In this issue:
"Assisted Living Admissions"
Part Three of Susan's Nine Part Series
Don't miss reading about THE MAGNIFICENT MRS. MB
The continuing story of Susan's professional journey with an incredible elderly woman
Susan's California Seminar Tour "RAISING UP Your Parents"
Coming To Your Town Soon. Its Free For Adult Children, Caretakers and Seniors
August 20, 2010
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This newsletter is designed
to help you know your rights when signing an admission agreement.
Some agreements can be quite convoluted.
Reminder. I am an attorney
and a gerontologist, and can help you navigate these issues and negotiate the terms for free.
Since I have toured every facility
in Los Angeles, Orange, Ventura, San Diego and Santa Barbara Counties, I can say with confidence that looks can be deceiving.
A nice looking
facility in a nice neighborhood can be a nightmare and facility in a
sketchy looking neighborhood, a godsend. Like I tell my children, monsters
can be very nice looking people. If you need assistance finding the
right facility, just call or email me. I will steer you in the right direction.
Taking a recommendation
from someone who had a good experience at a good chain might not work
out so well.
Last week, I toured a facility whose corporate reputation
is very good, but I was appalled to see a woman lying on the concrete
sleeping with a soiled bottom.
Remember, if you do not wish to read the entire newsletter, but would like to ask me any questions, call me at 1 (888) 422-6070 or email me, susan@mymomnpop.com
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What
must an assisted living facility do to
prepare 
for the admission of a prospective resident?
Before any of my clients move
into a facility, the facility's admissions coordinator must meet with
them and provide sufficient information about the facility, its services,
and its costs. Likewise, the prospective resident must provide sufficient
information about her medical history, and about any specific service
needs or functional limitations. Usually this is done by having a medical
report completed by their physician.
After that, a written care
plan is drafted. The meeting may be coordinated and combined with the
meeting described in the initial meeting. A similar meeting must occur
at least once every twelve months to make any necessary changes to the
care plan.
What terms must be included
in an admission agreement?
An admission agreement must
detail basic and optional services, along with the charges for each.
The admission agreement also must include the conditions under which
it can be modified.
The admission agreement must
list any facility policies on resident behavior. In addition, the
admission
agreement must detail any circumstances that would justify the
resident's
eviction. Most often, individuals get evicted if their behavior can no
longer be managed and they become a danger to themselves or others.
Sometimes, however, facilities will evict residents if it becomes
obvious
that the resident will be running out of funds. This is very rare
however.
As discussed on part 1, assisted
living facilities can charge different rates to people depending on
the level of services they need. However, if a facility wishes to set
varying rates, those rates must be specified in the admission agreement.
For example, an assisted living admission agreement could specify rates
varying with a resident's needs. Generally, such admission agreements
set a flat amount for a core package of services and assess extra charges
for additional services.
A prospective resident should
be wary of 
admission agreements that are vague in
explaining when extra
charges are assessed.
For example, some admission agreements set
out
price levels that give the facility a great deal of discretion in deciding
when the resident's care needs have moved her from one price level
to another.
Remember also that rates can
vary with the level of services only if the rates were set out in the
admission agreement. If an admission agreement does not provide for
varying rates, a facility cannot assess extra charges for particular
services that the resident requires.
Even though a notice of rate
increases is required, when I tour facilities with my clients, I always
ask how often they change their rates. Explicitly exempted from
local rent control ordinances, many assisted living facilities do increase
their rates.
An admission agreement must
provide for at least 60 days written notice of any increase in the facility's
basic rate. However, advance notice is not required when a resident's
rate increase is due to increased care needs, and such an increase is
authorized by the admission agreement.
If a resident is an SSI recipient,
state regulations prohibit assisted living facilities from charging
more than the basic SSI rate.
Can an admission agreement
require a resident to pay a deposit?
Yes, in a way. State law allows
a facility to collect a 
"preadmission fee."
A facility must provide
a written statement
explaining any preadmission fee.
A preadmission
fee is not allowed if a resident receives SSI.
A facility must refund all
of a preadmission fee if the prospective resident decides to live elsewhere
before the facility completes its required appraisal of the resident's
condition, or if the facility fails to give a written statement of the
preadmission fee and refund conditions.
Otherwise, the facility is
allowed to keep at least $500 of a preadmission fee, along with the
following specified percentages of any amount over $500:
· 20% if a prospective resident
decides to live elsewhere after the facility has completed the preadmission
appraisal, or a resident moves out for any reason during the first month.
· 40% if a resident moves
out for any reason during the second month.
· 60% if a resident moves
out for any reason during the third month.
After the third month, the
facility is allowed by state law to keep all of a preadmission fee.
Although a facility can require
a preadmission fee, it cannot hold residents financially responsible
for damage to the facility. In addition, state law prohibits assisted
living facilities from requiring a security deposit for damages.
Also, the state does not allow
assisted living facilities to charge for cleaning a unit after a resident
leaves. Cleaning is a basic service which must be provided automatically
by every facility.
Can an admission agreement
limit a facility's responsibility for a resident's safety or personal
property?
No. State law prohibits a facility
from using an admission agreement to limit the facility's legal responsibilities.
Is a resident entitled to
a rent refund if she is discharged before the end of her paid days?
Not necessarily. State law
requires that an admission agreement list refund conditions, but these
regulations do not designate particular refund conditions.
If a facility fails to mention
refund conditions in the admission agreement, the resident should argue
that the facility is obligated to pay a refund for all days for which
the resident paid but did not use. In addition, a rent refund is required
if a resident dies before her paid days have expired.
Can an admission agreement
require that an entering resident give all of his savings to the facility?
Yes, but only under certain
conditions.
A "continuing care contract"
can require a person to pay a lump sum of money in exchange for a stay
of over one year in an assisted living facility. A "life care contract"
(which is a type of continuing care contract) can require a person to
pay all or most of his savings in exchange for residence in certain
facilities for the remainder of his life.
An assisted living facility
can offer a life care contract only if the facility operates an adjacent
nursing home. The life care contract must offer the person all necessary
levels of care, including nursing home care. Many life care contracts are
offered by facilities associated with religious denominations or non-profit
organizations.
Will I be able to keep my
room or bed at the assisted living home if I take a vacation or have
to be in the hospital for a time?
Your contract must include
a bed-hold policy both for unavoidable absences (such as hospitalizations
or recuperation in a rehabilitation setting) and optional absences (such
as vacations, visits to family, etc.).
This policy must include the
conditions under which the facility will hold a bed, what this costs
and who must pay for it, and the circumstances under which the bed will
no longer be held. This is very important because assisted living facilities
are accepting people with higher and higher levels of chronic illnesses
and dementia.
As a result, the resident may go to the hospital many
times over during the course of residency. When helping my clients find
the right facility for themselves or their loved ones, I always ask
whether any fees are stopped or reduced when the resident is from the
home. Changes in fees for special circumstances should be a part of
your contract.
Final note, and THIS IS A
BIGGY
Often there is a separate document
to be signed by a "Responsible Party", "Authorized
Representative", "Agent for Resident", or
some other language that asks that person to take responsibility for
payment for your care.
If your friend or family member does not want
to use their own funds to pay for your care, any document they sign
should say that they are responsible "only to the extent of
the resident's personal funds and/or resources".
THE MAGNIFICENT MRS. MB
The story of the Magnificent
Mrs. MB is now posted on my blog. I will posted updates every week. If you
want to travel with me on my elder care journey with the magnificent Mrs. MB, I think that you will
find it fascinating. Just click on http://mymomnpop.com
"Raising UP Your Parents?"
My California seminar tour... coming to your neighborhood.
Its all about the continuum of elder care and aging, covering everything from assisted living to understanding the difference between Alzheimer's and dementia. "Click Here" to be taken to my web page for the seminar and you can register for free. Huntington Beach, Irvine and Woodland Hills are coming in October and November.
As an elder law attorney and a former elder law professor, and as a gerontologist with a B.S. in speech pathology, I feel comfortable saying that this seminar accurately represents what you need to learn about the aging process. It can help prepare you for what lies ahead for you, or what you may be currently dealing with.
Don't forget to visit my website, MyMomnPop.com and read the latest blogs. They are filled with cutting edge information about the aging process, elder care, and more.
If you wish to ask me any questions directly, you can email or call, susan@mymomnpop.com or (310) 897-7434.
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