Case Study: Skilled Nursing Care or Private Duty/Home Care?

Recently an elderly woman named Clara (real name withheld) was hospitalized for a treatable condition. She became very weak and deconditioned because of all the time spent in the hospital bed. The hospital Physical Therapist recommended that Clara be transferred to a Skilled Nursing Facility for rehabilitation and strengthening. Clara and her family agreed with the recommendation.

In the process of searching for an acceptable Skilled Nursing Facility, it was determined that Clara was going to be taking a very expensive medication to treat her condition. Three Medical Certified Skilled Nursing facilities refused to accept Clara because of the cost of the medication. A Skilled Nursing Facility is responsible for paying for all of the medications when a person is admitted for rehabilitation and Medicare is covering the cost of stay.

Clara continued to work with the Physical Therapist at the hospital during this search for a facility. She soon was medically stable for discharge.

Clara’s family realized that they needed a “Plan B” for Clara to be safely discharged.

It was decided that Clara would discharge to her daughter’s home where she could have a bedroom and a bathroom on one level. Clara and her family agreed to hire private duty aides to be with her several hours a day while her daughter worked. Other family members supplemented hours with Clara around the private duty staff.

Clara’s doctor ordered Home Health Care which included a nurse to visit 1-2 days a week to complete a physical assessment and insure that Clara was taking her medications properly. The Home Health Care orders also included a Physical Therapist and an Occupational Therapist to visit her 2-3 days a week to treat her rehabilitation needs.

Clara’s recovery was successfully accomplished with the combined efforts of family care, private duty care and home health care.

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