Thank you nurse Mary and all the staff for taking care of my sister. God’s blessing be with all of you.

— Carol B., Georgetown, MD

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Frequently Asked Questions

What is Long-Term Care?

Long-term care refers to assistance with the very basic, every day activities that most of us can do for ourselves. We call them ADLs or Activities of Daily Living. As a result of illness, injury or advanced age, many people need assistance in order to eat, dress or bathe. The need for long-term care may also result because a person has cognitive impairment. Some people need supervision or reminders to accomplish every day activities such as using the toilet, eating, bathing, and dressing.

What is Assisted Living or Personal Care?

Assisted living or personal care bridges the gap between the constant nursing care provided in nursing homes and the unsupervised private home. An assisted living or personal care facility is designed to provide private or semi-private apartments for residents who meet certain standards of self-sufficiency.  People who live in an assisted living or personal care facility need assistance with daily living needs.

What is the current Medicare coverage for long-term care, nursing home care, and skilled nursing facility care?

Generally, Medicare does not pay for long-term care. Long-term care can be provided at home, in the community, or in various types of facilities, including nursing homes and assisted living facilities. Most long-term care is considered to be “custodial care.”

Custodial care is nonskilled personal care, such as help with activities of daily living like bathing, dressing, eating, getting in or out of bed or chair, moving around, and using the bathroom. It may also include care that most people do for themselves. Medicare does not pay for custodial care.

Medicare pays only for medically necessary skilled nursing facility (SNF) care. Generally, skilled care is available only for a short time after a hospitalization. Skilled care is health care given when you need skilled nursing or rehabilitation staff to manage, observe, and evaluate your care. Examples of skilled care are changing sterile dressings and physical therapy.

What is a Medicare deductible?

A deductible is the amount you must pay each year before Medicare begins paying its portion of your medical bill. There are deductibles for both the Part A (Hospital Insurance) and Part B (doctor services) portions of Medicare. Your deductible is taken out of your claims when Medicare receives them. Medicare will not start paying on your claims until you have met your annual deductible.  For the current deductibles for Medicare Parts A and B,  please refer to this website: http://questions.medicare.gov/app/answers/detail/a_id/2305 If you have any questions on the status of your deductible please contact 1-800-MEDICARE (1-800-633-4227).

Does Medicaid cover long term care?

The Medicaid program provides coverage for long-term care services for individuals who are unable to afford it. Although the federal government establishes general guidelines for the program, the Medicaid program requirements are actually established by each state. Whether or not a person is eligible for Medicaid will depend on the state where he or she lives. Each state has different Medicaid eligibility income and resource limits.

When an individual applies for Medicaid coverage for long-term care, states conduct a review, or “look-back,” to determine whether the individual (or his or her spouse) transferred assets (e.g., cash gifts to children or transferring home ownership) to another person or party for less than fair market value. The “look-back period” is 60 months (five years) prior to the date the individual applied for Medicaid. In general, you should apply for Medicaid if your income is low.  (Even if you are not sure whether you qualify, if you or someone in your family needs health care, you should apply for Medicaid and have a qualified caseworker in your state evaluate your situation.)

What is the difference between Medicare and Medicaid?

Medicare

Medicare is an insurance program. Medical bills are paid from trust funds which those covered have paid into. It serves people over 65 primarily, whatever their income, and serves younger disabled people and dialysis patients. Patients pay part of costs through deductibles for hospital and other costs. Small monthly premiums are required for non-hospital coverage. Medicare is a federal program. It is basically the same everywhere in the United States and is run by the Centers for Medicare & Medicaid Services, an agency of the federal government.

Medicaid

Medicaid is an assistance program. Medical bills are paid from federal, state and local tax funds. It serves low-income people of every age. Patients usually pay no part of costs for covered medical expenses. A small co-payment is sometimes required. Medicaid is a federal-state program. It varies from state to state. It is run by state and local governments within federal guidelines.

For more information regarding Medicare and its components, please go to www.medicare.gov.
For more information on Medicaid, please go to http://www.cms.hhs.gov/home/medicaid.asp

Visiting my loved one at a long-term care center is difficult. How can I make it more enjoyable and fulfilling for both of us?

Visitors are very important to our residents and a well-planned visit can be rewarding for both of you. When visiting a loved one, talk to the staff about the best time to visit. Coach your children on what to expect and plan an activity such as working on a photo album, writing letters, playing cards or a game, or eating a meal together. If possible, plan an activity outside of the center. Check with our facility for its policy on bringing cherished pets for visits.

As a caregiver, I feel I need some help. Where can I turn?

As the child or spouse of an aging or ill loved one, guilt or fear may prevent you from getting the help you need. Our admissions team will be happy to provide you with literature support, community support programs and information about our services, including respite care, to help you take a break and get the rest you may need.

Who are Long-Term Care Ombudsmen?

The Long-Term Care Ombudsman program assists residents of nursing homes and advocates on their behalf. Ombudsman staff visit nursing homes and speak with residents throughout the year, working to make sure that the residents’ rights are being upheld. The state inspection team gets information from the ombudsman about problems in the facilities.

The ombudsman is an important resource to residents, their families and friends. The ombudsman can provide information about how nursing homes are organized and regulated. The ombudsman may be able to highlight the nursing home’s strengths and weaknesses. The ombudsman can also work to resolve problems such as poor care, dietary needs and financial issues. Sometimes consumers’ problems can be dealt with very effectively by the ombudsman who mediates between the resident and the nursing home staff; however, the consumer may want to file a complaint with the regulatory agency which has the power to enforce federal guidelines on nursing homes. The ombudsman can work with you to determine how problems in nursing homes may best be handled.


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