Why Are We Different?

Long term care in America is largely administered by the federal government through the Centers for Medicare and Medicaid Services (CMS). Medicare is provided directly through the federal government, meaning that Medicare pays providers for the care rendered. Medicaid is provided as a percent of funds expended the individual states, who are then responsible for administering the use of those dollars. Each state has their own rules and regulations about obtaining those funds.

Medicare and Medicaid each are set up for specific uses. Medicare funds can be used when the patient has need for post hospital skilled care, that is, care certified by the attending physician and requiring a licensed professional to perform or supervise. Medicaid funds are expended after the patient exhausts their Medicare benefits and moves to lower levels of skilled care, such as routine nursing and nursing aide services. Custodial care is where a lay person, untrained, is able to provide the care on an intermittent basis in a non institutional setting. Some examples:

• Medicare skilled care examples – post hospital nursing care, wound care, managing medications, providing therapies, carrying out restorative and psycho/social programs to move the patient to their highest level of functioning.
• Medicaid skilled care examples – routine nursing and nurses' aide services, controlled dietary and weight management programs, restorative and psycho/social programming triggered by the MDS assessment instrument.
• Custodial care examples – brushing teeth, assistance with walking, bathing provided by a lay, untrained relative or friend

It stands to reason that Medicare skilled care would be more expensive than Medicaid. Therefore, the payment structure for Medicaid is less reimbursement to the provider for services rendered, and has an unlimited duration, while Medicare is limited to 100 days coverage for each spell of illness.

A nursing home that relies primarily on Medicaid as the primary source of reimbursement would have a difficult time meeting all their expenses, leading to deplorable conditions and despair. Patients simply do not get well in this kind of setting.

All-American Care Centers are completely different, thanks to an exclusive proprietary tool that is unique to our centers. Our Caregiver Management computerized Restorative Care Planning and charting system is designed to assure that all patients receive the full Medicare benefits that the government has allotted for their care. Documentation of skilled need and delivering of skilled interventions as defined by the Medicare rules and regulations are key to receiving full benefits and that is exactly what our software does. Better funding means better individual care:

With the Caregiver Management tools we are able to:

• Appropriately bill Medicare for all skilled care rendered
• Simultaneously lower our dependence on state Medicaid dollars
• Protect patient’s assets by postponing the need to spend down
• Restore all patients to their highest level of functioning
• Control quality and cost using customized care plans for every patient
• Document all interventions and outcomes
• Hold staff accountable to state rules and regulations
• Improve staff morale through improved patient results
• Retention of staff due to maximum efficiency and productivity

As a result of this system created by our senior management:

• A high percentage of our patients improve and return home
• Our staff – who chose the medical profession because they wanted to help people – actually are able to see the results of their efforts and move up our career ladder.
• The communities we serve are revitalized because we restore and return active patients back into the community, utilizing local businesses to supply and service our facility.

Economics of Elder care  

At All-American Care, our 40 years of experience has taught us that federal funding for elder care is in danger. The Long Term Care industry is using this precious resource at a very fast pace, and that is predicted to increase as the Baby Roomers move into their golden years. We believe it is necessary to reverse the trend. All American Care stands for:

• Eliminating waste in the industry by using a team staffing model that has proven to be patient effective as well as cost effective.
• Using the appropriate insurance coverage at each step of the way to insure that entitlement dollars are spent wisely, and that All-American Care does not tap into the wrong source contributing to a shortfall in future years.