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Tuesday June 25, 2019

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"How to get Medi-Cal coverage for your nursing home care... without selling your home or leaving your family without a dime... Surprising ways to pay for your assisted living and long term care costs."

Elder Law Today Newsletter | January, 2012


Selecting a Nursing Facility

Selecting a Nursing Facility
The decision to move a family member or a loved one into a nursing home is one of the most difficult decisions you can make. Perhaps the move is being made because the family member can no longer care for him or herself...or perhaps the person has a progressive disease like Alzheimer’s, or has had a stroke or heart attack. No matter the reason, those involved are almost always under great stress. At times like these, it is important that you pause, take a deep breath and understand that there are things you can do. Good information is available and you can make the right choices for you and your loved one.

When nursing home placement is necessary, it is crucial that the family and/or potential resident decide what is most important to them in choosing a facility. It is important that the resident’s needs and wants be included in the evaluation. Things such as location of the facility, if a special care unit is necessary, and type of payer source should also be considered when beginning this process.

The next step is to identify the facilities in your area which meet the criteria you established above. You can consult the internet, geriatric social workers and your elder law attorney, for example, for recommendations. If placement is “down the road” and you have time, call the nursing facilities and ask them to send you their information packet including an activity calendar and a menu.

Get ready to tour the facilities you have chosen. Don’t schedule your tours. Just show up during regular business hours. You will be able to meet with the administrative staff who will answer all your questions. Next, you will want to tour a second time in the evening or on the weekend just to see if there is a drastic difference in the atmosphere of the facility or the care being provided. It is important to tour at least two facilities so you can see the difference in the physical plant and the staff. When you are touring, you should pay attention to your gut feeling. Ask yourself the following questions: Did I feel welcome? How long did I have to wait to meet with someone? Did the Admission Director find out my family member’s needs and wants? Was the facility clean? Were there any strong odors? Was the staff friendly? Did they seem to generally care for the resident? Did the staff seem to get along with each other? Listen and observe. You can learn so much just by watching and paying attention.

When touring a facility, ask any questions that come to mind. There are no “dumb” questions. Here are a few examples of questions you will want to ask to make sure that the administration of the facility is giving proactive care instead of just reacting to a crisis: How do you ensure that call lights are answered promptly regardless of your staffing? If someone is not able to move or turn him or herself, how do you ensure that they are turned and do not develop bedsores? How do you make sure that someone is assisted with the activities of daily living like dressing, toileting and transferring? Can residents bring in their own supplies? Can residents use any pharmacy? How many direct care staff members do you have on each shift? Does this number exceed the minimal number that state regulations say you have to have or do you just meet the minimum standard? What payer sources do you accept? How long has the Medical Director been with your facility? How were your last state survey results? (Ask to see a copy.) How did you correct these deficiencies and what process did you put in place to make sure you do not make these mistakes again? Has the State prohibited this facility from accepting new residents at any time during the last 2 years?

How to Pay for the Nursing Home
There are basically three ways to pay for nursing home care: 1. Long Term Care Insurance; 2. Pay with one’s own funds; 3. Medi-Care and Medi-Cal. Medi-Care pays for awhile. After that, you will need to qualify for Medi-Cal to obtain that benefit. You can contact your elder law attorney in order to get your ducks in a row for Medi-Cal qualification. You should plan as far ahead as possible to ensure Medi-Cal qualification.

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