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Audiology services in nursing homes

ANNESELTZ anneseltz at aol.com
Tue Aug 1 21:43:11 EST 1995

Some of us are providing audiologic services to residents in NH, some
includes HA management/sales, some doesn't.    Re: contracts with NH.  You
need to understand that residents in NH can choose their vendor.  For
example, should they have a long term relationship with an audiologist and
want to continue seeing that person, they can do so regardless of any
contract with the NH.  That policy is defined in federal regs.  Look in
the Code of Federal Regulations #431.51 regarding freedom of choice for
vendor (and other things).  There are businesses in MN which have told NH
that they must have an exclusive contract.  

I believe audiologists are not considered rehab personnel and therefore
need to continue being independent providers but I may be wrong on that. 
I don't think the nursing home usually does billing for audiologists.

Also, it is my understanding that Medicare covers no services related to
hearing aid management except for those of a speech language pathologist
doing aural rehab.  You need to check on that as my currency is not great.
 I personally stopped doing NH three years ago because, at age 61, I
couldn't tote all my equipment to and fro each day.

Now to the real audiologic issue.  The NH residents are great and
appreciate anything you can do.  I remember being in a clinical setting
and a NH resident would come in, wheelchair bound, accompanied by a driver
who didn't know her, and I had minimal expectations for habilitation. 
Then, seeing this same person in her natural environment with supportive
staff and familiar surroundings made all the difference in her ability to
communicate.  There are many persons in the NH who can be helped and some
who cannot.  

I wouldn't expect it as my main source of income as there is not much
money to be made if you practice ethical audiology because there is much
counseling needed of family, resident and staff; staff is not always
amenable to change as they would rather clean a catheter then insert a
hearing aid; and we as a profession have done little to educate them
positvely about the joys of good communication.  Good luck

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