Cumberland County is fortunate to have a number of good care-communities for older people. However, many people have difficulty understanding the differences in care between them. The following is a guide to help you understand the various levels of care provided by these facilities.
Acute Care Hospital- This is what people normally think of when they think of a hospital. These facilities provide inpatient medical and surgical care for people with serious medical problems. In Central PA these facilities all have Emergency Care Units (ECU), and admission to the hospital is frequently, though not always, through the ECU. Examples: Carlisle Regional Medical Center and Holy Spirit Hospital.
Long Term Acute Care Hospital (LTACH) – These hospitals are specialty hospitals. They receive referrals from Acute Care Hospitals for complex medical cases which may need an acute level of care for several weeks. They are sometimes confused with Rehab Hospitals, but while they provide therapy services, their primary focus is medical care, not rehabilitation. Some insurance companies require precertification before they will pay for an LTACH. Examples: Life Care Hospitals of Mechanicsburg and Select Specialty Hospital.
Rehab Hospital- These facilities provide rehabilitation services on an inpatient basis for patients who are medically stable and who require and can participate in at least three hours of therapy sessions over the course of the day. The Center for Medicare and Medicaid Services (CMS) has developed a list of 13 diagnostic categories that especially benefit from a Rehab Hospital. CMS requires that a certain percentage of all Rehab Hospital admissions come from these 13 diagnostic categories. Many insurance companies require precertification before they will pay for a Rehab Hospital. Some Rehab Hospitals are freestanding facilities, while others are part of an Acute Care Hospital. Examples: Carlisle Regional Medical Center’s Inpatient Rehabilitation Program; HealthSouth Rehab Hospital.
Nursing Home- Nursing Homes can be known by several names: Extended Care Facility (ECF), Skilled Nursing Facility (SNF), or Nursing Home (NH). They provide both long-term care for patients with chronic disabling conditions and short-term rehabilitation for patients who may not need a Rehab Hospital but cannot return directly home from an Acute Care Hospital. With the provision of an increasing amount of rehabilitation many nursing homes incorporate the term “rehabilitation” in their names. Some nursing homes have secure units for memory- impaired individuals. Examples: Claremont Nursing and Rehabilitation Center; Forest Park Health Center; Golden Living Centers (two facilities in Camp Hill); HCR Manor Care (Carlisle and Camp Hill); and the Shippensburg Health Center.
Assisted Living Residence (ALR) – Pennsylvania began official licensing of ALRs in January, 2011. They are residential facilities which provide personal care as well as nursing services. The concept behind ALRs is “Aging in Place.” The goal is that once an individual moves into an ALR, he or she will never have to move again; services will come to him or her as physical needs for care increase, rather than having to move to a Nursing Home setting. Example: MapleWood Assisted Living at Bethany Village.
Personal Care Home (PCH) – For years many Personal Care Homes were known as Assisted Living Facilities; now they can no longer use the term “Assisted Living” unless they have an ALR license. A PCH is a residential facility which provides room and board as well as a certain amount of assistance with a person’s Activities of Daily Living (ADLs). Many PCHs provide medication administration and have extensive activity programs. Some PCHs have secure units for memory-impaired individuals. Examples of PCHs: The Bridges at Bent Creek; Country Meadows of Mechanicsburg; Elmcroft of Shippensburg; Emeritus Senior Living at Creekview; the Episcopal Home; Golden Living Community-Blue Ridge: The Woods at Cedar Run.
Independent Living Facilities- These facilities are for people who are able to function without supportive services. They may provide from one to three meals per day for their residents; they usually have activity programs; and they have transportation services. They do not assist with personal care, but residents may arrange for assistance with their ADLs through home care agencies. Some Personal Care Homers and most Continuing Care Retirement Communities have Independent Living settings. Example: Essex House.
Continuing Care Retirement Community (CCRC) – These facilities have multiple levels of care: Independent living cottages and/or apartments that may or may not include meals; PCH and/or ALR units; and NH units. People who move to a CCRC usually move in at either the independent or personal care level and plan to remain for the rest of their lives, moving to higher levels of care if their health and functional abilities decline. These facilities usually have significant entrance fees, although some CCRCs do not have entrance fees for people admitted directly to their nursing home unit. A distinguishing feature of CCRCs is that they will care for a resident for the rest of the resident’s life, even if the resident runs out of money. Some CCRCs have secure units for memory-impaired individuals. Examples: Bethany Village; Chapel Pointe; Church of God Home; Cumberland Crossings; Green Ridge Village; Messiah Lifeways at Messiah Village; Sarah A. Todd Memorial Home; and Thornwald Home.
If you find it difficult to keep track of all these different levels of care facilities, you are not alone. Even some medical professionals, whose patients come from these facilities, have difficulty remembering what kind of care is provided in each one. Adding to the confusion is that some facilities provide more than one level of care: some Nursing Homes have personal care units, some Personal Care Homes have independent living units, and most Continuing Care Retirement Communities have at least three levels of care. It is important to understand these different levels of care because Medicare and Medical Assistance (Medicaid) will only pay for certain levels of care.
The inclusion or the exclusion of any facility on this list is neither an endorsement nor an intentional oversight of any facility. Addresses, phone numbers and other information about the facilities mentioned in this article can be found in “The 2012 Capital Region Directory of Services for Senior Adults and Caregivers” which can be downloaded for free by clicking here. For public information on inspections of licensed facilities, we suggest you view: www.dpw.state.pa.us or www.health.state.pa.us.
