Selecting an Assisted-Living Facility

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Checklist for Financial Planners

[By Staff Reporters]

Thousands of boarding homes cater to the elderly. Their operators promise to provide at least a place to sleep and food to eat. Beyond that, the services and assistance offered will vary from facility to facility. This checklist will help the financial planner or his or her client find a facility that is appropriate in all respects to the client’s resources and needs. Unlike nursing homes, assisted-living facilities often operate without any scrutiny from public agencies. Furthermore, Medicaid often will not be a source of funds.

The Checklist

The items the financial planner and client should consider when selecting a facility are listed below.

      1.   Determine the client’s willingness to live in a group environment.

      2.   Avoid unlicensed facilities, particularly if Medicaid-provided services may be needed in the future.

      3.   Review the facility’s inspection report.

      4.   Review the facility’s service contract and house rules. Look for answers to the following questions:

            a.         Where will the resident live?

                        Are there any types of ownership rights?

                        What flexibility is there with respect to furnishings?

                        Will the same unit be available after a hospital stay?

            b.         What meals are included?

                        Will the facility provide appropriate meals and a special diet?

            c.         What form of transportation does the resident currently use?

                        What transportation is provided by the facility?

                        Can residents shop, dine, attend services or visit doctors?

            d.         What help does the facility provide during a medical emergency?

                        What type of staff training is provided or required? Is there 24-                        hour-a-day staffing?

            e.         What provisions are there for privacy? When are rooms cleaned and when can staff access the rooms?

            f.          What is the basic cost and what are the costs for extras?

                        What is included in each?

                        What provisions for fee increases are there?

            g.         Can a resident see his or her own doctor?

                        Does the facility offer transportation for appointments?

            h.         Who’s in charge of administering and scheduling medication?

                        Can medication and other supplies be purchased at the facility?

            i.          What happens if the resident’s health begins to fail?

                        Does the facility provide additional services to help with ADLs?

            j.          What is the procedure for transfers from one unit to another?

                        Does the resident have any opportunity to express an opinion?

            k.         What’s required if a contract is terminated by facility or resident?

                        What is the provision with respect to refunded fees?

                        Is there a required minimum stay?

Assessment

What have we missed?

Conclusion

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3 Responses

  1. No matter how nice and clean the facility may be – caregivers are usually minimum wage workers – even in the most expensive private facilities.

    Taking care of your loved ones is just a job to them. Be careful and very afraid!

    Katherine

    Like

  2. New York State Office of the Medicaid Inspector General
    (“OMIG”) Issues Audit Protocol for Assisted Living Programs

    OMIG published an audit protocol for assisted living programs (“ALPs”) on November 22, 2013 to take immediate effect. The protocol provides guidance for ALP providers in complying with certain requirements under the Medicaid program. OMIG uses the audit protocol during audits to determine if payments made should be disallowed. See a copy of the protocol here.

    Below is a list of some of the deficiencies in a provider’s records that might result in a paid claim being disallowed under the Medicaid program.

    Deficiencies of Patient Record

    • Patient Record: Missing, fails to support the service provided, or fails to document the specific service provided

    • Medical Evaluation (“ME”): Missing or lacks required signatures (e.g. physician’s signature)

    • Interim Assessment: (Follow-up examination 6 months after ME): Missing or lacks required signatures

    • Plan of Care: Missing, lacks nurse’s signature or is not dated

    • Nursing/Functional/Social Assessment: Missing, lacks required signature or is not dated

    • Patient Review Instrument (“PRI”): Missing, is not dated or signed by a qualified assessor, or the PRI level assigned to the patient is not supported by the patient record

    Deficiencies in Billing

    • Incorrect rate code billed

    • Services billed when patient was an inpatient at another facility

    Deficiencies of an Employee’s File

    • Missing personnel file

    •The following documentation in the caregiver’s personnel record is missing:

    • Documentation of mandatory training

    • Certificate of immunization

    • Documentation of annual Health Assessment

    • Documentation of annual PPD skin test (tuberculosis) or any related follow-up

    • Annual performance evaluation

    Garfunkel Wild PC
    info@garfunkelwild.com

    Like

  3. “We Don’t Even Know Who Is Dead or Alive”
    Trapped Inside an Assisted Living Facility During the Pandemic

    What it’s like to stay alive as the virus charts its fatal course through a home for the elderly in one of the worst-hit neighborhoods in the Bronx.

    https://outlook.live.com/mail/inbox/id/AQMkADAwATIwMTAwAC0wMABiNC1lN2E5LTAwAi0wMAoARgAAA45XPvPLbidClpyDnegZn%2FkHACfALpkdWIFAoFpwqJkAmu8AAAIBDAAAAJmLSnnVPTdJjYaRAm3M0E4AA4ObXY8AAAA%3D

    Blake

    Like

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