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Frequently Asked Questions
Q. What is respite care in an assisted living or retirement community?
A. Respite care means a “short term stay.” A person can come to any one of our retirement communities (based on availability) and pay a daily rate for services
rendered. Any one of our communities can provide these services, all you have to do is call the preferred community and ask to speak to the Leasing Counselor
regarding “Respite Services.”
Q. What is Medicare and what does it cover?
A. Medicare is a federal health insurance program that has serious
limitations when it comes to paying for assisted living or long-term
care.
Medicare has 2 parts:
Part A: Hospital Insurance: helps pay the cost of inpatient hospital
care. Under certain conditions, Part A helps pay for inpatient care in
a “skilled” nursing facility, hospital related home health care, and
Hospice care.
Part B: Helps pay for necessary doctor’s services, outpatient hospital
services, home health care, and some preventive services.
Q. What is Medicaid and what does it cover?
A. Medicaid is a health care program for low income persons
cooperatively financed by Federal and State governments. Benefits
cover both institutional and outpatient services. Medicaid will pay for
skilled and intermediate nursing home care for as long as the
individual is determined by a physician and the state Medicaid review
department to need that level of care.
If the application is approved, the nursing home resident must
contribute all monthly income (except for a small “personal and/our
spousal allowance”) and Medicaid will pay the balance up to the
Medicaid rate.
Q. Does Medicare or Medicaid pay for assisted living?
A. Unfortunately, no federal or state insurance program provides a
supplement to the custodial support in an assisted living facility.
Maybe someday that will change, but for now, only private pay and
some long term care insurance policies that have attached riders will be accepted.
Q. Is there any insurance that pays for assisted living?
A. Long term care policies that have riders attached to them.
Q. What is home health care and can you have it in an assisted living
facility?
A. Home health care is a skilled service provided to a beneficiary of either an
HMO or Medicare. It begins with a doctor’s order and an assessment by a chosen
home health care company to determine eligibility for said services. Among those
skilled services are nursing, physical therapy and occupational therapy. It is
intermittent in nature and the whole object of home health care is to teach and
enable the client and their family to be knowledgeable and as independent as
possible. Yes, you can have home health care in any assisted living setting
because that setting is determined by the payor source to be “home” for that
resident.
Another type of “supportive care” often referred to as “home health care” is in
all actuality personal care support services. These are custodial in nature;
therefore they are not deemed skilled services. Personal care support services
are paid for by the individual or the family requesting those services. Examples
of these would be bathing, dressing, and general activities of daily living. At
Sovereign Healthcare facilities, we have lists of providers. The resident and
their family, at all times, have the right to choose what agency or company will
provide either skilled or custodial “home health care”. Remember, personal care
support services are generally paid for by the person requesting them.
Q. What is PASSPORT?
A. PASSPORT is a personal care support program paid for by the government.
This is essentially a Medicaid program with eligibility criteria that must be met.
For example: You must be deficient in the execution at least 2 of the activities
of daily living.
Q. Do you think assisted living facilities can take the place of a long-
term care facility?
A. Absolutely not. Long-term care facilities’ staff are all certified and
Licensed professionals who are trained in assessment and intervention
and are required to take care of the resident with more advanced needs.
Q. What are “retirement communities?”
A. Retirement communities offer one or more of the following types of
living accommodations:
- Assisted living facilities provide services for older people who are functionally
and/or socially impaired and may need 24-hour supervision
- Congregate living facilities generally provide supportive services such as a
main meal, housekeeping, social activities and transportation but do not provide
the degree of personal assistance offered in assisted living facilities
- Residential Care Facilities (RCFs) provide a level of care that is clearly
defined by state licensure requirements. These include, in addition to assistance
with personal care, the ability to prepare special diets and provide assistance
with self-administration of medications. They have trained staff on duty 24 hours
per day.
Assisted living is offered in a variety of settings from senior
apartment complexes to multi-level retirement communities or
nursing homes. Accommodations, are physically designed to serve those who need some assistance with activities of daily living, such as dressing and bathing; or those who use a wheelchair or a walker to get around.
Our facilities have licensed nursing personnel who monitor
medications and provide a variety of health counseling and screening
programs. Retirement living has many options and benefits to it.
Q. How do I choose a retirement community?
A. Determine what you want in a retirement community:
- City, suburban or country
- House, townhouse, apartment
- Low or high rise; one or two bedroom
- Ambience, lifestyle and the kind of social and recreational activities desired
- Learn the terminology to differentiate the kinds of care facilities that are available
- Select retirement housing based on the services, amenities, location and ownership arrangements most suitable to current and future needs
- Ask specific questions to determine the facility’s viability, such as history of the management, community reputation.
- Carefully examine the occupancy contract. Contracts can vary widely from one facility to another. Our contractrs are very
straight-forward. In addition to this, if our resident has a change in medical condition the necessitates a change in level of care, the
lease can be broken to accommodate the change in condition.
Q. How do I decide which nursing home to choose for Mom or Dad?
A. It is important that the older person participate in the decision-making
Process as much as possible. This is the right of the individual. Choosing a home that
provides the kind of care and environment that meets the individual’s physical, social,
emotional and spiritual needs will significantly help the older person make the
adjustment to the new surroundings.
Primary factors affecting the choice of a nursing home are:
- The type of care required. The facility should be able to provide
the level of care needed.
- The financial resources available. Families need to determine what
funds are available to pay for care. If the older person is unable to
pay for nursing home care, the choice of a nursing home is limited
to a facility which accepts Medicaid and has an opening.
- Location. The best choice is a facility convenient to family,
friends, and physician.
Q. What do we do first?
A. Before making any visits, call a few retirement communities to inquire about:
- Particular services that will be needed. If the needed services are not available, there is no point in making a visit.
- Whether or not there is a waiting list and how long is the waiting period if you need immediate care.
- What are the community’s admission qualifications? Some require that residents be able to care for themselves
to a certain extent. Ask about basic costs, extra charges, and anticipated increases.
Q. What are advance directives?
A. Federal regulations require that all health care facilities participating
in the Medicare or Medicaid programs ask patients when they are
admitted whether they have advance directives. These are documents,
usually a living will and/or durable power of attorney for health care,
that reflect in writing, the individual’s wishes regarding life-sustaining
medical treatment if the individual becomes incapacitated.
Q. What will happen to my mother if the money paying for her retirement community runs out?
A. This is a question many people ask. Your concern is valid; however I want to
reassure you that your mother will be taken care of. About 6 months before you
know the money will run out, all you have to do is call our RN Community Liaison
(Beth Fallon 216/346-4901) and relay the concern to her. She works with many
families under the same circumstances with very positive outcomes. Because the
funds are exhausted for assisted living, your mother still has other options.
One of them being long-term care. This is due to the fact that she will most
probably have to go on Medicaid assistance. At that time, Beth and the the
social worker in our care center will contact you and start the Medicaid
application process. We will do all the work necessary to ensure a seamless
transition. With any questions in regard to this please call Beth and she will
explain the process to you.
Q. If my mother moves into a retirement community what will happen to
her furniture?
A. Moving into a retirement community is akin to moving into an apartment.
This will be your mother’s home even though she will most probably need to” scale down.”
We strongly encourage families to consider her most cherished items and try to take
them with her when she moves.
Q. Does my mother need furniture for a respite stay?
A. No, our respite suites are fully furnished.
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