What you need to know about financial, health and legal requirements.
Nursing Homes and Assisted Living facilities are not the same, but many people don’t understand the difference. Nursing homes are a “skilled nursing” facility (SNF), designed for residents that need constant nursing supervision.
Assisted living communities on the other hand, do just that, assist seniors with medications, activities of daily living, meals, housekeeping and hold social activities. If your senior can no longer live on their own safely, but doesn’t need the high level of care provided in a nursing home, this is a great alternative. (Jump to Lessons Learned)
Moving to an assisted living facility is a big decision on your part and the community’s . To ensure you are a good fit, expect to have your senior’s suitability assessed in three areas: Finances, Health, and Legal documents.
Finances are a huge concern for potential residents and the assisted living facility. Residents pay in one of three ways: Private Pay, Long Term Care Insurance, or Medicaid. The application process requires you fill out a financial disclosure form which helps the facility better secure an idea of when, or if, you might need Medicaid assistance.
If you have Long Term Care Insurance, make sure you have carefully read your policy and understand what it will and will not cover. If necessary, have an elder care lawyer review it to make sure your options have not been limited. Fully disclose any limitations to the facility during the financial review.
Facilities will charge a one-time community fee which includes: Admission Paperwork and Processing, Room Maintenance, Facility Grounds, Social Gatherings, Certain Outings and Programming Supplies.
Prior to move in, the assisted living nurse will conduct a clinical assessment. This “level of care assessment” can occur during a visit to the facility, at your home or wherever you currently reside, like a rehabilitation center. This assessment, along with a history and physical report from your doctor, determine what level of care the facility will need to provide.
Here is an example of potential care levels:
- Traditional level – requires no assistance
- Level 1 – may need assistance in dressing
- Level 2 – may need assistance in dressing and bathing
- Level 3 – may need assistance in dressing, bathing and ambulation (light activity like sitting, standing and walking)
- Medication Management – may need assistance in ordering, dispensing, administering and planning of medication
In addition, you must prove that you do not have a communicable disease like TB. Proof in the form of a chest X-ray, or the results of a Purified Protein Derivative (PPD) skin test are required before moving in. And, your doctor must provide an original (hard copy) script for each medication.
As a resident, if you are released from a hospital stay and need physical and/or occupational therapy, most assisted living facilities have a floor, wing or building where you can undergo rehab. A hard copy of scripts for physical and/or occupational therapy must be provided by your doctor.
But what if your need becomes more medically complex over time? There are limits to the medical complexity assisted living communities can handle. A resident that needs a feeding tube or Hoyer lift will be directed to a nursing home. The assisted living center staff will helps your senior make that transition.
Prior to move in, there are four legal documents that need to be in place: Living Will, Health Care Proxy, Durable Power of Attorney and a POLST form. For more information on these topics: 4 Tips Before You Become Your Parents Caregiver
With thanks to my collaborator on the Assisted Living series, Jennifer Ennis MSW.
Jen Ennis received a Masters degree in Social Work from West Chester University in Pennsylvania in 2007. She then worked for ten years at St. Mary Medical Center in Langhorne, Pa as a hospital social worker. Jen still works at St. Mary Medical Center once a month as she loves working in the hospital setting. In 2012 Jen ventured in to the marketing/clinical liaison field in New Jersey where she has been working for the last 5 years. Jen enjoys working with seniors and their families to ensure the best possible outcome for everyone.
Disclaimer: The material in this blog is for educational purposes only. It is not intended to replace, nor does it replace, consulting with a physician, lawyer, accountant, financial planner or other qualified professional.