As part of Pleasantview’s ongoing construction, four cottages have been relocated to date, with an additional five — plus the maintenance garage — slated to be moved as well. The nine units were among 68 ILUs, with the first built in 1963; they will make way for a Memory Care expansion on the north edge of campus, as well as a new access road surrounding the entire campus.

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When was the last, or first, time you thought about Long Term Care? 

I have been known to inject some humor when I have an opportunity to speak with folks about Long Term Care Support and Services (LTCSS), particularly noting that most people don’t get up on a Saturday morning and say “Hey, let’s go shopping for Long Term Care today”.  And though the need for these services is rarely front and center in most people’s minds, it often comes as a surprise the overall complexity that is LTCSS.

It has been long touted that, second to the Nuclear Power Industry, LTCSS has more state and federal regulations than any other profession.  A quick list of National and State agencies having such oversight include: Centers for Medicare & Medicaid Services (CMS); Centers for Disease Control and Prevention (CDC); National Healthcare Safety Network (NHSN);  Iowa Department of Inspections and Appeals (DIA); Iowa Medicaid Enterprise (IME); Iowa Department of Public Health (IDPH); Iowa State Fire Marshal (SFM), Iowa Office of Ombudsman (IOO); Occupational Safety and Health Administration (OSHA); Department of Labor (DOL); Iowa Board of Pharmacy; Iowa Board of Nursing; Iowa Board of Nursing Home Administrators; and a host of subset authorities associated with the above noted agencies. 

Paying for services can be accomplished using Medicare (Traditional or Medicare Advantage), Medicaid, Private Insurance and Private Pay.  Medicare is a federal program whereas Medicaid is a state program.  The latter being administered in Iowa by Medicaid Managed Care Organizations (MCO’s).  Both have particular requirements and limitations.  Medicare Advantage Plans, also known as Medicare C, are administered by various insurance companies.  And just for fun, you need to be familiar with Medicare B  D, E and Medicare supplements. 

If all that hasn’t made you dizzy enough, how do you go about evaluating one facility from another? In fact, services often vary from one location to another.  Are you looking for a Skilled Nursing Facility (SNF), Assisted Living (AL), Independent Living (IL),  or a Chronic Confusion Dementing Illness (CCDI) aka Dementia Unit?  I always recommend speaking to someone who has a loved one in a particular community.  And you should always call and ask for a tour.  These will typically be conducted by the facility’s Social Service Director.  For some objective comparison, you can go to Nursing Home Compare at: https://www.medicare.gov/care-compare/?providerType=NursingHome&redirect=true.  Here you will find information regarding an organizations Five Star Status.  This is a useful tool as the Five Star System is how CMS communicates to the public information on Health Inspections, Staffing and Quality Measures.  These data points are also used by insurers when negotiating contract language with the facility.  You can review Inspection History, Staffing models, e.g., Registered Nurse hours per patient day and Certified Nursing Assistant (C.N.A.) hours, along with Quality Measures such as Infection Control; Falls; Hospitalizations; and Post-Acute Care rehabilitation. 

The need for LTCSS is not an easy discussion for individuals or families to have, yet it is one that impacts most at some point.  As illustrated, it can be a difficult sector of healthcare to fully understand or navigate.  I would be happy to answer your questions whether it be related to services locally or outside our community.  I can be reached via email at jschmidt@pvkalona.com.

Jeffrey K. Schmidt, MS, ACHCA

Executive Director

Pleasantview

Kalona, Iowa