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Can I enter a nursing home without a long-term care rating?
2023. 10. 12
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“Is it necessary to have a long-term care rating to be able to enter a nursing home? My mother’s condition has recently worsened due to a hip fracture, and there is no one to take care of her. In a few weeks, I will have to move out of the house she is currently living in, so I will have to take her to a nursing home right away. Long-term care “I heard it takes a while to get a grade, but before that, can’t we take her to a nursing home first?”
Those eligible for admission to a nursing home are those who have been recognized as “facility benefits” among long-term care recipients.
If you are in a situation where you need to urgently take the patient to a nursing facility without a long-term care rating, you can enter as an out-of-class (non-covered) resident through consultation with the nursing home.
At this time, the monthly admission cost for non-level residents (non-benefit) may vary depending on the nursing home because there is no separate cost.
Please note that you should consult with the nursing home for the exact cost based on the senior’s condition!
If you are classified as long-term care while living in a non-benefit facility, you can receive 80-100% support from the National Health Insurance Corporation by applying the long-term care benefit rate from then on.
💁♀️ What if I am a patient who needs rehabilitation treatment and it is difficult to receive a long-term care rating?
In this case, it is difficult to determine long-term care level, so a nursing hospital may be a better choice if the cost is similar than entering a nursing home at 100% self-pay.
In particular, if rehabilitation treatment is required for a hip fracture, as in the consultation case above, you may consider transferring to a nursing home after sufficient rehabilitation treatment at a specialized rehabilitation nursing hospital and when a long-term care grade is obtained.
🙅♀️ What if I was diagnosed with a long-term care level and received “home care benefits”?
Apply to change your benefit type through the National Health Insurance Corporation right away!
The conditions for applying for a change in salary type are as follows, and you can usually receive a change in salary level after two weeks.
○ When it is difficult to receive care from a family member who is the main caregiver
– When there is a high possibility of being neglected, abandoned, or abused by a family member who is the main caregiver.
– When it is difficult for a family member who is the main caregiver to provide care due to reasons such as work, illness, or overseas stay.
– When there is no family member who can be considered as the main caregiver
○ When admission to a facility is unavoidable due to poor living conditions
– When it becomes difficult to live in the house or building you live in, such as fire or demolition
○ Cases where in-home benefits cannot be used due to problematic behavior due to dementia, etc.
– When both dementia diagnosis and dementia symptom requirements are confirmed
– When the requirements for dementia symptoms have not been confirmed, but the beneficiary’s problematic behavior places a heavy burden on the family and is under severe stress.
< In the case of level 5 beneficiaries, all of the requirements below must be met >
○ In cases where it is difficult to receive care from a family member who is the main caregiver, or in cases where admission to a facility is unavoidable due to poor living conditions.
○ According to the submitted doctor’s opinion and certification questionnaire, behavioral changes due to dementia are above a certain level.
🤷♀️ What if I need to undergo a long-term care grade visit screening while admitted to a nursing hospital or nursing home?
After applying for a long-term care level, a National Health Insurance Corporation employee will contact the applicant in advance to determine the place and time to visit.
It is possible to conduct an inspection (visit) even while hospitalized or admitted to a nursing facility. However, the nursing facility may restrict visits to outsiders for reasons such as COVID-19, so please check with the nursing facility in advance to see if this is possible.
Please refer to this content to find out what items are based on the accreditation (visit) survey!
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