Eldercare Options

1
Eldercare Options

• Types of Facilities and their function

2
A Spectrum of Services

• Senior Housing
• Enriched Housing Program
• Adult Care Facilities
• New York State Assisted Living Program
• Skilled Nursing Facilities
• Sub-acute Rehabilitation

3
Senior Housing

• Independent living units
• Handicapped accessible accommodations
• Some are subsidized by the government

4
Enriched Housing

• This setting resembles independent housing units.
• Provides room, board, housekeeping, personal
  care, and supervision
• May be operated by a public or not for profit
  sponsoring agency

5
Adult Care Facilities

• Congregate living arrangements
• Provides 24 hour supervision, meals,
  housekeeping, laundry, and recreational
  activities
• Limited assistance with daily living activities
  and medication supervision.
• Special units for care of residents with dementia
  is available at some area ACFs

6
New York State Assisted Living Program

• Allows Home Care Agencies to provide additional
  personal care assistance in the ACF setting
• This program is typically the step prior to a
  Skilled Nursing Facility.

7
Skilled Nursing Facilities

• 24 Hour care for persons who need high-intensity
  medical care and supervision
• Services include nursing care, assistance with
  daily care, meals, MD care, rehab services,
  housekeeping, laundry, dementia care and social
  services
• Specialized care units are often incorporated
  into this setting

8
Sub-acute Rehabilitation

• A unit housed within a skilled nursing facility,
  designed to care for those individuals who need
  specialized, short-term nursing and/or
  rehabilitative care.
• This level of care can be paid for privately,
  with Medicare and with private insurance.
• Usually is a separate unit or wing within a
  skilled nursing facility.

9
What level of care am I?

• For Senior and Enriched Housing levels, a
  screener from that complex will assess
  appropriateness
• A Patient Review Instrument (PRI) will be
  completed for individuals needing SNF, Assisted
  Living or ACF care
• The PRI score will determine which level of care
  is appropriate

10
What information goes into the PRI?

• Demographics
• Medical Diagnosis
• Proficiency of Activities of Daily Living (ADLs)
• Tolieting Feeding
• Ambulation Transfer
• Behavioral Issues
• Medication, Treatments and Special Requirements

11
After all information is gathered and calculated,
a score is given to the PRI
12
PRI Categories

• The higher the category or score, the more
  reimbursement a facility will receive.

• Special Care
• Rehabilitative
• Clinical
• Behavioral
• Physical

13
Financial Considerations

• Most Senior and Enriched Housing is out of
  pocket. Some is subsidized by municipal housing
• ACFs accept private payment while some also
  accept SSI (Supplemental Security Income)

14
Financial Considerations

• Assisted Living Program is funded by Medicaid
• Skilled Nursing Facility stays can be paid by a
  combination of sources including
• Private Payment
• Private Insurances
• Medicare
• Medicaid

15
Questions and Answers