For many families, choosing a nursing home or long term care facility can be a daunting task. And if the loved one to be placed in the home is ill and cannot participate in the choice, a social worker from a hospital may be making the recommendation of which facility to use. In stressful times, families often rely on “experts” to make the choice for them. But with a little pre-planning, the transition into a nursing home can decrease stress and families will feel more secure in their choice.

Look at the Miles

One of the most basic things to consider is distance. How far is the nearest relative? You’ll want to have someone who can look in on the loved one on a regular basis, so this person will need to be in close proximity. Emergencies happen. Items from the loved one’s home may need to be brought in. In the first few days after admission to the home, loved ones may be called upon a few times until everything is settled.

On the Outside

After a few facilities have been identified, site visits are in order. The on-site information gathering starts in the parking lot. What does the outside look like? Any paint peeling? Are the grounds well-maintained? Does the building look well-maintained? Can you see an outside enclosed courtyard for the residents? This will tell you the facility wants to make a good impression and that they are willing to spend the money to do it.

On the Inside

When you cross the threshold of the facility, make sure you had to be buzzed in. The front door should be locked at all times in order to prevent residents from leaving unless of course, the facility is an assisted living facility.

What do you smell? Literally, sniff the air. Are there any unusual odors or bad smells wafting through the hallway? Are there many residents crying out? Do the residents appear happy? Are there any activities going on? Most often there is a large calendar in the lobby of the facility with the scheduled monthly activities listed. There should be several activities per day, preferably one at least every two hours. Look around at the décor. Is it warm and inviting or cold-looking and sterile? Does it make you comfortable being there?

Staff

Notice how the staff responds to you. Are they smiling, maybe laughing with each other? How are their interactions with the residents? Are residents simply parked in front of the TV or is the staff openly trying to engage them in conversation or activities? Look at the residents clothing and faces. Are they clean?

Of course, these are just a few of the things to consider when searching for a nursing home or long-term care facility for a loved one. For more assistance, you should consult a qualified elder law attorney.

Levine & Furman, LLC is a member of the American Academy of Estate Planning Attorneys.

Continuing Care Retirement Communities, CCRC’s, are an excellent solution to the ongoing dilemma of providing the proper living arrangements to senior citizens as their needs change. CCRC’s offer several levels of living options, assistance and health care for seniors all on one ‘campus’. They normally offer two or more of the following living arrangements within their community:

• Independent living for residents who require no assistance, normally in lower maintenance housing such as one level homes, apartments or townhomes. Amenities such as swimming pools and fitness facilities are shared as they are in many community settings.
• Assisted living facilities for those who require some assistance with their normal activities of daily living. Meals are often provided in a group setting while the rooms or apartments offer small or limited kitchen space.
• Nursing home facilities for those who need short and long term care when additional assistance or medical care is necessary; and
• An Alzheimer’s unit or memory care facility offering 24 hour assistance and care.

Residents normally move into CCRC’s as an independent living resident. As more assistance becomes necessary, they are able to transfer to assisted living, or in a medical emergency, the short or long term care facility. As the senior citizens’ needs begin to change, they have the peace of mind that living options are available without having to relocate.

Many CCRC’s are managed by not-for-profit institutions. The advantage of the non-profit status is that profit is reinvested within the community rather than distributed to individuals or investors. Not only does this keep the community updated and well kept, but it may allow the CCRC’s to offer living options to a resident who outlives their assets.

CCRC’s normally charge an entrance fee and a monthly fee to residents. One distinct financial advantage of CCRC’s is that a percentage of the entrance fee and monthly fee is often tax deductible as a medical expense, making these comprehensive living arrangements even more attractive as a senior living solution.

Levine & Furman, LLC is a member of the American Academy of Estate Planning Attorneys.

Medicare is a Federal health insurance program that falls under the Social Security Program. It provides benefits primarily for people age 65 or older, but people younger than age 65 can qualify for Medicare, including those who have certain disabilities and those with permanent kidney failure.

While Medicare helps with the cost of health care, it does not cover all medical expenses or the cost of most long-term care. Since the Medicare program is complex, we’ve put together a sampling of our clients’ top frequently asked questions.

How do I enroll in Medicare coverage?

Most people assume you contact Medicare, the CMS (Centers for Medicare and Medicaid Services), to enroll in the Medicare program. This is not the case. Your first point of contact is the Social Security program, although you do not have to be receiving Social Security benefits to enroll in Medicare. If you are already drawing Social Security before the age of 65, you are automatically enrolled in Medicare’s Part A and Part B. Your Medicare card is sent to you approximately 3 months before you turn 65. If you will not be receiving Social Security benefits at 65, you have to contact Social Security to enroll in Medicare – they will not contact you.

Is Medicare free?

Medicare consists of several parts, and only Part A is free for most citizens:

• Part A – Hospital Insurance – free when the individual qualifies for social security benefits.
• Part B – Medical Insurance – The cost is a monthly premium
• Part C – Medicare Advantage (Parts A and C combined) – The cost is a monthly premium
• Part D – Prescription drug coverage – The cost is a monthly premium

While the costs of the coverage may be free or involve premiums, there are often co-pays and additional costs for health care similar to standard insurance policies.

Does everyone qualify for Medicare when they turn 65?

Every U.S. citizen qualifies for Medicare Part A when they turn 65. Even those who do not qualify for Social Security benefits qualify for Medicare Part A, but there may be a premium involved if either you or your spouse worked for less than ten years.

Does Medicare cover long term care?

No! Medicare only offers extremely limited coverage for long term care. While it may cover up to 20 days in a nursing home, a large co-pay amount comes into play after that time. The bottom line determining coverage normally is whether the care offered is medically necessary or strictly custodial, which means the care provided assists with the activities of daily living (ADL).

Part of a comprehensive estate and retirement plan is understanding the Medicare program and planning for the expenses and coverage that it does and does not offer senior citizens.

Levine & Furman, LLC is a member of the American Academy of Estate Planning Attorneys.