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post #1 of 35 (permalink) Old 04-14-2011, 10:40 AM Thread Starter
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More waste, dumb, dumb, dumb

There's no doubt this has been a given for many years. I've been talking to numerous Adult Care Facilities, and nursing homes. The cost difference isn't the main issue, but the way it is paid by Medicaid certainly is.
A nursing home is a higher level of care, so it would make sense they would be more expensive, but ,many times a patient is housed there instead, when really, a less expensive Adult Foster Home would be more appropriate, and a whole lot cheaper. Much of it has to do with the finances of the family, and what Medicaid covers.
Now, a couple or more things I've discovered. These are all cost per month, and in the state of Michigan, and my area, so your figures could be different.

Adult Foster care -$1800-$2400
Nursing home - $6700, and up
Now, Medicaid will not cover a thing for that Foster care facility, but picks up the entire bill for the nursing home, after the patients Social Security contribution, in other words, all, except for $60 a month for personal spending.
With the Foster care, it's all on the family to pay. I haven't checked with my insurance company to see if they do anything, yet.
Make sure you see the difference in cost here.
Why would a state, that administers the Medicaid program, with federal financing, rather pay for a nursing home than a Foster care home? Remember those figures?

Hospice, another grand scheme at taxpayers expense. Here, in my area, we have a number of hospices, 3 different ones at least. Are you ready for a shocker? These guys get $6000 per patient, per month, all paid by Medicaid.
Don't take it wrong, the caregivers with hospice are usually very good, although I can't say a lot about the social workers I've dealt with.
One thing that is a big cost is the medications provided by Hospice, at taxpayers expense. Some medications are so expensive, that unless the patient has some sort of medical coverage other than Medicare, they can't afford them. Very sad, and very true.
Take a hospice that has 100 patients, I'll do the math, $7.2 MILLION a year going to them, and you better bet, the RN, the nurses aid, the chaplain, and the social worker, aren't splitting that.

Please guys, this isn't something you can blame on any one administration. Would social medicine be an answer? Likely not, we all know what happens when the goobermint gets involved, and I suspect insurance companies that need a new skyscraper as well. [Hancock building in Chicago, comes to mind]
I'm not smart enough to figure out the insurance companies angle, just a suspicion.
Just thought I'd throw my discoveries out there, all my figures were gleaned from people actually involved in these schemes, but not in charge.

Another nonaligned spokesperson.

Good stuff, trucks bring it!

I don't care if my thread goes off topic, it's all BS anyway!!!
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post #2 of 35 (permalink) Old 04-14-2011, 11:49 AM
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Re: More waste, dumb, dumb, dumb

Thanks for putting this out there! I am with ya on this. Unbelievable. I know if either my parents or my wifes parents needed a place, my wife and I would gladly take them in our home and take care of them.

It is easy to find more ways to spend more money, but it always seems harder to find ways to cut it. People are making big money off of this.

I am with you on this, cause everyone has their hand in it. I am getting so sick of which side you are on. Just because your Dem or a Rep you only think a certain way. I define a person by their actions and how they implement them. I always have and always will. We all grew up with it, I think, cause I believe we all experienced a blowhard that talked a big game but never showed up for the game.

My time is gonna get limited on checking in on here cause things are heating up right now. Potatoes, sweet peas, and new seeding is going in right now here real heavy. And since friday of last week, I have sold about $811,000. This is the year farmers are pulling out all the stops.
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post #3 of 35 (permalink) Old 04-14-2011, 12:16 PM Thread Starter
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Re: More waste, dumb, dumb, dumb

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Thanks for putting this out there! I am with ya on this. Unbelievable. I know if either my parents or my wifes parents needed a place, my wife and I would gladly take them in our home and take care of them.
Who'd a thunk. eh? What you said about your parents is what I've been contending with, only my wife. But there comes a pointe when the caregivers have to think of themselves as well. There are many cases where the caregivers went first due to the stress, and there is stress. Please, no sympathy, maybe a prayer or two, I only let that out to show where I'm coming from.
Luckily, I can get my wife into a foster home due to finances. But there are so many out there, likely more than you or I can imagine, that have no choice but to go the nursing home route. Not because the patient needs that level of care, rather than that is the only way they can afford it.

The older I get, the more pissed I get. there are other things I've found out as well about medicaid that would piss off a preacher. May be depending on how this thread goes, I'll throw that in here later on.
There is definitely something wrong here.

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I don't care if my thread goes off topic, it's all BS anyway!!!
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post #4 of 35 (permalink) Old 04-14-2011, 12:34 PM
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Re: More waste, dumb, dumb, dumb

I'm sure it has to do with the unions that the nurses aides at the nursing home are in more than anything. Complete BS!

Only our government would rather spend three times as much for institutionalized care instead of in home care.

Of course, if Obama get's his way, the government will just give us a "pill" and all our misery will go away, and in seconds we'll be off the government dole after paying into the system for decades.

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post #5 of 35 (permalink) Old 04-14-2011, 12:46 PM Thread Starter
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Re: More waste, dumb, dumb, dumb

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Originally Posted by GlockF250 View Post
I'm sure it has to do with the unions that the nurses aides at the nursing home are in more than anything. Complete BS!

Only our government would rather spend three times as much for institutionalized care instead of in home care.

Of course, if Obama get's his way, the government will just give us a "pill" and all our misery will go away, and in seconds we'll be off the government dole after paying into the system for decades.
I'm not sure what any union has to do with how the money is allocated, possibly the expense though. I don't know if the CNA's are unionized or not.

Obama isn't going to fix a bloody thing, he's just another mouth piece with a rich history of many before him, that's for sure. This whole thing doesn't make sense to me. Spending like this is just one example I guess for the reason the US is in such a losing position. It just reinforces my thoughts on the "ruling class". God, I'm pissed!!

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I don't care if my thread goes off topic, it's all BS anyway!!!
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post #6 of 35 (permalink) Old 04-14-2011, 12:51 PM
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Re: More waste, dumb, dumb, dumb

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I'm sure it has to do with the unions that the nurses aides at the nursing home are in more than anything.
Amazing.

Do you actually think about what you write, or does it just flow while you're in a catatonic state?



Quote:
Complete BS!
We agree!

Albeit, not exactly on the same thing.


.

Never have so many politicians, screwed so many Americans...just to make one black person lose his job.
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post #7 of 35 (permalink) Old 04-14-2011, 12:54 PM
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Re: More waste, dumb, dumb, dumb

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I'm not sure what any union has to do with how the money is allocated, possibly the expense though. I don't know if the CNA's are unionized or not.
I'll bet any additional costs, due to unionized workers........ is minuscule.

Most of the money is in doctors fees, medicine and............. profit.




Quote:
It just reinforces my thoughts on the "ruling class".
Now we're getting to the crux of the problem.

I guess maybe we should just give them some more tax breaks.

.

Never have so many politicians, screwed so many Americans...just to make one black person lose his job.
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post #8 of 35 (permalink) Old 04-14-2011, 02:50 PM
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Re: More waste, dumb, dumb, dumb

Wow, this thread is a shining example of mis-information.

First, try learning what the different types of care really are, because there's a HUGE difference, and it FULLY explains the differences in cost as well as why Medicare covers one thing, but not another:

- Adult Foster Care - this is in-home care for an adult who is right at the point of not being able to be fully independent, yet at the same time not requiring the care and supervision of a medical staff. Get the medical staff part down, because that's why Medicare does NOT subsidize AFC. Medicare is not in the business of paying for someone's housing simply because of age, or paying for minimal aid of daily tasks, they are in the business of medical care. AFC is not like hospital or nursing home care, because it doesn't involve medical attention. It simply involves lifestyle.

Here's something from the Dakota Department of Social Services website (it was one of the first things that popped up in my search) that outlines what qualifies someone for AFC, and when someone should skip it and go to a nursing home:

Quote:
Individuals Appropriate for Adult Foster Care

-Oriented to time, person and place and not a danger to themselves or others in the adult foster care home.
-Unable to live independently.
-Require minimal supervision and/or assistance in completing one or more of the following: dressing, personal hygiene, transportation, ambulation, nutrition, health supervision.
-Capable of taking action for self-preservation in case of fire or storm with direction.
-Usually has control of bowel and bladder, but may have stress incontinence and/or capable of meeting their own needs when incontinent.


Individuals Not Appropriate for Adult Foster Care

-Consistently not oriented to time, person and place to such a degree they pose a danger to themselves or others in the home.
-Unable or unwilling to meet own personal hygiene needs under minimal supervision.
-Has a communicable disease or infectious condition which pose a threat to the health or safety of other residents of the home.
-Chronically disruptive and unable or unwilling to comply with adult foster care rules.
-Behavior poses a threat to other residents.
-Unable to self-medicate on one's own or with the assistance of supervision or monitoring.
-Require a complex, therapeutic diet.
-Require any other type of care which can only be provided safely by or under the supervision of a licensed practical nurse or a registered nurse.
- Nursing Home - It's different from Adult Foster Care because nursing homes DO come equipped with a licensed medical staff and supervision. This is also the reason for the huge cost difference. In Adult Foster Care, there really isn't a medical staff on board. Did some of you folks really not comprehend why the difference in price in the first place?

- Hospice Care - Mainly focuses on the care of terminally ill, not necessarily just the elderly, and it's not always confined to in-home care.... although that's what it's primary function is. Again, attention here is MEDICAL CARE, which is why Medicare steps in and helps fund this, and why it's different than AFC.


So get your facts straight guys. This thread failed from the onset, as it completely ignored very significant facts, and instead played on emotions that a couple of guys fell sucker to without thinking first. That's called bias, misinformation, and misdirection. If some of you actually knew the differences between AFC and nursing homes to begin with, there would have been no discussion in the first place. Because everyone would have seen the cost differences, and seen what Medicare does and doesn't cover, and go "oh, well duh, thanks for pointing out the obvious".

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post #9 of 35 (permalink) Old 04-14-2011, 06:07 PM
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Re: More waste, dumb, dumb, dumb

I'll tell you the small amount that I known about these facilities as I drop my fiancÚ off to work at one 5-6 days per week. My fiancÚ is a Speech Language Pathologist and works at a SNiFf (Skilled Nursing Facility) and it's been an education for me. She certainly is not a Union nurse but a highly in demand professional than earned a Master's degree and at 38 still has $70K in student debt. Basically she keeps people alive that have completely outlived any physical usefulness what-so-ever.

Her job consists of going thru a series of procedures and tests where she analyzes her patients to see if they can eat w/o putting food into their lungs (instead of their stomach) and asphyxiating or dying of infections as a result. This is more important than it sounds because w/o this, most just waste away and die, or die of infections.

Her patients are very often barely conscious for the most part and are completely unable to wipe their butts, feed or shower themselves, or do anything productive what-so-ever for general society. Many had strokes, multiple overlapping health conditions, and her youngest patient is a 52 year old that hit his head working around his home and now has no idea how to do anything. It's a revolving door where they go to the ER, sometimes recover and come back to her (by ambulance), or just die somewhere in between. Less than 1% will ever be in a good enough position to go back home where an unskilled loved one can successfully take care of them. This care, clearly is incredibly expensive and it's pretty accurate to say that many will use more Health Care dollars in the last 5 years of their life, than their entire income after an entire lifetime of working.

About half the funding for the facility comes thru Medicare and the other half is thru paying clients. Eventually Medicare financial funds dries up, the family is typically financially ruined, and the patients typically only get the minimum care that Medicaid will pay for. Medicaid is NOT generous so my girl also volunteers and has several project patients that she works w/ after hours. She has to pick and choose and she typically picks the ones that are younger, in better physical and mental health, and seem to have an engaged family working toward a recovery. The 52 year old I mentioned, his parents are in their all of the time and even though Medicare dried up she continues to work w/ him almost daily. Obviously picking and choosing creates a terrible moral dilemma for her and when one passes she can't help but wonder if she should have diverted more of her limited volunteer time in that direction.

She also has realized that it's very wasteful and a strain on our Medical System to keep so many people alive and although she doesn't pass judgment on the system, she is clear in that I'm to take her out if she ever becomes incapacitated. She also views the lack of self-Euthanasia procedures in the USA as incredibly cruel.

Like I said, it's been educational for me.

I'd like to here everyones' position on how many of our medical dollars should be directed at people at the end of their lives? Should it only be what the patient can afford? Should the government provide very basic health care services for all but extended services (such as SNiFfs) must be paid cash by the patient or possibly by secondary Health Insurance purchased on the open market for 'premium' care services? Should an independent government committee be responsible for looking at patients and determining, based on predicted future quality of life and current age how much limited dollars should be spent?

I'm not suggesting any of the above options, just curious what everyone thinks is the right decision in the face of rapidly increasing medical costs.

I'm officially...Stroke-less.
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post #10 of 35 (permalink) Old 04-14-2011, 06:17 PM Thread Starter
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Re: More waste, dumb, dumb, dumb

Quote:
Originally Posted by Pocket View Post
Wow, this thread is a shining example of mis-information.

First, try learning what the different types of care really are, because there's a HUGE difference, and it FULLY explains the differences in cost as well as why Medicare covers one thing, but not another:

- Adult Foster Care - this is in-home care for an adult who is right at the point of not being able to be fully independent, yet at the same time not requiring the care and supervision of a medical staff. Get the medical staff part down, because that's why Medicare does NOT subsidize AFC. Medicare is not in the business of paying for someone's housing simply because of age, or paying for minimal aid of daily tasks, they are in the business of medical care. AFC is not like hospital or nursing home care, because it doesn't involve medical attention. It simply involves lifestyle.

Here's something from the Dakota Department of Social Services website (it was one of the first things that popped up in my search) that outlines what qualifies someone for AFC, and when someone should skip it and go to a nursing home:



- Nursing Home - It's different from Adult Foster Care because nursing homes DO come equipped with a licensed medical staff and supervision. This is also the reason for the huge cost difference. In Adult Foster Care, there really isn't a medical staff on board. Did some of you folks really not comprehend why the difference in price in the first place?

- Hospice Care - Mainly focuses on the care of terminally ill, not necessarily just the elderly, and it's not always confined to in-home care.... although that's what it's primary function is. Again, attention here is MEDICAL CARE, which is why Medicare steps in and helps fund this, and why it's different than AFC.


So get your facts straight guys. This thread failed from the onset, as it completely ignored very significant facts, and instead played on emotions that a couple of guys fell sucker to without thinking first. That's called bias, misinformation, and misdirection. If some of you actually knew the differences between AFC and nursing homes to begin with, there would have been no discussion in the first place. Because everyone would have seen the cost differences, and seen what Medicare does and doesn't cover, and go "oh, well duh, thanks for pointing out the obvious".
I see you pulled that off a Dakota DSS website. I'm not sure what that is. I do know that states have different guidelines as to how Medicaid is distributed, it's federally funded, but administered by the state.
You may have misunderstood what I'm pointing out. I can either go with Foster Care, or a nursing home in my case. The foster home comes out of my pocket, no medicaid at all. Nursing home is paid thru Medicaid, $6700 a month and up. Which is cheaper? Which is paid by medicaid?
I did not pull any of this out out of my ass, this all came from foster home owners, and nursing home owners.
What you pointe out, the difference in levels of care are very true, I think I touched on that in the original post, but at the same time there ARE people in nursing homes that could have been serviced in a foster home, but due to their own finances, couldn't.
I'd call that waste, a great amount at that.
It doesn't take a whole lot to get the primary care provider to put anything qualifying on paper, to admit to either foster care, or nursing home.
I think when you mention medicare, you're meaning medicaid?
So, I guess, the people that have informed me, and sat down and spoke with me, don't have their facts straight? Or did they just want to agree with whatever I "assumed"?
I just got home an hour or so ago, after spending an hour and a half with a foster home owner, and this misinformation was all discussed, at length. Everything I said was confirmed to my understanding by this owner as well.

Another nonaligned spokesperson.

Good stuff, trucks bring it!

I don't care if my thread goes off topic, it's all BS anyway!!!
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