FAQ’s

Q: Won’t Medicare pay for long-term nursing home care?

A: No. Medicare is health insurance for people over sixty-five.

Q: What Assets will be used to pay for Nursing Home care?

A: Your home, jointly held property, gifted assets, bank accounts, securities and insurance policies will all be used to pay for nursing home care. Most or all of your assets will be spent. A single person could be left with only $4,000 in Rhode Island.

Q: What will insurance pay?

A: Typically, a medical emergency triggers a stay at a rehabilitation center or skilled nursing home following hospitalization.  Following admission to a hospital–after a stay of at least three days (which can’t be “for observation)–and upon transfer to a nursing home, your health insurance, which includes Medicare, will typically pay toward your care for a limited period of time, not to exceed one hundred days.  Your coverage may also be supplemented by health insurance such as Blue Chip for Medicare, United Health Care, or other supplemental health insurance plans that are available.

However, insurance will only cover for “skilled care.” Once the patient has been determined to be “long-term care,” the insurer will stop paying.

Q: Can’t I just give my assets to my children?

A: Transferring assets to children can be a huge mistake.  For example, you no longer control your assets. If a child is sued, your assets may be taken. If a child gets divorced, their spouse may be entitled to a share of those funds. Or, if a child dies, your funds may not go to individuals you have specified. Most important, transfers or gifts are subject to a five-year look-back period.  If a nursing home resident files a Medical Assistance application before the five years has passed, a “penalty period” will be imposed.    The applicant will be ineligible for Medical Assistance for a period of time determined by the size of the gift.

Q: Can’t I just put my money into a revocable trust?

A: Many seniors believe that asset protection can be achieved by putting everything into a revocable trust. This is not true. All monies in revocable trusts are deemed available for nursing home care and are not protected.

Q: Is it too late to plan once you are in a nursing home?

A:  It’s  not too late.  There are ways to safeguard a lifetime of savings and property, even if someone is already privately paying in a nursing home.  We can help you save your assets.

Q: Can I get assistance in financing long-term care?

A: Unless long-term care insurance was previously purchased, few options are available to assist in financing nursing home care. The majority of individuals in this situation turn to Medicaid.  In Rhode Island, the program is called Medical Assistance.

Preplanning is an important action to assure that assets are protected. If someone is not currently in a nursing home, pre-planning can be done to be sure their home and life savings are protected if nursing home is needed in the future.  By not taking the proper steps to protect your life savings, home, and other assets, all could be used to pay for nursing home care.

Q: Applying for Medicaid is so confusing. Is there anyone I can turn to for help?

A:  The Medicaid application process is lengthy and cumbersome. Most people are unfamiliar with Medicaid regulations and the recent regulatory changes associated with them.  We are here to help you protect your assets. You provide us with the documentation, and we do all of the paperwork and we’ll help you maneuver through the Medicaid red tape.

Q: Will my loved one be treated differently if on Medical Assistance?

A:  No. All nursing home residents should be treated the same. If Medical Assistance recipients are being discriminated against by being treated differently, the nursing home could be legally liable.  Generally, most staff members don’t even know who is paying privately and who is on Medical Assistance.

Questions To Ask When Selecting A Nursing Home:

Facilities: Inside & Outside

• Are the grounds and building attractive and well-maintained?

• Are there wheelchair ramps?

• Are there unpleasant odors in the building?

• Are there outdoor areas where residents can sit or walk?

• Is there an activity or exercise room?

• Are the rooms well-ventilated and kept at a comfortable temperature? Are there individual

thermostats in the rooms?

• Is the facility air-conditioned?

• Is smoking permitted?

• Can residents bring their own furniture? Is there ample storage? Can residents

have a private phone? A pet?

• Do rooms have windows?

• Are there adjoining bathrooms? Are they private?

• Is a married couple allowed to share a room?

• If the room isn’t private, is there a screen or curtain for privacy?

Safety Measures

• Are fire exits clearly posted? Are there smoke alarms and extinguishers?

• Are there grab bars in the bathroom and handrails in hallways and stairs?

• Are there emergency call buttons and intercoms in the rooms? Is there an emergency

evacuation plan posted?

• Is there a written statement of patient rights? Is the number to file complaints available?

Staff, Services and Administrative Issues

• What kind of medical supervision is provided? Physical or speech therapy?

• Beauty or other personal services?

• How do staff and residents interact? Are there language barriers?

• Are there social activities? Are residents mostly in their rooms or interacting?

• Is the food appetizing and well- presented? Is assistance with eating available?

• Are you able to get a copy of the owner/developer’s financial statement? What is

the history of price increases for this facility?

• Is down payment refundable if the resident moves or dies?

• What role, if any, do family members have in paying unmet obligations?