Oregon Senior Referral Agency Association Raising Industry Standards since 2004
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Older adults risk cognitive damage and memory loss after surgery. The condition is called post-operative cognitive dysfunction (POCD). POCD affects about half of adults 60 years and older after surgery.
When it comes to the differences between Medicare and Medicaid, there is much confusion surrounding the two. We break down who qualifies for each program, what services are covered and the qualifying steps needed to get started.
Medicare is a Federal health insurance program. It provides health care for people over 65 years who’ve paid into the program. Seniors enroll in the program. Medicare health care coverage is available regardless of income. But the insurance is not free.
Seniors pay a monthly premium for Medicare insurance. Medicare covers most medical bills. These include: doctor’s appointments, hospital stays, rehab services, some treatments and specific equipment. Besides monthly premiums, patients pay a deductible when using services.
The federal government sets all rules, regulations and standards for Medicare. Medicare is also available for younger disabled people and dialysis patients.
There are several parts to Medicare insurance. Medicare Part A covers up to 100 days in a “skilled nursing” facility per incident of illness. Strict guidelines determine qualifying for a skilled rehabilitation stay.
A three-day admission to a hospital is one of the requirements. The first 20 days are covered. Days 21 through 100, have an out-of-pocket copayment per day. A weekly evaluation determines a patient’s progress. Medicare will continue paying its part if the patient meets progress standards. Patients rarely get their full 100 days of rehab care – whether they’re fully recovered or not.
Medicare DOES NOT pay for long term-term care. Medicare only covers a short stay in rehab following a three day hospital admission.
Medicaid is a low-income assistance program. It’s jointly funded by Federal and State taxes. Medicaid provides health care coverage for very low-income people – not just older adults. Some people can have both Medicare and Medicaid for health care coverage. Medicaid helps pay for premiums, deductibles, medications and services for those who can’t afford to pay.
Medicaid is jointly administered by states and the federal government. Medicaid eligibility requirements vary from state to state. People eligible for Medicaid coverage must meet strict income and asset guidelines.
The most significant difference between Medicare and Medicaid is coverage for long-term care. Medicaid covers long-term care. These care settings include:
People must apply for Medicaid assistance. To qualify, applicants must meet low-income standards, have limited assets AND have significant daily care needs.
In Oregon, a single person can make up to $2,205 per month (in 2017) in gross income to qualify for Medicaid. Asset requirements are usually limited at $2,000.00
Applicants cannot give away or “gift” their property or assets. There is a 5-year look-back law. The application process requires proof of income. Medicaid workers search for any hidden or undeclared income. The Medicaid application requires bank records, bills of sale and financial documents.
To understand acceptable ways to “spend-down” assets, consult an Elder-law attorney. Pre-plan long before applying for Medicaid.
Part of the application process for Medicaid includes a care needs assessment. A Medicaid worker collects medical history, diagnosis’ and documentation. Applicants must prove they need help with daily activities of living (ADLs). Assistance with the following are evaluated:
Each ADL is scored based on the amount of help needed. The combined total determines a person’s level of care. The care level determines the monthly reimbursement a care home or nursing home receives. This level of care is for Medicaid purposes. Don’t confuse it with other levels of care many communities talk about.
Medicaid continues covering long-term care if a senior continues qualifying for care. Yet, Medicaid eligibility rules change frequently. Income and care levels are forever in a state of flux.
Also, significant numbers of care facilities do not have contracts with the State. They do not accept Medicaid payments.
Accessing Medicaid takes significant pre-planning. We highly recommend contacting an Elder-law attorney.
Dear Editor of The Oregonian & Oregon Live,
Thank you for your recent series “Selling Senior Care: Kept in the Dark.” It’s true, when consumers search for senior care housing, it’s a daunting task. Finding information for making informed decisions is time-consuming and stressful. Consumers search the internet and weed through marketing hype. It’s hoped they’re looking up facility complaint history. But consumers don’t know what they don’t know.
The better alternative is calling a senior referral agency. Consumers seeking senior housing can rely on a senior referral agency as a “one stop” resource. There are several qualified agencies in Oregon. They specialize in helping seniors and families find exceptional care in their area.
The best place for finding an expert referral agent is through the Oregon Senior Referral Agency Association (OSRAA). OSRAA is a member organization. The organization developed a Code of Ethics and Best Practice Standards. An older adult’s well-being depends on prudent decisions. OSRAA members arm them with the information they need.
Referral agents make referrals to senior housing based on a comprehensive intake. Agents determine care needs, social preferences, goals and budget. A list of communities matching a senior’s criteria is compiled. Personal help in touring communities is part of an agency’s service. As is a follow up call after a senior’s move.
OSRAA members pre-tour and pre-qualify any facilities they refer. Agencies maintain information on senior facilities. This includes data on:
Families receive education on other resources like Veteran’s benefits and government programs.
Like you, OSRAA members support better access to public disclosure files. But families often don’t take time to search it out. Relying on a referral agent provides access to information. Families can make informed decisions. Working with a referral agent helps ensure safer transitions for our vulnerable seniors.
It’s critical that families get accurate information from a referral agency. That’s why OSRAA advocates for stronger regulation of referral agencies in Oregon. OSRAA and industry partners have teamed with state legislators sponsoring HB 2661. This bill would require certification, verification of training and background checks on all referral agents. For more information about OSRAA and HB 2661, go to www.osraa.com.
Our seniors deserve quality service and care. Families need reassurance about the choices they’re making. They need to know where to turn for help. Please consider running additional articles about senior referral agencies, OSRAA and HB 2661.
Sincerely,
Liz Fischer, President, OSRAA
Local referral agencies do business quite differently than online lead generators. Read one Portland woman’s story about her experience and the differences between help via the internet vs a local, caring and listening agency.
Mary called me as her husband needed help. Mary’s story was sad, her husband had Alzheimer’s and needed a lot of help. Her son had just passed and she just had surgery. Mary didn’t have time to grieve for her son or recover from her surgery because she was the main caregiver for her husband.
Mary contacted an internet lead generator that sent her a couple of names of memory care facilities in her community. The marketing people from those facilities immediately started calling Mary asking her to come for a tour, come for lunch, come soon as they only had one room available and others were interested—she should come right away or the room would be rented by somebody else. She was getting a lot of pressure to tour right away, so Mary, on her own, visited the places the internet lead generator sent her. She hated them both so decided to keep her husband at home putting her own recovery and grieving on hold.
A friend of Mary’s let her know there are local referral agencies that can help too, so she contacted me. I met with Mary, listened to her talk about her husband and what care he needed and her need for time to grieve for the death of her son and recover from her surgery.
I asked about her finances and what they could afford long term to ensure they weren’t leaving her without money to live on. I introduced her to an elder law attorney so she could get a Power of Attorney for her husband as moving into a memory care community requires POAs. I asked what was important to her and to him. I listened.
I took Mary to tour a memory care community less than a mile from her house. The community doesn’t contract with the internet lead generators so they didn’t tell her about that option. The community is tucked back into a neighborhood so she didn’t even know it existed. She loved the community, clicked with the staff and knew right away it was the right place for her husband. She was able to move him in as soon as the Power of Attorney was completed. She was then able to focus on her own care and become a wife again rather than a caregiver.
Local referral agencies do more than send clients names of options. They listen to what their clients need. They ask about finances and offer ideas on how to pay for retirement living. They tour with their clients; they ask questions clients may not think to ask. They visit every community before touring so they’re familiar with the community’s strengths and weaknesses. They check county records to see if there are substantiated complaints or bad survey results that may be red flags. They hold their clients’ hand through the process and are advocates for the clients.
Local referral agencies know that the senior’s needs come first and do everything they can to ensure the ultimate decision is the right fit.
One of my close loved ones has always loved having cats. She has limited mobility and isn’t able to provide the care needed to have one nor is her husband who has his hands full taking care of her. Studies show pet therapy helps seniors better cope with health problems, such as heart disease, cancer and mental health disorders. Not being able to provide the care needed for a pet has eliminated her ability of having a pet from which she would truly benefit and so dearly love.
She was given a therapy cat, it’s a very lifelike ‘robot’ cat that has realistic fur. The cat purrs and meows, it rolls over so you can pet its stomach, and its eyes open and close. My loved one quickly learned if she pets the cat’s left cheek it will nuzzle its head in her hand, if she pets the cat’s back it will purr. The more she petted it the more relaxed the cat got then it goes to sleep. The best news for her is the cat doesn’t need care (other than occasional fresh batteries) or feeding and there are no vet bills. It’s a perfect pet!
The benefits of pets are numerous. They making owners happier, they lessen depression, decrease loneliness and isolation by giving pet owners a companion. They also reduce boredom and lessen anxiety because of their calming effects. The Companion Pet meets the mark in providing just what my loved one needs without the care an unstuffed pet requires.
With Boomers rounding the corner on their “Golden Years” and so many not financially prepared, how do we invent a lifestyle that is both affordable and engaging? Whether devastated by the recession or just plain failed to save, the result is the same. Millions of Boomers don’t have enough money to make ends meet and the options look bleak; work ‘til I drop…maybe, but live with my kids… never!
But wait a minute here…try thinking outside the box. How about the idea of pooling resources and sharing your life with others by matching yourself with compatible housemates? That way each party lives for a fraction of the cost and can actually afford to think about retirement. What might be possible if those housemates actually thought of themselves as community and elected to age together and support one another as a lifestyle choice? Welcome to a new model for aging! Let’s Share Housing is a tool for matching homeowners with compatible housemates or the opportunity to meet other home seekers interested in renting a place together.
Now I realize this idea flies in the face of the “American Dream”, you know the one… where everyone has their own home, their own car and their own lawn mower? The one that keeps you on the treadmill of work, work, work, so that when you do finally have a day off all you do is recuperate so you can go back to work again? How about taking life easier NOW, by sharing? Wow, what a concept!
So what might the benefits be? How about that trip of a lifetime you’ve been dying to take but could never get away… well now you can! Or what about all those leisure activities you would just love to do but never have the time…well, now you do! Maybe you are passionate about volunteering or have some great idea that you’ve always wanted to develop into a little business of your own. Let’s Share may be your answer!
How about having folks to socialize with right where you live? And who says you have to live with other Boomers? Maybe you’d prefer having some younger or older folks around to share your life with! The possibilities are limited only by your imagination.
Shared housing offers us the opportunity to be proactive and create our own futures. You can group yourselves any way you choose…artists, musicians, organic gardeners, etc. etc. Maybe you don’t like to cook so your dream is to live with someone who does! If you like lots of alone time how about finding someone who still works full time so you could have the house to yourself all day? What do you want…what would make your life more enjoyable and less stressful? Be creative; let your imagination run wild!
Want to know more? Come join us for a Meetup here in Portland OR. You can find us at Meetup.com/Lets-Share-Housing/. We will be launching our website within the next few months and you can sign up on our landing page right now at LetsShareHousing.com to receive an email alert when we launch.
Hey there…happy sharing and cheers to a new way of life! Live better together…
An unfortunate reality of our times is that dishonest people prey on the vulnerable. Senior’s are particularly vulnerable and trusting of others. Because of this, senior scams are all too common.
When I worked in a community, we saw various attempts to defraud our residents over the years. One in particular was tried several times. The crooks would call unsuspecting individuals and say “Grandma, I’m stuck in Mexico and I’ve been arrested”. Grandma might then say, “Bobby, is that you”? Now the crook has the grandson’s name. They would go on to say, “Yes, Grandma it’s Bobby. Please don’t tell mom and dad, they will be so angry. I trust you, that’s why I called you. I need $1,000 sent via Western Union right away. Can you do that for me”? Staff at the community was alerted by the in-house Banker when residents would try to withdraw money to help their grandson. Community staff then contacted family and found out that “Bobby” was home and just fine. We stopped this scam in its tracks at least twice. The community then sent out alerts to residents and families, preventing future attempts.
The good news is, The State of Oregon has rallied forces to help protect us from these scammers. The information below comes directly from the Oregon Department of Justice website.
“In partnership with the Department of Consumer and Business Services, Oregon District Attorneys’ Association, Oregon State Sheriffs’ Association, Oregon Association of Police Chiefs, AARP and Elders in Action, the Oregon Department of Justice brings you the Oregon Scam Alert Network. This network coordinates the Department’s regular scam alerts with the media, elected leaders, consumer watchdogs, and advocates for the elderly and disabled across the state to get important consumer information out to you.”
Because of the alert staff at the bank and the senior housing community, the people in our story were protected. They did not send money to the crooks and the staff at the community were able to offer comfort and protection. Community living has many benefits including, safety, socialization, transportation, housekeeping, meals and activities.
NW Senior Resources helps seniors find housing when they no longer want to be alone or are not safe in their current setting. Our services are at no charge to the client. For more information on our services please go to www.nwseniorresources.com.