More than you might think, lots of care is paid from from the pockets of the recipients. With strict financial requirements for Medicaid qualification and numerous services not directly Medicare reimbursed, including adult day care and around-the-clock private duty care in a person’s home, many opt to pay for what they want and need. This often includes adult day care participation or 24/7 care at home. The latter can get expensive fast.
It is not unusual for a nursing home to get a bit frantic when they establish that a patient is nearing the end of a 
care period wherein the home can be Medicare reimbursed. While some patients may be transitioning to long-term or Medicaid reimbursed beds many do not and cannot. So the patient and/or their designated representatives scramble to identify assisted living or other options. One thing for sure the nursing home is going to do all it can to avoid having to render uncompensated care. With this business model that’s somewhat understandable.
However, with adult day care centers and companies that provide private duty care in-home there may be things you can do to help families make usage of your services even as their financial pictures change. If it becomes your custom to simply remind a family to start looking elsewhere as someone’s financial circumstances take a downward spiral you may get labeled as a “hit and run” artist with no real commitment to people but specially committed to maximizing income.
If you want to sincerely avoid this label here are some tips:
1. Ask people what they are experiencing. Find out how you can shave costs and stretch care out longer
2. Be a real case manager. Learn what other community resources are available that could be used to complement your services and off-set costs. Who knows, is someone you serve a veteran or the surviving spouse of one?
3. If you are a non-profit, tax exempt provider might you supplement your operational revenue by soliciting donations from people who can help you broaden your services to those who cannot afford you but who need you desperately
How you choose to approach this may or may not be a real concern for you. But there is something pretty sweet about a generous spirit that contributes to helping others solve problems.
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