Frequently Asked Questions
How do I know if my loved one requires assisted living level of care or nursing home level of care?
There are numerous issues that are taken into consideration when the determination is made as to whether a potential resident requires assisted living level of care or nursing home level of care. Maximus Clinical Services is an agency contracted by the state of Maine that makes that assessment. Nonetheless a good rule of thumb is the resident’s ability to accomplish activities of daily living. To qualify to live in an assisted living facility a resident would need to be able to transfer independently in and out of bed and on and off a chair or toilet. The resident would also need to be able to feed themselves. In an assisted living facility they can be helped with hygiene, grooming, bathing, and medication administration. Nursing homes provide total care to their residents.
How do I contact Maximus Healthcare Management?
Maximus can be reached at 833-525-5784. Maximus will usually send a registered nurse to the location of the potential resident within 5 days. You will need the name, date of birth, and social security number of the applicant when you make a referral.
What are the payment options for RMI facilities?
All three of our facilities accept private pay residents, long term care insurances, and Mainecare. Horizons Living and Rehab Center also accepts Medicare reimbursement when a resident qualifies.
What is required for Medicare to pay for a resident in a nursing home?
Per Medicare guidelines the patient would need to be eligible for Medicare benefits and to have spent a minimum of three consecutive overnights in a hospital within 30 days of admission to the skilled facility. Additionally the medical provider at the hospital would need to certify that the patient requires “Skilled Nursing Facility” level of care.
Are there costs or restrictions associated with Skilled Nursing Facility level of care?
Medicare allows a patient to receive up to 100 days of skilled care. The first 20 days are paid in full by Medicare. There is currently a co-pay that fluctuates per day for days 21 – 100. The majority of Medicare Supplemental Policies offered by insurance companies cover that co-pay. Medicare Advantage plans often provide different coverage and are not always accepted at the Horizons Living and Rehab Center.
What kinds of services are provided in a nursing facility?
Nursing homes are licensed medical facilities. At the Horizons Living and Rehab Center we have a medical director and/or his/her nurse practitioner in house at least 3 days a week and on call 24/7. We also have a geriatric psychiatrist attending to our residents whom visits weekly. We have licensed nurses on the units 24/7. We offer physical, occupational, and speech therapy in house. We have x-ray and phlebotomy services available. We administer all medications and treatments. We have a full time licensed social worker to assist residents and their families. We have full time activities staff that provide a full range of activities and entertainment regardless of the resident’s physical or cognitive limitations. Our dietary staff provides delicious meals while being attentive to each resident’s specific dietary restrictions. Our housekeeping department keeps the facility safe and clean and provides laundry services 7 days a week.
Whom do I contact for more information, a tour, or to refer a potential resident?
Please contact our Admissions Director, Jenny Kyllonen. She can be reached at her office (207) 721-6610, on her cell (207) 212-8340, or by email hlrcadmittingnurse@rmimaine.com.
What kinds of services are provided in the Assisted Living Facilities?
Assisted living facilities, also referred to as Residential Care Facilities, are not licensed medical facilities but provide basic medical attention to all the residents. In these facilities we administer medications and treatments per each resident’s physician’s orders. We can check blood sugars and administer insulin accordingly. We can provide transport to local doctors’ appointments at no charge. We provide activities daily to keep our residents involved and content. We prepare all meals in accordance to each resident’s dietary restrictions. We provide full housekeeping and laundry services 7 days a week.
Are there any restrictions or limitations as to the kind of resident that can be admitted?
Residents must meet the admission criteria for this facility. Our facilities are not secured and residents are encouraged to enjoy designated areas outside of the facilities therefore we cannot accept any residents that have the potential to wander away due to dementia. Our admissions staff carefully screens each potential resident to assure that their needs can be met by the facility and that they will be able to co-exist with other residents.
