Hurley Elder Care Law Newsletter - July 2017
 
 
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July 2017   

Finding a Nursing Home Bed

I get that Medicaid might be an option for paying for the nursing home. My problem is actually finding a nursing home bed for my mom. Every place we call says they have no beds available, and my neighbor has warned me that there are no good Medicaid nursing homes. What can I do?  So much of our information in the recent blogs and newsletters has focused on paying for nursing home care—but many families are stuck at just trying to get into a nursing home. Finding a nursing home bed can be difficult to do, and it’s important to understand how nursing home admissions work. For starters, individuals are admitted to a nursing home in one of two ways: for short-term rehab or for long-term care. The first, and most common way, is by being admitted to a nursing home following a three-night inpatient stay in a hospital whereupon the doctor feels that the patient needs sub-acute rehabilitation services in order to maintain or improve functioning. Rehabilitation services can include physical therapy, occupational therapy, speech therapy, wound therapy or skilled nursing care. Medicare Part A pays for short-term rehab for a short period of time. The second way that individuals enter a nursing home is from home or an assisted living facility. This means that the individual is seeking a long-term care bed, not a sub-acute rehab bed, and Medicare does not pay for long-term care in a nursing home. Finding a nursing home that will accept an individual for long-term care (and not for sub-acute rehab) can be difficult. Nursing homes are reimbursed at a higher level for residents receiving short-term rehab than for residents receiving long-term care. This means that nursing homes want more residents seeking short-term rehab, and they do not have an abundant supply of long-term care beds. Individuals seeking a long-term care bed may be placed on a waiting list.

Furthermore, admissions to a nursing home for short-term rehab is generally arranged by the social worker or discharge planner at the hospital. This is not the case for individuals seeking a long-term care bed from home or from an assisted living facility. Without having a social worker or discharge planner to help with the admission, most families have to handle the process (including the paperwork) on their own. Families should visit all nursing homes in their area and identify their top three to five choices; once that is done, it is important to stay in contact with the Admissions Coordinator at each of those facilities to monitor bed availability. Provide them with the forms and medical records they need and explain your loved one’s needs. The forms that families must provide to a nursing home in order for the facility to consider an individual for admission include: physician orders for nursing home care (this will be a written order in addition to the DMA-6); a Level 1; a current list of medications; a negative TB test; and latest medical records, physical, or clinical notes from a healthcare professional. Some facilities may require more information as they are trying to determine if they can adequately meet the potential resident’s needs. It is possible to find a nursing home bed, but it takes time and persistence.

As to your last concern about “good Medicaid nursing homes,” most nursing homes in Metro Atlanta are dual-certified for Medicare and Medicaid. That is, most of our nursing homes accept both Medicare and Medicaid, and there are no Medicaid-only nursing homes. There are a few private-pay only or Medicare-only nursing homes, but not very many. And in the dual-certified homes, visitors, residents and even staff have no indication of who is a Medicaid recipient and who is paying privately to be in the nursing home. Discrimination based on source-source is prohibited and remember that most nursing home residents are Medicaid beneficiaries. That being said, not all nursing homes provide the same quality of care, and you should do your homework to find ones that have good ratings and reputations. Here are some resources that might help:

Medicare’s Nursing Home Compare - www.medicare.gov/NursingHomeCompare/

Georgia Healthcare Facility Regulator -
www.GaMap2Care.info

Georgia Health Care Association -
www.ghca.info

Georgia Long-Term Care Ombudsman Resource Center - www.georgiaombudsman.org

Making the decision to move a loved one into a nursing home is never easy, and then finding a nursing home bed can be difficult. It’s not impossible, but it is difficult.  Our firm has three care coordinators on staff to help our families navigate this process. If you have any questions or concerns, please contact us at (404) 843-0121 or at https://hurleyeclaw.com/contacts/

  
Family Business We all love our pets here at Hurley Elder Care Law! Clockwise starting at top left(1) Grace’s Shih tzus Alfie, Willie Joel and Boz (2) Miles and Joanna’s Cockapoos Fred and Ginger (3) Kim’s rescue dog Roxy (4) Theresa’s Husky mix Ginny and (5) Louise’s Maltipoo Poppy!
Upcoming Speaking Events and CEUs

Tuesday, August 22-  Join Danielle Humphrey, JD, CELA, for a Complimentary Lunch CEU on “Guardianship: An Overview and Ethical Consideration for Healthcare Professionals” at Ridgeview Institute Monroe

The process of applying for guardianship (or conservatorship) is complex and can be overwhelming to healthcare professionals and families alike – we will review the basics of guardianship and conservatorship. These situations are likely to be unpleasant for the proposed ward as well as the proposed guardian. Such hearings demand families share humiliating and very personal stories, at times publicly shaming one another in front of a judge. What are the ethical implications of suggesting to a family that they pursue this route? We will explore the ethical principles professional social workers/case managers must confront within the guardianship process. In addition, learn what can be done to avoid Guardianship/Conservatorship. Current information on Georgia’s Advance Directive will also be provided. CEUs available: 1 ethic or core hour for social workers (GA NASW); 1 contact hour for case managers (CCMC); 1 contact hour for RNs (TNA). 11:30 AM -12 PM: Registration and Lunch, 12 PM-1 PM  CEU Education, Ridgeview Institute Monroe, Community Room, 709 Breedlove Dr., Monroe, GA 30655. RSVP: ridgeviewmonroeceu.eventbrite.com

 

Wednesday, August 23- Join Danielle Humphrey, JD, CELA, for a Complimentary Lunch CEU on "Capacity, Competency, and Ethical Interventions: A Legal Discussion for Healthcare Providers” at Garden Plaza at Lawrenceville

Conflicts of interest and determining decision-making capacity often create complex ethical dilemmas for case managers, social workers, and other practitioners working with older adults. Competing interests of the older adult’s family can also have the helping individuals make difficult decisions even more challenging. This presentation will provide guidance and tools for assessing areas of concern when clinicians are confronted with ethical dilemmas. The presenter will explain the difference between capacity and competency and provide guidelines for evaluation. Ms. Humphrey will also review an ethical decision-making model for practitioners to use when confronted with such dilemmas in clinical practice. CEUs available:  1 ethic or core hour for social workers (GA NASW); 1 contact hour for case managers and RNs (CCMC). 11:30 AM -12 PM: Registration and Lunch; 12 PM-1 PM  CEU Education; Garden Plaza at Lawrenceville, 230 Collins Industrial Way, Lawrenceville, GA 30043. RSVP: gardenplazaaug23.eventbrite.com 


Thursday, August 24- Join Danielle Humphrey, JD, CELA, for a Complimentary Lunch CEU on "Capacity, Competency, and Ethical Interventions: A Legal Discussion for Healthcare Providers” at Georgia Funeral Care and Cremation

Conflicts of interest and determining decision-making capacity often create complex ethical dilemmas for case managers, social workers, and other practitioners working with older adults. Competing interests of the older adult’s family can also have the helping individuals make difficult decisions even more challenging. This presentation will provide guidance and tools for assessing areas of concern when clinicians are confronted with ethical dilemmas. The presenter will explain the difference between capacity and competency and provide guidelines for evaluation. Ms. Humphrey will also review an ethical decision-making model for practitioners to use when confronted with such dilemmas in clinical practice. CEUs available:  1 ethic or core hour for social workers (GA NASW); 1 contact hour for case managers and RNs (CCMC). 5:15 PM-5:45 PM Registration, Wine & Heavy Hors d’oeuvres; 5:45 PM-6:45 PM CEU Education; Georgia Funeral Care and Cremation, 4671 South Main Street, Suite 110, Acworth, GA 30101.  RSVP: GAfuneralAug24.eventbrite.com

 

Tuesday, September 12- Join Danielle Humphrey, JD, CELA, for a Complimentary Dinner CEU on "Planning for the Expected: Decisions, Documents and Death” at The Waterford at Hidden Lake

Death is unavoidable, yet most Americans are woefully ill-prepared for this eventuality; planning for the expected means taking control. Atty. Humphrey will provide guidelines to begin essential conversations about advanced planning and the benefits of taking charge of the inevitable. This presentation offers a welcome road map for healthcare professionals supporting patients and their families facing the end of life. Key discussion points include: the impact of dying without a will, the benefits of a trust, detailed guidelines regarding what to do when someone dies as well as an overview of the probate process. CEUs available:  1 core hour for social workers; 1 contact hour for case managers; 1 contact hour for RNs. 5:30 PM- 6:00 PM Registration and Dinner; 6:00 PM-7:00 PM CEU Education; The Waterford at Hidden Lake, 3100 Hidden Valley Drive, Canton, GA 30114. RSVP: waterfordhiddenlake.eventbrite.com 


For more details and a complete list of upcoming events, please visit Hurley Elder Care Law Community Education.
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Miles P. Hurley, JD, CELA  Miles P. Hurley founded Hurley Elder Care Law in 2006 to provide legal assistance to the elderly population on issues relating to aging including retaining independence, quality of life and financial security. Mr. Hurley is one of eleven attorneys in the state of Georgia to receive the Elder Law Attorney Certification, and one of approximately 400 nationwide. 
Hurley Elder Care Law is dedicated to the process of long-term care and estate planning. 
Call us today for a free phone consultation with a client coordinator at (404) 843-0121.


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Hurley Elder Care Law
100 Galleria Pkwy, Suite 650
Atlanta, GA 30339
404-843-0121

Satellite Offices
2011 Commerce Dr. Suite 100, Peachtree City, GA 30269   
225 Creekstone Ridge, Woodstock, GA 30188       
2180 Satellite Blvd, Suite 400, Duluth, GA 30097


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