paying for assisted living

When Will Health Insurers Pay for Someone’s Stay at an Assisted Living Community?

Assisted living communities have served an important role in the US’s health care continuum—often they have been the next stop for older people who have been discharged from a hospital or a skilled nursing facility. Assisted living communities assist their residents with medication management and activities of daily living. With such an important role serving seniors, why don’t insurers pay these providers to keep their constituents safe?

Apart from long-term care insurance, it is not common for health insurers to pay assisted living communities because many insurers and providers operate on a fee-for-service basis. That means providers charge the insurers for each procedure/line item. Under this payment structure, preventative care, like what is provided in assisted living communities is over looked by the insurers–much like your insurer now probably doesn’t pay for your vitamins or exercise classes.

The Center for Medicare and Medicaid Services(“CMS”) in tandem with private insurers, are experimenting with a fee-for-value payment model. Through this model, a cohort of providers are paid a flat fee to manage the health of the insurance company’s constituents. In this model, the group of providers can earn more money by reducing the health care costs of the insured population.

As this new fee-for-value system rolls out, assisted living communities will have an opportunity to take payments from insurance companies as a way to reduce the cost of managing the health care costs of their constituents, most notably through lowering readmission rates into hospitals.

If assisted living communities become part of the formal health care continuum, many will have to change the way they do business. Now, a lot of assisted living communities operate as hospitality companies with a sliver of supplemental care. That’s because these communities must woo consumers in to their communities and we believe they do that through enhancing their hospitality features over care capabilities. The way we understand consumers is they generally require a minimum level of care and then focus on choosing a community with the nicest hospitality features that they can afford.

Under a system by which an insurance company pays an assisted living community, a community must show it knows how to manage a population of people effectively. To do this, assisted living communities may have to improve their health care capabilities. A few notable aspects that Dr. Kevin O’Neil pointed out in his interview with Senior Housing News is senior living communities must work on systems to help prevent falls and manage the medications of its residents better1. That means communities may need to have software systems in place to track metrics about their residents, to train their staff to spot people who are a fall risk, and to hire more staff to manage the communities’ residents better.

Two things need to happen for assisted living communities to take payments from insurers: (1) assisted living communities need to focus more on providing health care; and (2) insurers and providers need to organize under a fee-for-value system. When those two aspects occur in a given market, then you will see assisted living communities take payments from insurers as a result of caring for the insurers’ constituents.

Sources:

  1. https://seniorhousingnews.com/2019/11/11/affinity-pushes-innovation-sees-assisted-living-as-next-big-frontier-for-value-based-care/
Assisted Living Funding

Senior Care Operators Need More Assistance In Light of COVID-19

Senior living operators including independent living and assisted living communities have shown declining occupancy rates due to COVID-19. In the second quarter of 2020, senior living occupancy rates dipped to 84.9%, down from 87.7% in the first quarter and down from 87.8% in the second quarter of 2019 (this reporting was the lowest since the second quarter of 2011)1,2. According to the National Investment Center for Seniors Housing & Care, assisted living communities’ occupancy rates have declined faster than independent living communities’.

We speculate that several factors are leading to declines in occupancy. Firstly, seniors are hesitant to move into communities which they feel will put themselves or others at an increased risk of contracting or spreading COVID-19. Secondly, and in our opinion most notably, more people are working from home, which may mean they have more time to care for their aging loved ones. The latter point seems to bear more weight, because not only are senior living communities’ volumes down during this time; home care providers’ volumes are down as well3. In other words, an industry which serves people in the comfort of their own homes is not getting the business that senior living communities seem to be missing. However, we need to know more before we can definitively say that home care is not picking up the slack from senior living occupancy levels. Yes, home care volumes are down, but are they down because seniors and their families are not hiring caregivers at the same rate? Or, are volumes down because hospital volumes are also down and hence home care companies are getting fewer referrals from hospitals?

Whatever the reason that homecare and senior living volumes are down, the fact of the matter is, they are down. While these types of business serve our senior population, they are having a harder time doing so as their budgets are squeezed and costs have increased because they must provide COVID-19 precautionary care. These businesses have likely been able to apply for grants and loans through the Small Business Administration; however, they have not yet received any additional funding to help cover the expenses of testing and managing COVID-19 responsibly like nursing homes have. Currently, the Senate is working on a bill to help with such expenses through the passing of the Health, Economic Assistance, Liability Protection, and Schools Act (“Heals”). According to LeadingAge, the package does not do enough to help aging service providers, particularly as it relates to the distribution of PPE and covering some of the additional costs health care providers must incur from managing COVID-19 safely. If you are interested, you may read more about LeadingAge’s synopsis here.

It’s important that Congress appropriate funds to senior living providers because in the past decade senior living communities have stepped in and filled a void that nursing homes have not been able to, which is provide a lower-cost setting of care for people who do not have skilled medical needs. Senior living is part of the US’s health care system, and in order for this country to protect itself from COVID-19, senior living communities also need the same defenses as hospitals and skilled nursing facilities. Congress needs to step up and not shortchange these providers.

 

Sources:

  1. https://www.mcknightsseniorliving.com/home/columns/guest-columns/senior-living-trends-prepare-for-historic-changes-in-2020/
  2. https://www.nic.org/nic-map/assisted-living-industry-analysis-reports/
  3. https://homehealthcarenews.com/2020/05/after-weeks-of-coronavirus-chaos-home-based-care-providers-welcome-early-signs-of-normalcy/

How to Find Nearby Nursing Homes in Washington Area

Nursing homes are a place with 24-hour monitoring along with providing on-site medical care and daily living assistance. Several nursing homes also include social activities for seniors to pass their time and learn new things. A nursing home is for any person who cannot be cared at their home due to any reason. The nursing staff is always present in nursing homes to ensure the safety of people.

If you are searching for nursing homes near Washington area, then read until the end to explore what you need to be vigilant about while searching for a nursing facility.

Compare QoL of Nursing Homes

Every nursing facility has one type of environment, which shows how your loved ones will be living there. The Quality of Life (QoL) in a nursing facility is defined by how they maintain hygiene, how they treat people, and other similar points. If you are visiting more than one nursing facility near Washingtion DC, then you must compare it with one another. This practice will help you to come up with the right option for your loved ones. QoL matters the most, so make the right choice.

Visit Nursing Homes

Do not act upon the word of mouth only. It is important to visit all the nursing homes that are in your list. By visiting you will be able to check everything with your own eyes that will allow you to make an informed decision. Often there are more positive reviews, but the opposite in reality. To avoid any mishap in the future, visit every nursing home for peace of mind.

Does it Meet Your Needs?

Coming to another important point, ask yourself if the nursing home meets your needs or not. The person that you are willing to admit in the nursing home should be the one putting forward their needs. Ask them if they are okay with the nursing facility or if it meets their requirement? Do not impose your decision upon them and let them choose where they want to stay for the rest of their lives. Once they are satisfied, then you can move to the next step, which is to finalize things.

Finalize

Once you have checked everything, now is the time to finalize the deal. Visit your favorite nursing facility and follow the procedure. Make sure to read everything that you have to sign to avoid any problems in the future. It will save you from a lot of trouble.

Conclusion

Choosing the right nursing facility is not simple or easy, you have to search for a long time to make a decision. Evaluate the place, the staff, hygiene, and several other things for your mind’s peace and your loved ones’ safety. Make the right decision at the end of the day by ticking all the boxes on your checklist. It is okay to take some time while deciding upon a nursing facility as it is not an easy decision. Select the best space!

Find the Right Senior Retirement Community Near You With Senior Advisors Plus

Senior Advisors Plus is one of the best places helping families and people requiring care in their old age. Choosing the right facility brings ease and comfort to both regimen and their families in the long term. There must be several retirement communities near you providing the same service, but how can you choose the best one? It remains an important question while selecting a senior retirement community for your loved ones.

Senior Advisors Plus can help you get in touch with the right senior retirement community that meets your needs. We offer two services: Referral Service and Advisory Service.

Our Advisory Service is the best option for you to analyze some of the top caregivers or retirement communities around you. Here’s how we help you find the right senior retirement community.

Evaluate Senior Care Options

Searching for a caregiver is a long process and it cannot be done by selecting the first one you come in contact with. Many senior communities in the society are tirelessly working for seniors; however, not all of them are suitable for you. At Senior Advisors Plus, we help families to build a strategy that works well for them. The strategy is based on the most important factors: the health of the senior, budget, preferred location, and lifestyle.

So, if you are looking for senior retirement homes near you, then these are a few important factors that we work upon. We will jot down a list of senior care options for you, which will help you in making the right decision.

Finding a Solution as Per Budget

As mentioned above, we work upon several factors; however, the budget remains our top concern. In our Advisory Service, we plan to pose less burden on the families, which is why we ask for their preference in all matters. While evaluating the right senior retirement facilities, we make sure that they fall under your budget with no hidden charges, whatsoever.

Meeting the Client’s Goals and Needs

Every senior have their particular needs and goals, which is important to fulfill if they want to spend a carefree and happy life in the retirement community. At Senior Advisors Plus, we find the right option for our clients that meets their needs and goals. For us, the satisfaction of our clients matters the most, so you can count on us for finding just the right place for you.

Why Should You Choose Us?

Senior Advisors Plus has years of experience in helping clients of all types with different needs and goals in their minds. We have several connections in the care industry, which will enable you to find a quick solution to your problem. We work side-by-side with our clients to ensure client satisfaction. Hence, if you are looking for a senior retirement community, then there is no better place than Senior Advisors Plus to help you in the process. Make sure that your seniors feel safe and happy in their community.

Decluttering and Downsizing: A Guide for Seniors and Their Loved Ones

This guide is designed to make the downsizing process as simple as possible for aging adults and their loved ones. It will help you prepare for the transition, as well as offer advice to loved ones on what they can do to help. Keep the lines of communication open, take it one step at a time, and don’t rush into anything before you’re ready.

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Senior care tax deductible

Senior Care Expenses Can Be Tax Deductible

The federal government postponed the date to file 2019 federal income tax returns to July 15, 2020. Many tax professionals advised their clients to wait to file their returns until the last minute. With the due date right around the corner, we wanted to make our readers aware that senior care costs may be tax deductible. For the 2019 tax year, there are two broad programs under which senior care costs may be tax deductible, the Federal Tax Credit for Other Dependents and the Dependent Care Deduction. This post will explain at a high level what these two programs are and how a family may qualify for them. To determine whether it’s better to file under one program or the other, consult your tax professional.

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3 AVOIDABLE MISTAKES PEOPLE MAKE WHEN CHOOSING A SENIOR LIVING COMMUNITY

Moving into a senior living community could be the second largest transaction one makes in his or her lifetime. It’s important to get it right; otherwise, a family may have to search for a new place, again, or risk depleting all their loved one’s assets. Here’s a list of three mistakes people make when searching for and choosing senior living communities.

  1. They don’t consider that their cost of care could increase. Many communities charge rates depending on the level of care that the resident requires. It’s common for a resident’s level of care to increase as he or she ages. As a result, costs are likely to increase during a resident’s stay at a senior living community, and by how much is something people generally do not consider. When selecting a community, it is a good idea to select one well within your income limit to avoid costs overrunning assets or income.

So, by how much should one account for costs increasing over their course of his or her care needs? It depends on the client’s age, diagnoses, level of care at the start of residency, and the home, among other things. This is a question we will help families account for in our process to find them the best place for their loved ones.

  1. They don’t find communities that specialize in their love one’s care needs. While some people may consider nursing homes and senior living communities all the same, those that are familiar with the industry know that they are very different. Not only are those two settings of care different, there can also be differences in the level of care at nursing homes and senior living communities. Meaning, not all nursing homes and not all senior living communities do the same thing. When selecting a home for a loved one, to maximize value, it’s important to choose a home which offers care tailored to your loved one’s needs. Homes can differ on what they specialize in based on diagnosis, such as people with dementia, or ambulation level.

When residents are properly matched with a home based on their level of care, they have a better chance to maximize the value of the home. For instance, a resident who is ambulatory who only needs medication management would probably be overpaying if he or she moved into a home that is heavily staffed to care for people who need two Certified Nursing Assistants (“CNAs”) to help them transfer from the bed to a wheelchair. In order for the home to be able to afford to pay its CNAs, it must charge its residents a premium above its rental expense. As a result, an ambulatory person will likely be paying for care he or she does not need. That’s why it’s important for people to search and choose homes that are tailored to their loved one’s needs.

  1. They don’t negotiate with the communities. In our opinion, many people don’t negotiate because they don’t know that they have considerable buying power over the providers or are frightened at the sign of confrontation. It bears repeating, moving into a senior living community, and hence signing a contract to do so, is likely the second largest purchase one will make in their lifetime. Negotiate!

To negotiate well, one has to know his or her negotiating position. When working with clients, we combine three things to develop a negotiating position: (1) our analysis of the client’s situation; (2) number of communities to choose from; and (3) knowledge of market indicators. By following this strategy, we have been successful helping many of our clients lower their costs.

If a family is successful at avoiding these three mistakes, they have a much better chance of giving their loved one the quality of life they intend. While any family can come up with a solution on their own, we strongly suggest they seek expert advice to avoid mistakes that naturally come with trying something new. We’re happy to set up a free consultation to talk about your circumstances.

Best Wishes,