Nursing Homes, Assisted Living & Scams

Sandra Covin / King BeahanFall Conference 2009

Nursing Homes, Assisted Living & Scams

• Definitions• Type of Homes• Scams

Nursing Homes/Skilled Nursing Facility

• Definition• Admission’s criteria• Factors when selecting a facility• Cost of living in a facility• Veterans Community Living Center• Texas State Veterans Homes

Definition

• A residential facility that provides skilled 24-hour care

• A licensed physician supervises each patient’s care and a nurse or other medical professional is almost always on the premises. 

Definition

• Most nursing homes have two basic types of services:

• Skilled medical care • Custodial care• May be integrated into a continuing-

care retirement community or a hospital.

Admission’s Criteria

• Each person’s needs are unique• Some may require short term care

due to rehabilitation• Some may require long term care as

recommended by a physician• Each case is independently evaluated

Factors to When Selecting a Facility

• Facility Certification and Financial Matters

• Specialty Care available• Location• Physical consideration • Staffing

Factors When Selecting a Facility

• Mental and Emotional Well being of Patients

• Room sharing an Furnishings• Residents Care Plan• Employees• Physician• Meals

Factors When Selecting a Facility

• Admissions Requirement• Cost of Care• Transportation Services

Cost of Nursing Home

• Cost for care is expensive• Average daily cost $192.00 a day for

a private room.• Average daily cost $169.00 a day for

a shared room.• Where you live also affects the

amount spent on care.

Cost of Nursing Home

• Payment options• Private Pay• Long-Term Care Insurance• Medicare• Medicaid

Veterans Community Living Center

• Mission• Goals of Care• Locations• Admission Criteria• Community Residential Care

Texas State Nursing Homes

• Seven Homes located in Texas• Designed to serve Texas Veterans

and spouses• Follow State and Federal guidelines• Resident qualifications• Admission Criteria

Texas State Nursing Homes

• Effective May 29, 2009• Change to 38 CFR Part 51 and 58• Per diem for Nursing Home Care of

Veterans in State Homes• Veterans rated less than 70 percent

or higher• Veterans rated 50 or 60 percent

Assisted Living

• Definition• Cost of Residing in a facility• Factors to consider when

selecting a facility

Definition

• Individuals needing assistance with ADL

• Care not as intensive as nursing home

• Provides intermediate care for seniors

Cost of Assisted Living

• Price differs depending on the type of quarters the individual prefers

• Most facilities are private pay• Medicare does not cover the cost• Medicaid may assist with the cost• Long-term insurance may cover the

cost

Cost of Assisted Living

• Fees may start at $1000 a month • The average daily cost is between

$60-$70 a day• May include room and board and

meals• Other care may be offered at an

additional charge

Factors When Selecting a Facility

• Atmosphere/Comfort Level• Services and Activities• Equipment /Amenities• Financial Considerations• Safety Considerations

Scams

• Definition• Elder Law• Financial Service Organizations• Benefits Counselor

Definition

• Financial exploitation is the illegal or improper use of another person’s money or property for personal profit or gain.

Elder Law

• Law that impacts the lives of older Americans

• Fastest growing area of the law• One person attains the age of 50

every seven seconds

Financial Service Organization

• Advertise to provide assistance with claims for A&A

• Promote placing funds in an annuity• Money is made from selling the

annuity

Benefits Consultants

• Provide veterans with information on long-term care

• Do not participate in the application process

• Most work for a Financial Service Organization

Questions??????

Thank You