Rod Holst541-685-1533rod@adultlivingsolutions.com

Your Independent and Assisted Living Referral Placement Specialists

adultlivingsolutions.com

2

FREE REFERRALS

•Active Retirement

•Assisted Living

•Residential Care

•Alzheimer’s & Memory Care

•Adult Foster Homes

•Skilled Nursing Homes

I can save a person a lot of time and frustration by recommending and taking them to the communities that best meet their needs availability.

There is no charge to clients or families for my services.

3

REFERRAL PLACEMENT PROCESS

1.Meet and Gather Information

2.Search for Best Communities

3.Visit Selected Communities

4.Move In

5.Follow Up

I only work with people who are private pay and not on state paid Medicaid.

4

RESIDENT’S BILL OF RIGHTS

•All facilities are licensed by the state.

•Care communities and homes are inspected on a regular basis by the state. •Skilled nursing homes are also inspected by the federal government.

•Caregivers must respect your privacy, dignity, independence and your right to make choices.

•Each facility must post the Resident’s Bill of Rights in the home and discuss those rights with each resident at the time of admission.

5

RETIREMENT COMMUNITIES

•Private Apartments (up to 3 bedroom)•Usually unfurnished•Kitchen and bath •Designed for those who are totally or nearly independent•Live in a community with other seniors•Secure

•Amenities Include:•Organized social programs•1, 2, or 3 meals per day•Weekly housekeeping & linen laundry•Transportation•Recreational activities•Barber, beautician, social services •Access to health and shopping facilities

•Disadvantages: •They usually do not provide nursing care services

•Average Cost: $1100 to $4300 per month•Studio $1600, 1 Bdrm $2200, 2 Bdrm $2700, 2nd person $500

6

ALL ASSISTED CARE COMMUNITIES PROVIDE

•Medication management (under lock & key)

•3 meals a day

•Weekly housekeeping and linen service

•Laundry (most Assisted Living facilities charge for personal laundry)

•Activities

•Transportation (most facilities, some foster homes)

•Assist with activities of daily living (ADL's)

Some charge for extra care using a point system based on the kind of extra care, others use a combination of points and level of services method.

7

ACTIVITIES OF DAILY LIVING (ADLs)

Eating/Nutrition: The ability to eat with or without special equipment.

Dressing: The ability to dress and undress and to comb one's hair, file nails, etc.

Personal Hygiene: The ability to bathe, wash hair, shave, care for teeth.

Toileting: The ability to get to and from toilet, to clean afterward and adjust clothing.

Mobility: The ability to get around, both inside and outside, using item like canes, walkers and wheelchairs if necessary; ability to transfer from bed or wheelchair.

Behavior management: The ability to understand one's needs in areas such as health and safety.

Confusion, disorientation, forgetfulness or wandering may be related to a behavior management need.

8

ASSISTED LIVING COMMUNITIESTypical resident: Individuals not needing continuous supervision but needing some help with ADL’s and want an apartment-like setting.

•Private Apartments (up to 2 bedroom)•Unfurnished•Kitchen and bath •Staffed 24 hrs each day, secured at night

•Amenities Include:•3 group meals per day•Weekly housekeeping & linen laundry•Social activities•Laundry Room•Access to health and shopping facilities

•Some Facilities Provide:•Nursing Services •Transportation•Dementia Care•Physically connected to Retirement Community for ease of transition when needed.

•Disadvantages: •Can have high staff turnover or understaffing•Some residents can become isolated

•Average Cost: $2400 to $4600 per month base charge•Studio $2800, 1 Bdrm $3500, 2 Bdrm $4400, 2nd person $600

9

Typical Resident: Older person that is dependent on someone else for care and safety. Wants more individual care than assisted living and more social interactions than foster care provides.

•Group Home with 6-100 Residents or More:•Can be small and home-like or larger with individual rooms or apartments•Can be private or semi-private•Can be furnished or unfurnished•Staffed 24 hrs each day, secured at night •Assistance with ADLs

•Amenities Include:•Medication management•Meals provided•Housekeeping•Social activities•Transportation•Nursing Services

•Disadvantages: •Less individual care than foster homes

•Average Cost: $2600 to $3800 per month base charge•Semi-private: $2600, Private: $3000

RESIDENTIAL CARE COMMUNITIES

10

ADULT FOSTER HOMES

Typical Resident: Needs assistance and wants a home-like setting. Residential care in a home-like environment for up to 5 or fewer senior or handicapped adults.

Homes are classified as level 1, 2 or 3, depending on the qualifications of the provider and the type of care provided.

•Private and Semi-Private Bedrooms•Staffed 24 hrs each day, secured at night •Assistance with ADLs•Furnished with bed, dresser, and night stand (can be replaced with resident’s furniture)

•Amenities Include:•Medication management•Meals provided•Housekeeping & laundry•Nursing Services

•Disadvantages: •Less interaction with fewer residents•Less amenities•Not appropriate for persons requiring heavy lifting, 2 person transfers or assistance at night.

•Average Cost: $1800 to $3500 per month base charge•Semi-private: $2300, Private: $2700

11

ALZHEIMER’S & MEMORY CARE COMMUNITIESTypical Resident: Usually a person with medium to advanced dementia or Alzheimer’s who is unable to get the care they need at their own home, in an adult foster home, or in a residential care community.

These facilities are sometimes located within a residential care facility. A doctor’s diagnosis is needed for admittance.

•Private and Semi-Private Bedrooms with Private and Semi-Private Bathrooms•Assistance with ADLs•Furnished with bed, dresser, and night stand (can be replaced with resident’s furniture)•Higher staffing ratio•Staffed and secured 24 hours a day with keypad lock entry.

•Amenities Include:•Medication management•Meals provided•Housekeeping•Social activities•Transportation•Nursing Services

•Average Cost: $2400 to $5300 per month. Many have a set price to include all care needs and most if not all supplies. Others have a base price and add on costs for care needs and supplies.

•Semi-private: $4200, Private: $4600

12

SKILLED NURSING HOMES

Typical Resident: For patients who need 24-hour nursing supervision and/or rehabilitation services. Many patients are confined to bed for some portion or all of the day and many are incontinent. .

Communities offer medical treatment under the supervision of licensed nurses and at least one registered nurse must be on duty.

•Private and Semi-Private Rooms•Assistance with ADLs•Furnished

•Amenities Include:•Medication management•Meals provided•Housekeeping•Social activities•Full time nursing and medical supervision

•Disadvantages: •Lack of individual attention•Highest cost

•Average Cost: $7000 to $10,500 per month

13

MEDICAID•Medicaid is not the same as Medicare.

•Many adult foster homes and facilities accept Medicaid residents.

•They usually will only place a Medicaid resident in the lowest priced private room, if that is all they offer, or in a semi-private room.

Qualifications for Medicaid:•Income•Assets•Apply only to Medicaid applicant, not spouse•Care needs

How Medicaid works:•If a person qualifies for Medicaid and has income of at least $150 per month, they are allowed to keep that amount. •Anything over the $150 is used, plus whatever the state needs to add, in order to pay for the cost of the person’s room, board and care needs.

•All of the person’s medical service, medical transportation and approved equipment needs are paid for by Medicaid.

14

PLANNING AHEAD•If a community has a Medicaid contract, they can take Medicaid residents, but not necessarily every one that applies.

•If a community does not have a contract with the state and therefore does not take Medicaid residents, and a resident runs out of money and becomes dependent on Medicaid, they can ask them to move.

•Usually communities that have Medicaid contracts will keep a resident if they run out of money and need to go on Medicaid, and very few have dropped their Medicaid contracts and asked their Medicaid residents to move.

•If running out of money is a possibility, a person should choose a community that accepts Medicaid residents to lessen the chance that they would have to move again.

•Rarely do facilities, except nursing homes and some foster homes that have Medicaid contracts, take Medicaid residents directly, even if a person can pay privately for a few months. They usually like a person to be private pay for 1 to 2 years before going on Medicaid. Therefore, it's generally recommended that a person consider moving before they are almost out of money.

15

SPENDING DOWN

•Spending down is when a person starts giving money or assets away to get down to the maximum $2000 of assets to qualify for Medicaid.

•Non-liquid assets are usually not counted.

•Be careful about spending down.

•Qualifying assets given away within 5 years prior to applying for Medicaid will be counted in disqualifying a person for that amount of money.

•A person should be sure that their care needs will qualify them in addition to meeting the income and asset requirements.

•A person spending down should consult Senior and Disabled Services and an elder law attorney for a 'resource analysis' and a care needs review before starting to spend down countable resources.

16

DAY AND RESPITE CARE

•Day care is placing a person in a facility for just daytime care and they go home at night. It can be for a few hours or all day.

•Respite care is placing a person in a facility for a few days at a time. They stay overnight.

•These are usually used to give caregivers some relief, especially those caring for a person with dementia.

•Some residential care, assisted living, and memory care facilities do both, if space is available.

•Most foster homes don’t do either.

17

CLOSING NOTES

•For war-time veterans or spouses of war-time veterans who need long term care, the veterans department has an 'Aid and Attendance' program which can help supplement a person's income to help pay for the cost of their care.

•There are some facilities and adult foster homes that don't take people with pets, wheelchairs, scooters, dementia, incontinence, etc. or that are overweight, wander, fall frequently, are on Medicaid.

•Some are full and need to put people on waiting lists which is not good if you have an immediate need.

I know all of the facilities and can match your needs with their criteria and availability.

Rod and Betty Holst