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We're stuck between two communities

The questions that break a tie once the tours all start blurring together.

Quick answer

The questions that break a tie once the tours all start blurring together.

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Home›By Situation›We're stuck between two communities

By this point you have toured enough that the buildings have merged. These are the questions that still separate them.

Short answer

The questions that break a tie once the tours all start blurring together.

What to do, in order

  1. Compare the all-in numbers, not the base rents. Ask each community for the total monthly cost at your parent's assessed care level, in writing.
  2. Compare the rate increase histories. Three years of actual increases from each.
  3. Compare overnight staffing, not daytime. Daytime ratios look similar everywhere. Overnight is where they diverge.
  4. Pull both state inspection records. Read the surveyor narratives rather than counting citations.
  5. Ask the Medicaid waiver question of both. If private funds might run out, a community that does not hold a waiver provider agreement is a future forced move.
  6. Go back unannounced. Same building, evening on a weekday.

Questions families ask

SIUH or Richmond University Medical Center gave us a discharge date in 3 days. What do we do first?

Ask the case manager or social worker for the discharge plan in writing, and confirm in writing whether your parent was admitted as an inpatient or held under observation status -- that single fact determines whether Medicare's skilled nursing benefit is even available for a rehab stay afterward.

What's the actual difference between "inpatient" and "observation status" after a hospital stay?

Medicare's skilled nursing facility benefit requires a qualifying inpatient hospital admission. Time spent under "observation status" does not count toward that requirement, even if your parent physically slept in a hospital bed for multiple nights -- ask the hospital directly, and in writing, which status applied.

Can I push back on a hospital discharge date if we're not ready?

Generally, yes -- discharge dates are often less fixed than they initially sound, particularly when no safe discharge plan has actually been arranged yet. Hospitals are required to discharge to a genuinely safe setting; raise specific, concrete concerns with the case management or social work team rather than a general request for more time.

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