What podiatry services are provided?
For the convenience of our residents, we have identified a podiatrist(s) who is licensed to practice podiatry in the State of Ohio, and who is available to provide services to our residents if their attending physician determines they have a need for podiatric services. If you need such services, you can elect to receive services from this podiatrist(s) or one of your own choosing. If you choose another podiatrist, he/she must be licensed in the State of Ohio and meet all of our credentialing requirements.
What optometry services are provided?
For the convenience of our residents we have identified an optometrist(s) who is licensed to practice in optometry in the State of Ohio, and who is available to provide services to our residents if their attending physician determines they have a need for optometric services. If you need such services, you can elect to receive services from this optometrist(s) or one of your own choosing. If you choose another optometrist he/she must be licensed in the State of Ohio and meet all of our credentialing requirements.
What therapy services are provided?
BrookHaven offers and provided medically appropriate therapy services for the purpose of maintaining and/or improving residents’ functional status. The therapy services are provided by an in-house or contracted therapy company and include physical therapy, occupational therapy, and speech language pathology.
What social services are provided?
Each resident at BrookHaven is assigned to a Social Worker upon admission. Your assigned Social Worker will assess your medically-related social and emotional needs. Your Social Worker can also assist you with many aspects of life at BrookHaven, such as helping you settle in, assisting with Medicaid applications, and coordinating your discharge plan. If you have any questions or concerns, please feel free to contact your Social Worker.
What recreational services are provided?
We offer a variety of recreational programs, both inside the facility and out in the community. Our Activity Department seeks to ensure all residents are provided the opportunity to participate both in group and individualized programs. Common activities include religious services, movies, art classes, pastoral visits, pet visits, guest entertainment and bingo. Upon admission, residents are evaluated by our Activity Department staff to determine their needs, interests and skills. From this evaluated an individualized activity plan is designed. If you have any special programs you would like to participate in and/or see included in the activity schedule, please contact that Activity Department. We also encourage family and friends of residents to participate in activity programs.
A monthly calendar of recreational activities is posted throughout the facility. The recreation staff encourages you to participate in these activities.
What diagnostic services are provided?
Diagnostic services include such things as taking x-rays, conducting modified barium swallows, and laboratory tests. Some diagnostic services may be able to be conducted at BrookHaven. However, a number of services may require transportation to a hospital or outpatient facility. If diagnostic services are required outside of BrookHaven, we encourage you to have a family member accompany you on the visit.
What dietary & food services are provided?
Our Dietary Department creates nutritious meals to meet your individual needs as well as your personal preferences and choice. We encourage you to eat your meals in the dining room, where you can enjoy socializing with other residents.
BrookHaven employs the use of a licensed dietitian and an experienced support staff to provide residents with nutritious and appetizing meals. The Dietitian or designee will contact you soon after your admission to determine your food preferences. This information will then be updated as appropriate throughout your stay. You will find the menu is rotated and provides a degree of choices and seasonal selection. If you have questions regarding the meals, you are encouraged to contact either the Dietary Manager or Dietitian.
Can visitors have a meal with a resident?
For a nominal cost, your family and other visitors are welcome to join you for meals. If visitors wish to have a meal at BrookHaven, arrangements and payment may be made with the Receptionist.
What pharmacy services are provided?
We have contracted with a pharmacy to provide medications to all of our residents. You have the right to choose another pharmacy to fulfill your medication needs if you so desire. Unless you are paying privately for medications, prior to receiving medications from another pharmacy, the pharmacy must enter into an agreement with BrookHaven that sets forth the prices that we will pay for medications and the terms and conditions of the relationship. Any pharmacy providing services at BrookHaven must agree to abide by all lows governing the provision of pharmacy services in a nursing facility, and all of our policies and protocols regarding medication distribution.
All medications and any item used for medical treatment must have a Physician’s order. This includes both prescription and non-prescription (i.e. over-the-counter medications such as Tylenol, aspirin, Ben-Gay, etc.) items. Medications may not be kept in the resident’s room or administered by the resident without the approval of your physician and interdisciplinary team.
Are barber & beautician services provided on-site?
For your convenience, barber and beautician services are available on a regular basis, and care provide a variety of services, such as permanents, styling and basic hair trimmings. Barber/Beautician services are available on an individual basis or on a continuing appointment basis. Please contact the Receptionist (ext. 100) or nurse or Beautician (ext. 118) to make arrangements for hair care services.
What are the costs of the services offered?
Beautician and Barber Prices effective as of January 1, 2015:
Women’s Services Available
Shampoo Only…………………………….$4.00 & up
Shampoo/Blow-dry only……………..$10.00 & up
Haircut Only………………………………..$10.00 & up
Haircut w/ Shampoo & Set…………..$20.00 & up
Shampoo & Set……………………………$12.00 & up
Permanent…………………………………..$40.00 & up
Permanent/Cut……………………………$40.00 & up
Color/Permanent Tint………………….$25.00 & up
Color & Cut………………………………….$42.00 & up
Temporary Color Rinse………………..$1.00 & up
Men’s Services Available
Men’s Haircut……………………………$8.00 & up
What housekeeping services are provided?
Resident rooms, bathrooms and halls are cleaned on a daily basis by our housekeeping staff. Additionally, a more thorough cleaning is conducted weekly. If you have any concerns, contact your nurse or housekeeper.
What laundry services are provided?
BrookHaven offers personal laundry and linen service for all residents. The facility’s laundry service will pick up your machine-washable laundry on a regular schedule and return the clean clothes to your room.
If you would prefer a friend or family member to launder your clothes, please make sure soiled clothes are kept in a covered container and picked up on a regular basis.
When choosing clothing to bring to BrookHaven, please remember our laundry cannot accommodate woolens, privately owned bedspreads, or clothes that require dry cleaning or afghans. These items may be brought to BrookHaven; however, the resident, family or responsible party must arrange for an alternative laundry method. All items to be washed by the Laundry Department must be wash and wear (also see section entitled “Clothing” under Personal Items).
What mail services are provided?
- Mail Opening Service; at the time of admission, you told us how and in what manner you wanted your personal and business mail delivered to you. If you would like your mail opened for you by BrookHaven, you will need to complete a form authorizing BrookHaven in this respect.
- Forwarding Mail; if your abilities change after admission and a family member or other responsible party needs to assume responsibility for business mail, please notify the Business Office so BrookHaven can assist in properly forwarding your mail.
- Reading and Sending Mail; if you would like assistance with reading mail or sending correspondence, arrangements can be made with the Activities staff. Postage may be purchased from the Business Office staff.
What religious services are provided?
We offer a variety of religious services in the facility. You will find a schedule of services on the Activity Calendars posted throughout the facility. You are welcome to attend religious services in the community. We encourage you to invite clergy and other members of your congregation to visit.