FeaturedHelp for Applying for Medical Assistance

Help Sheet for Applying for Medical Assistance

January 2017

Please note that I am writing this to you as a guide. I have had many family members voice frustration with me as to the “how’s” of navigating through the medical assistance application process. I am not an attorney, and this is not legal advice but rather, things I have learned over the past 25 years of helping families through the medical assistance process.

We accept the GRH, Group Residential Housing rent rate, which the State of MN determines every summer, for a shared companion room. This means that you can only remain in a private room while on medical assistance, if someone other than the person applying for medical assistance chooses to pay the private room differential for the resident.

  1. When should you apply for Medical Assistance, which is generally titled elderly waiver (EW) in assisted living settings?
    1. A good rule of thumb is to call the county phone numbers in the county which you reside 60 days before your assets reach $3,000 as a total balance.
    2. If you do not have care needs as determined by the state, you may be denied access to assisted living if your needs could be met in another independent setting. The nurse who determines your level of care needs determines this on the LTCC Consultation or MN Choice Assessment. The State of MN wants to make sure seniors are placed in settings which meet their needs.
    3. You can access the medical assistance application on the Diamond Willow and Keystone Bluffs websites.

 

  1. There are two very important steps to take: (1) Apply for financial assistance and fill out the medical assistance application and call the county financial worker (2) Call for a LTCC or MN Choices level of care assessment with the county.
    1. The financial eligibility is one aspect of the process, which determines financial need after the county reviews the application completed by the resident/family member. Once the financial eligibility process is started, the case has to be opened in 60 days. Otherwise, if paperwork is not completed, the case will go back to day zero and the process for opening medical assistance may be delayed and the resident may have no payer source to pay their bills for care in a setting such as an assisted living.
    2. The level of care assessment is something that is a second aspect of the process, and this is done by a separate agency in the county. This level of care assessment determines medical need and is called a LTCC assessment or MN Choices assessment. Once the nurses from the county do the level of care assessment, this is good for only 60 days. This means that the financial team must have all the paperwork they need in a timely manner, to assure the case is opened for the senior applying for medical assistance.
    3. Once the financial team opens the case, and the nurse determines level of care need to support assisted living need, then the provider can bill the State of MN for the service portion of the cares. It is important to know that the state does not allow back billing, therefore the resident is considered private pay until the county opens the medical assistance case.
    4. Important phone numbers to call for the county you reside in:
      1. For Diamond Willow Residents who reside in Lester Park, Proctor, Mountain Iron and Keystone Bluffs Residents, call 218-733-2725 to apply for financial assistance. Please call 218-726-2366 for a LTCC/MN Choices level of care assessment.
      2. For Diamond Willow Residents who reside in Little Falls, call Morrison County at 320-631-3577 and ask for the long term care team to assist them with the financial application. Then they should call 320-632-6664 which is public health for the MN Choices application.
      3. For Diamond Willow residents who reside in Alexandria, call Douglas County at 320-762-2302, and this is the number to call to apply for medical assistance. Then call 320-763-6018 and this is the public health nurse line to request a level of care assessment which is known as a LTCC consultation or MN Choices.
      4. For Diamond Willow residents who reside in Detroit Lakes, call Becker County at 218-847-5628, and press zero and ask for: The adult service intake team who processes the LTCC Long Term Care Consultation which is known as MN Choices and this determines level of care need. Then you will need to call back the same number at 218-847-5628, and press zero and ask for the financial team to apply for medical assistance in assisted living.
      5. For Diamond Willow residents in Baxter, call Crow Wing County at 218-824-1250, and when they answer it will say Crow Wing County Economic Assistance line. Then there will be a menu of seven choices. Press 0 to speak to a county representative. Then it will list to four more choices, then press 4 to speak to a county representative. Please let them know you need to apply for medical assistance and you currently reside in an assisted living. Then call 218-824-1140 to schedule a LTCC screen/MN choice assessment which determines the level of care need.
      6. For Diamond Willow residents in Grand Rapids, call Itasca County at 218-327-6706 or 218-327-6146 and let them know you need to apply for financial assistance and you currently reside in an assisted living. You also need to let them know you need a LTCC/MN Choices screen from a nurse to determine the level of care need of the person who is applying.
      7. For Diamond Willow residents in Park Rapids, call Hubbard County at 218-732-2453 and let them know you need to apply for financial assistance and you currently reside in an assisted living. You also need to let them know you need a LTCC/MN Choices screen from a nurse to determine the level of care need of the person who is applying.

 

  1. Other things to be aware of:
    1. It is important to know that your monthly income is a completely separate thing from your total assets when applying for medical assistance. Therefore, assets can be a variety of items such as savings, checking, stocks, bonds, commercial or residential property, land, etc. as just a list of some common examples.
    2. If you are a married couple, the county will do an assessment to determine your eligibility and sometimes one person remains in their home and one person needs a higher level of care. Sometimes both people need a higher level of care and the county has a formula for this which the state has set forth.
    3. The look-back period is 60 months before the date of applying for medical assistance (elderly waiver), therefore if assets are transferred inside of this time period there may be a disqualification period to match the amount of money transferred. This is something the county would determine when doing the application for medical assistance.
    4. Have you had a Long term Care Consultation? This is what is also referred to as MN Choices which determines that the applicant has care needs which the assisted living provider offers.
    5. If the county determines you have a high monthly income as defined by the State of Minnesota, you may have what is called a “Spenddown or waiver obligation.” What this really means is that in addition to the amount you pay for your rent, which is currently $891 per month for a shared room on medical assistance, then you are personally responsible to pay an additional amount of money from your monthly income to the provider each month. This is what “spenddown or waiver obligation means”. If you have a spenddown or waiver obligation, the state reduces the amount they pay the provider for the services, because the resident has a high monthly income and can afford to pay a higher portion.
    6. During the time you are applying for medical assistance, the resident is responsible to continue paying the provider monthly to avoid an eviction notice. All residents are considered private pay until they are opened on medical assistance.

 

  1. Some items to gather early for records the state will want to review:
    1. Recent bank statements of balances
    2. Real estate property tax statements, and documents showing amount owed against property
    3. Burial contracts and the name of the company or funeral home that holds the contract
    4. Other assets such as bonds, trusts, stock ownership, annuities, etc. and you must have the current statement with any balance owing against asset.

How Assisted Living Improves the Health of Seniors

Seniors citizens consider the concept of assisted living as a threat to their independence, oftentimes rebelling against staying at such an institution. But as their health begins to decline, living alone begins to pose a serious challenge, and in some cases, it could prove to be fatal. This is where assisted living communities offer an opportunity for seniors to get access to 24-hour care, medical attention and other amenities.

These establishments offer great accommodation and a healthy lifestyle for seniors all the while respecting their privacy and independence. Initially, the change can be a challenge to accept, but with time, seniors tend to adjust to their new lifestyle. In addition, with all the services and amenities they have access to, like cleaning, bathing, dressing and nursing, etc. they start enjoying their living conditions more than ever.

Safety and security is also one of the main concerns of seniors. Modifying your home to better accommodate to their living condition can prove to be an expensive undertaking. Assisted living institutions on the other hand, exist to take care of senior citizens suffering with debilitating diseases and chronic medical conditions. The facilities have everything required to keep these citizens under supervision and to take care of their basic needs on time.

Assisted living institutions also recognize the importance of socialization and its health benefits for seniors. This is why various social activities are organized on a routine basis to encourage social interactions, building relationships and finding new friends with similar interests.

Another important benefit assisted living establishments offer is the access to proper dietary and nutritional meals. Meals are customized based on individual needs and dietary requirements kept in mind to ensure their optimal health and physical wellbeing. Other than that, residents also enjoy full access to senior classes and exercise programs specifically designed and taught by professionals that are specialized in senior health and fitness.

Are Assisted Living Costs Tax-Deductible?

Introduction

Currently, there are a large number of people who use assisted living facilities due to a disability or any other problem, which leads to loss of independence. Most of them pay their fees on their own. These costs are high and some people face problems paying for them. There are some costs that are tax deductible, which include long-term care expenses. There are some exceptions to this:

Who Is Exempted?

For the expenses to be tax deductible, a person must be chronically ill. For a person to be termed chronically ill, it must be certified by a doctor that either he cannot perform routine daily tasks, such as eating, drinking, toileting and taking a bath, or needs constant supervision. In addition to this, the person must be receiving care and treatment from a qualified and licensed doctor or medical practitioner. This means the person must be given a plan to follow by the doctor.

There are also some costs, such as cost of transport to get to the facility, health insurance premiums, qualified long-term care services and dental treatments, which are also, tax deductible. All these costs are not included in the medical expenses.

There is also a dependency deduction that can be claimed if the person who is paying for it has income below a certain level and cannot file a joint tax return. Another scenario can be when the caregiver pays for the services but the person he is caring for must be an immediate family member.

Conclusion

It can be said that the tax rules are composite and a person must consult a tax accountant for the rules regarding these expenses. You can also seek the help of an expert to learn about all the expenses you can deduct from your taxes, so you can reduce the cost of assisted living for a senior loved one.

How to Convince Your Senior Loved One to Consider Assisted Living

A person only seeks what is best for his loved ones. Sometimes the choice is hard to make, but is considered with the greater benefit in mind. Our elders prefer to live in their own house for as long as they can. Most of them with a conventional attitude tend to consider this as their ultimate destination in life. However, this may not always come in their best interest to do so and you may need to convince them otherwise. This is especially true if they are suffering from degenerative mental or physical illnesses such as cancer or Alzheimer’s.

Once their health starts failing, situations may arise where it turns out to be more dangerous for them to stay at home alone and unsupervised. Your house may not be equipped to accommodate them during a medical emergency or there may be cases when they are left unattended for hours causing serious health complications.

This is the part where you need to convince your elders to move to assisted living centers for a better lifestyle. The problem with convincing elders is that most aren’t aware of the facilities that modern assisted living centers offer. They have a fear of losing their independence and privacy. Elders also regard this move to be a step closer towards the inevitable, which is why they will always rebel.

Many other factors hinder their decision in support of moving out of their homes. However, mentioned below are some tips on how you can successfully and honestly convince them to go to the assisted living institution:

  • Talk to them indirectly, do not approach with a decisive statement and try to mention options that they can seek for a better living condition.
  • Offer them a tour of assisted living center to let them know about all the facilities that are being offered and to get them better acquainted with the friendly staff. Show them how significantly better off they will be under professional and time supervision.
  • Ask a friend if he has his elder living in an assisted living center, if so, take your loved one to them and let them have a heart-to-heart conversation on why this is a better option.
  • Show interest in how much you prioritize their privacy and security – and above all, their health and wellbeing.
  • Don’t force unless there is an emergency. It may take a lot of time for them to process this change in lifestyle. This is why you must always be patient.

Why Hygiene Is an Important Factor When Selecting a Nursing Home

It is of utmost importance that nursing homes maintain a high standard of cleanliness and personal hygiene for all their residents. Poor hygiene in a nursing home can often be a cause of serious health complications for the patients living there. This can be especially dangerous for patients suffering with debilitating diseases such as cancer – where even something as simple as a cold can lead to massive medical complications. Moreover, the bacteria and germs all over the place can also affect the senior citizens under care, compromising their immunity, which will exasperate their medical complication. The increasing age of elder patients further inhibits their body’s ability to counter such diseases.

Many infections found among nursing home residents are attributed to poor hygienic conditions. In addition, nurses and other staff members neglect providing optimal care such as changing bandages, diapers, etc. which is something that can also lead to medical emergencies.

The physical environment is also an area of concern for nursing homes where proper hygiene is important. Bathrooms and shower areas need to be sanitized on a regular basis to avoid germs and diseases to spread among other people there. The kitchen and dining area should always be kept nice, clean and sanitized.

The nursing home’s staff often fails to recognize the importance of hygiene given their lack of training and basic awareness. Many times, due to understaffing, employees may come under excess workload and may simply forget to carry out their necessary duties to ensure they provide professional care when it comes giving patients a bath, serving them food, etc.

For example, not washing hands can lead to numerous problems such as infection and other types of problems that sensitive patient will not be able to bear. Training is therefore a big must when it comes to successfully running a nursing home.

Assisted Living vs. Home Care: Why Assisted Living is a Better Option

When your senior loved one fails to handle daily life tasks on their own, such as eating, toileting and running errands, the best solution is to seek in-home care or external care in the form of nursing homes, assisted living and senior care centers. Many people think that assisted living is quite similar to home care, but that is untrue to a good extent.

Assisted living is kind of care facility that helps senior residents with their daily tasks while allowing a certain level of independence. This type of facility does not typically offer daily medical service, unlike a nursing home.

As a resident of an assisted living, your senior loved one becomes a member of the community, which then enables them to partake in various social circles, community activities, and helps them form a routine. Assisted living facilities offer housekeeping, laundry, transportation, and some medical services. The purpose of these facilities is to offer their residents mobility, safety and activity. However, assisted living could mean loss of privacy and independence.

Home care is different from care offered at an assisted living facility. It is like having a trained professional help a senior family member with their daily chores, 24/7. Many people prefer the comfort of their own home and value the privacy factor. However, home care could mean living with other family members or relatives, and that may be annoying or intrusive.

Most assisted living facilities have tiered programs, and their price range is diverse, depending on the service. On the other hand, the cost of home care is also dependent on factors, like the number of hours, the type of service and the difficulty of tasks (depending on the senior’s health condition)

Both options are great, but assisted living is better as it helps the senior member explore their surroundings, make new friends and gives them a chance to engage in different self-fulfilling activities. These facilities are the perfect balance of independence and dependency and so are a great option for older people.

A Guide to the Future of Assisted Living

As the economy changes, so do the realities of assisted living. It is no surprise that senior care facilities are responding to the changes in socioeconomics, which means that both providers and consumers have to get creative and look outside the box. Keeping in mind the overall trends, here are some predictions regarding the future of assisted living.

Rise in Technology-Enhanced Care

Personal care robots are just one of the amazing examples of the type of technology expected to revolutionize assisted living care. There are numerous options that promise health, safety and quality of life for seniors. For example, smart computer systems that keeps track of vital signs and medications to wireless networks, which in turn provide mobile support to residents in care facilities.

Increase in Multigenerational Housing Choices

Seniors who can’t afford or don’t want to move in a community are now looking for more independent lifestyle options. One example of this is multigenerational housing where a family pools their resources and either moves into places that’s designed for both older adults and young families, or amends their present home to suit different generations.

More Lifestyle Perks and Amenities in Conventional Senior Housing

With expected increasing costs for assisted living options, more traditional types of housing have begun that offer a broad variety of amenities to attract potential residents, from cultural and lifestyle-based communities that cater to Asian-Americans or LGBT seniors to a wide array of recreational options, such as cultural events, educational opportunities and fitness classes.

Greener Senior Living

Environmental awareness is causing a stir in assisted living facilities where seniors are encouraged to be more environmentally minded. Facilities and homes are LEED-certified, and different greener methods, like energy saving appliances and lighting are used for saving both money and the environment.

So, these are some changes you can expect in assisted living in the future. Keep these in mind, you can make informed decisions when selecting an assisted living facility for your senior loved one.

3 Don’ts When Deciding on Assisted Living for Your Senior Loved One

When choosing an assisted living facility for your senior loved one, you know there is no room for mistakes and that you have to get it right the first time. This is because jumping from one facility to another is time-consuming, expensive, exhausting and can be demotivating for your loved one. So, get a heads-up of 5 don’ts that you need to steer clear of in order to land on the best facility:

1.     Judging the Book by Its Cover

Just because an assisted living facility is expensive or has lavish features does not mean it is the right option. Beautiful landscaping and fancy furniture are not the best and only indicators of quality care. The best way to avoid this situation is to personally visit the facility and linger around enough to get a good idea of the staff and the general ambience. At the end of the day, you need to trust your instinct and back it up with visible evidence.

2.     Focusing Too Much On Nearness of the Facility

Many emotional family members go for an assisted living facility that is nearest to them in the hopes of visiting their loved ones daily. Keep in mind that a facility a mile further away may be offering better care and more activities. Visiting every day is an unrealistic expectation anyway that you will soon grow out of.

3.     Deciding Too Quickly

Some families are in such a haste to get over with this overwhelming task of choosing the right facility that they end up picking the first one they see without giving regard to other better options. Hence, you should take your time, do your research, make the necessary comparisons and don’t forget to trust your instinct.

Avoiding these 3 major mistakes will help you come across the right assisted living facility.

A Few Helpful Tips for Moving Your Loved One to Assisted Living

Change is never easy, especially for older people. If you are planning to send a senior loved one to an assisted living facility, here are a few tips to keep in mind, which will smoothen the whole transition period for both parties:

Communicate

Leaving your home and loved ones for an alien assisted living facility is bound to trigger apprehension and sadness in your loved one. The best way is to let them vent and grieve about this decision and upcoming change. Try to make the discussion more appealing by bringing in the benefits and perks provided by the facility and explain to them how they will get to make new friends and live a brand new and interesting life.

Plan Properly

Before starting the organizing and sorting process, it is a useful idea to provide your loved one with a visual representation of what they are getting into. Plot out the floor plan of your loved one’s new residence or give them a tour in advance.

Involve Relatives

Although this may be relatively hard, involving your relatives and close friends in the whole transition process will greatly help your loved one. Encourage everyone to take out time and just be present while your senior family member prepares to leave. This will provide great emotional support and ease the stress of moving.

Make Their New Abode More Inviting

Before your loved one shifts to their new home, make sure it is welcoming. Decorate their new residence with their favorite items, bunch of family pictures and proper means of communication (like a cell phone or computer). If they have specific habits, like morning walks or preferences when it comes to breakfast or lunch, make arrangements with the facility to provide them with what they need.

So, follow these tips and make it easier for your senior loved one to move to and settle in an assisted living facility.

3 Key Factors to Consider When Selecting a Nursing Home

Sending off a loved one to the care of a third-party facility is one of the hardest decisions to make. You can never be sure what state they are living in and what level of quality of quality care is provided. To help you choose the right nursing home in the first place that will ensure the health and happiness of your senior loved one, here are three key factors to keep in mind.

  • Facility Certification: The facility that you choose must be registered with a higher regulatory body or by Medicare and Medicaid. This will help you assess the quality of their service and what to expect from it in general.
  • Location: Another key factor to consider is the location of the nursing home. You first need to see whether the area is pleasant and secure enough and whether it has the right infrastructure, such as public transportation, recreational spots, energy and water supply. Next, you need to see whether the facility is in proximity with other friends and family members.

Frequent visits from relatives and friends will generally improve the overall mental health of the patient as well as give a chance to address any problems that may arise. Family members/friends will be personally able to assess the environment and the care level and can lodge complaints as soon as possible.

  • Emotional and Mental Wellbeing Of Patients: Carefully see the kinds of activities planned for the residents. A good program will have scheduled events like musical events or movie nights, physical exercise activities, religious services, educational classes, bingo and other social events. Also see if there’s a library accessible to residents with audio and large print books, a garden for recreational activities and natural elements in the environment.

Keeping these factors in mind will help you come across the best nursing care facility for your senior loved one.

 


Diamond Willow Support Services Office
Assisted Living With Memory,
Medical and Physical Care
1411 London Road
Duluth, Minnesota 55806
877-247-1205