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Who are you caring for?
Which best describes their mobility?
How well are they maintaining their hygiene?
How are they managing their medications?
Does their living environment pose any safety concerns?
Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
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Acknowledgment of Disclosures and Authorization
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment. You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
Remember, this assessment is not a substitute for professional advice.
Share a few details and we will match you to trusted home care in your area:
Nasmir, each business can decide on their own terms. They can decide whether to take this insurance or that insurance or no insurance at all. As long as they tell you upfront what they will accept, they are not trying to deceive or hide anything.
Health care businesses can determine IF they want to participate in and accept assignments for any insurance. Its pretty straight up like JessieBelle described.
Many providers will not accept duel eligibles (on Medicare & Medicaid). Often a NH will participate in Medicare but not Medicaid. A NH can choose not to accept LTC insurance. My moms NH didn't - to be a resident it was either Medicare, Medicaid or private pay.
About the "submission of a care plan", if they are coming into a NH from a hospitalization, they will have had various ICD -10's in their chart at the hospital. There would be an ICD - 10 probably Z series on rehab in the discharge paperwork in their chart. That's viewed as the care plan & with the codes needed for Medicare. It was there as she admitted to the facility as under Medicare rehab benefit. ICD-10 (which went into effect last year) now provides for easier bridging of codes between doctors & clinics to hospitals / hospitals to NH & vice versa.
The bill for the 20% coinsurance will need to be paid either from the assets of moms estate or by you or whomever signed off on the paperwork to be financially responsible. There could be invoices in the pipeline from OT & PT & the outside pharmacy the rehab/NH uses as well - these seem to take longer billing to be sent. Debts like this gets turned over for collections unless probate is opened.
Nasmir, as the wife of a health care provider who helps with the office clerical work, I can tell you that sometimes the paperwork required by an insurance company or out of state Medicaid can be so complicated that it is not worth staff time to try to get reimbursement. We just write off the charges and don't renew our provider contract with that company. I imagine that it is the same with long term care insurance. Also, it is unlikely that a nursing home would want to pay an insurance specialist to navigate the paperwork (probably different for each insurance company) if it is an independent company with limited population turnover. Our insurance person attends seminars every year (multiple times in the last two years because of the roll-out of the ICD 10 codes) just to keep up with the changes. The salary of this person and the cost of the training would need to be passed along to the nursing home residents.
Couple of things to find out about BEFORE yiu do the medicaid application: - will moms $ 50 a day ltc payment be considered "income" by medicaid. Medicaid has a ceiling on monthly income. It varies by state, most are around $2,100 a mo. If moms SS, retirement and LTC (50 x 30 = $ 1500 mo) all count as "income", mom may be over the income ceiling & ineligible for Medicaid. You need to speak with a caseworker clearly on this before you do moms application. There may need some paperwork filed to state it's not reportable "income". - Will the LTC policy will stop paying once Medicaid eligible? Some LTC are written to be a supplemental payment and since medicaid pays all costs in theory is no supplemental needed once Medicaid pays. This should be a question in writing sent to the LTC for a written response to you/mom. - will the NH accept the LTC payment? My moms NH would flat NOT take any LTC policies for payment. Why? Well billing told me that each LTC would require some sort of info on staffing ratios, care plan, licensing & CE credits of staff etc in order to pay & each insurer had their own system....there was always paperwork issues and foot dragging by the insurers....that it just wasn't worth the time needed & delays in payment to take LTC.
Do what you can to make sure no nasty surprises later.....
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Many providers will not accept duel eligibles (on Medicare & Medicaid). Often a NH will participate in Medicare but not Medicaid. A NH can choose not to accept LTC insurance. My moms NH didn't - to be a resident it was either Medicare, Medicaid or private pay.
About the "submission of a care plan", if they are coming into a NH from a hospitalization, they will have had various ICD -10's in their chart at the hospital. There would be an ICD - 10 probably Z series on rehab in the discharge paperwork in their chart. That's viewed as the care plan & with the codes needed for Medicare. It was there as she admitted to the facility as under Medicare rehab benefit. ICD-10 (which went into effect last year) now provides for easier bridging of codes between doctors & clinics to hospitals / hospitals to NH & vice versa.
The bill for the 20% coinsurance will need to be paid either from the assets of moms estate or by you or whomever signed off on the paperwork to be financially responsible. There could be invoices in the pipeline from OT & PT & the outside pharmacy the rehab/NH uses as well - these seem to take longer billing to be sent. Debts like this gets turned over for collections unless probate is opened.
- will moms $ 50 a day ltc payment be considered "income" by medicaid. Medicaid has a ceiling on monthly income. It varies by state, most are around $2,100 a mo. If moms SS, retirement and LTC (50 x 30 = $ 1500 mo) all count as "income", mom may be over the income ceiling & ineligible for Medicaid. You need to speak with a caseworker clearly on this before you do moms application. There may need some paperwork filed to state it's not reportable "income".
- Will the LTC policy will stop paying once Medicaid eligible? Some LTC are written to be a supplemental payment and since medicaid pays all costs in theory is no supplemental needed once Medicaid pays. This should be a question in writing sent to the LTC for a written response to you/mom.
- will the NH accept the LTC payment? My moms NH would flat NOT take any LTC policies for payment. Why? Well billing told me that each LTC would require some sort of info on staffing ratios, care plan, licensing & CE credits of staff etc in order to pay & each insurer had their own system....there was always paperwork issues and foot dragging by the insurers....that it just wasn't worth the time needed & delays in payment to take LTC.
Do what you can to make sure no nasty surprises later.....