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Health and Rehabilitation at Peak Resources

in Articles, Newsletters by Greg McIntyre Leave a comment

In my never-ending quest to discover all available options to seniors, I had the privilege of sitting down with Kris Thompson, the Executive Director at Peak Resources. We spoke briefly about the services that Peak Resources offers, what families and seniors should look for when choosing a nursing home, and the many benefits awarded to individuals who become a part of this incredible system.

See the full video interview here:

 

What are your responsibilities as Executive Director at Peak Resources?
I’m pretty much responsible for everything that goes on at the facility. The financial part, the business part, making sure we meet at the rules and regulations, which in healthcare and with nursing homes, there is an awful lot. I’m also involved in the healthcare part of it. There is a director of nursing in the department of nursing that oversees her staff and makes sure that the healthcare aspects of the nursing home are met.
What should a senior look for when choosing a nursing facility? What should the family of the senior look for?

Location. Everyone talks about real estate, which is very important. It’s crucial that you’re going to feel comfortable visiting, so you want to be close. If you have to drive across town and deal with a lot of traffic, that’s probably going to be burden and a factor that keeps you from visiting. Individuals who enter nursing homes shouldn’t lose contact with their family members. I would also recommend that you go through the facility and tour, just do a walk-through. Most facilities would be glad to do that and have a representative walk through with you to answer questions and point out things that the facility offers. As you’re walking around, look for common sense things such as this:

 

  • Are there any pervasive odors that you notice throughout the facility?
  • Are the residents of the facility happy? Are they socializing and doing different activities? 
  • Are the staff members happy? If they are happy with their job, that is going to be reflected in their performance and how they interact with residents. 

Positive communication is one of the most crucial components that a nursing home resident can have. Is it a warm and welcoming environment? That’s always a good thing. 

 

All facilities are also required to have their 25/67, which is their annual survey where the state comes in with nurses, pharmacists, and dietitians. It is state required to make sure that the employees are doing their job. You won’t see a federal survey every year, but you’re guaranteed that each year the state one will be conducted. They come in and look at all of those rules and regulations, they are making sure that the residents are getting the treatment that they need. They ensure that they are not being taken advantage of and that they can have access to their money right there. 

Most facilities have the shopping aspect. On Fridays, we take everyone to the Wal-Mart to go out shopping, and if the resident doesn’t feel like going out, he/she can give the list to an employee who is managing the funds to go pick up personal items that the resident needs. 
Not all nursing homes are health and rehab facilities, is that correct? 


Right, and that’s usually part of the Medicare benefits. Most people have Medicaid Part A or Part B. That’s going to cover if they’re coming in from the hospital. For most people right now, unless it’s coming through a bundle payment part of Medicare, you’re required to have a three-day hospital stay. You want to make sure that if you are in the hospital, that it is a stay and not an observation because then you are qualified to use your Medicaid Part A benefits. If you meet that criteria – of which therapy or wound care is a part – you can use your Medicaid Part A benefits. 

So if you’re going to be there at the facility 100 days, that first 20 is covered at 100%. The next 80 days is paid 80%, so there is a 20% co-pay. The supplement would pay that 80% if you have the supplement. Now, if you have long-term care insurance, it would pick up for that deficit and pay. 
Does the supplement stop paying if the prognosis of the patient worsens?

 

Yes. When it comes to the Medicare criteria, the therapist will set up goals, such as, “I want him to be able to walk 10 feet in 5 days”. So if the patient is not increasing and making progress – and there’s a little bit of leeway there. Some people might have other stuff going on. They say you can refuse three times, but after that the therapy is going to be required, which is going to drop the Medicare Aid benefits and the supplement, as well. 
Say if it’s a 10-bed facility, maybe 50% to 80% of the beds are certified, and that can also be with Part A, too. You can have them duly certified with Medicaid and Medicare, or one of each. Of course, if you have Medicare and you’re not in the certified bed, Medicare is not going to pay, so the home would advise you of that. 

 

You meet with families from time to time, and you have folks at the facility who are trained to meet with the families to ensure that they have their affairs in order and can find a way to pay for the services and qualify them for the process. Is that right? 


Yes, one of the federal regulations is that you have to have  a social worker, and with that they do set up systems. You have to have a business manager that takes care of the billing. The social worker will deal with community resources, and there are options there as far as to help pay or help get them set up in the system. For some families, this is the first time that they are going through the process. Their parents have aged and they have reached that threshold where they need to enter the system. For many, it is a new and unfamiliar process. It can be very complicated, and considering those rules and regulations, they need to know when they meet the qualifications and how to determine eligibility. 

Do you find that most families have planned ahead for this type of situation? 


No, and I think people tend to put it off and not think that this is going to happen to them. If you look at statistics, you have a one in three chance of being in a skilled nursing facility. A lot has changed now because we do have 20-22% of our residents that are short-term that may come for that Medicare Part A, they get the rehabilitation, and then they’re able to go back home to live with their family. Others that return home with receive some type of home health care and sitter. There are a lot of good supports out there. 

However, if someone at the facility feels that there is going to be what is known as an unsafe discharge, meaning the individual is well enough to go back home, but perhaps will not be taken care of the way he/she should in the home, then we are required to notify Adult Protective Services (APS). They would come in and do a home assessment to make sure that it is a safe environment for the senior citizen. Someone has to be home to take care of the senior, administer medication, etc. APS checks all of that out, and if they do not like what they see in the assessment, they’ll step in. That’s not meant to be a big brother system; this is meant to protect the seniors and get their needs met. 

 

If you would like to know more about Peak Resources or speak to one of their employees, you can contact them by phone at 704-482-5396. They are located at 1101 N. Morgan Street in Shelby.

Call me if you have any questions:

Greg McIntyreGreg_Full
Elder Law Attorney
McIntyre Elder Law
123 W. Marion Street, Shelby
704-259-7040

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Client Communications and Education – Another Way We Use Technology in Elder Law

in Elder Law TV by Greg Leave a comment

Really great hurricane weekend spending it with my 15 year old, Jordan, in Raleigh both studying and having fun with my son. This short video showcases how we use tech to keep our clients constantly educated and abreast of new legal developments and be part of our culture and family at McIntyre Elder Law

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Live – WOHS – Making Life’s Most Important Decisions

in Elder Law TV by Greg Leave a comment

Today we feature JOURNEY, a coallition of different professionals devoted to end of life issues experienced by seniors and others. We are honored to have with us the founder of the JOURNEY program, Len Byers and fellow board member, Nancy Abasiekong to speak with us about the JOURNEY program.

#theelderlawguy

Prepare for Disaster! with Hurricane Hayden

in Elder Law TV by Greg Leave a comment

Prepare for Disaster! with Hurricane Hayden
Seniors need to be prepared for the disasters ahead. Watch/Listen to this fun show where Milton, Greg and Hurricane Hayden talk hurricanes and assets protection.

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ACCESS Care with Jane Wright

in Articles, Newsletters by Greg McIntyre Leave a comment

Some members of our Elder Law family recently participated in the health fair at the Neal Senior Center in Shelby. This is the second year in a row that our Elder Law office has participated in the event and we even set up a booth in order to talk to seniors about health care options. The seniors that go get to connect with other professional service providers right on the spot, which is great for them.

Communication with seniors is key to ensuring that they are fully knowledgeable about the healthcare options available to them. One woman that I had the pleasure of interviewing who subscribes to that school of thought is Jane Wright of Care Solutions. Care Solutions in Shelby is located across from the formerly-known Cleveland Regional Medical Center, now known as Carolina’s Healthcare System Cleveland. We spoke a bit about ACCESS Healthcare, of which Jane is the President. This is a group that meets and is made up of affiliates. Jane touched on the important issues facing seniors, and what ACCESS does to benefit seniors.

ACCESS is one of the older groups in Cleveland County that has been meeting for 26 years. At its core, it is a large group of healthcare professionals that work to help seniors. They started off with some of the best people in Cleveland County and are running strong. It started around a cup of coffee, and Suzi Kennedy – who I had the pleasure of interviewing not long ago – was an instrumental part of the group’s kick-off. It’s a group that gets together once per month to share in round-table fashion how the respective agencies that comprise the group serve the elder population. They discuss things that occur in the community that need to be addressed, such as elder dental care and other matters.

Some of the matters that they discuss have been on-going. For instance, in 1992, the United Way of Cleveland County took a survey that was known as a needs assessment. That survey revealed three particular areas that needed to be addressed in the county. The first was aging well, the second was senior housing, and the third was care giving. We know that aging well and illness prevention has been addressed and is still being addressed by many different agencies. But the Senior Center is a wellness place where people can go to exercise, socialize, and to have a good, hot lunch. They also offer line dancing and senior games. The Senior Center is a highly organized place that should be more utilized in Cleveland County.

Another option for seniors is the YMCA, which promoted diabetes prevention. This county is highly advantaged due to the fact that there have been so many people for decades who have been willing to give their time to create locations where care givers can go, such as Care Solutions. In addition to the many facilities, seniors have infinite opportunities to drop off their old prescription medicine, such as at the Senior Center. Once they drop off the medication, it is taken care of swiftly and efficiently so that the medication does not find its way into water supplies or anywhere else where it might harm others.

 

Advantages of ACCESS

We are learning from each other and we all sometimes have the same clients, and we know who to refer to for a certain thing. Everybody is so different, each individual story is different. So when they call us, I have to listen and think like a database. I have to process, “What do I tell this individual?”

Instead of having everyone out there doing their own thing, ACCESS provides the members the ability to meet up every four weeks and to discuss what they have been doing and what methods have worked when it comes to senior healthcare. The goal is the same between ACCESS members, and effectively delivers accountability.

Personally, I am in the central part of Cleveland County, so the professionals that I refer the seniors to are going to be a bit different due to my location. I therefore want to know who the professionals are and I want to know the quality of work they do. I will hear back, so the beauty of it is that I get to establish relationships with the people at these facilities, such as Bayada. It is just invaluable that we meet and get to know who is taking care of the seniors.

 

Funding for Care Solutions

We are funded mainly by the hospital. They are our lifeline. They give us our building, our space, our training, all our technology such as computers. They also pay our employees and give us wonderful benefits. They are there for us, plain and simple.

Our manager is Anzie Horn, who is wonderfully connected to the community. We are also funded by Isothermal Planning and Development, which means it’s state dollars that come down from Isothermal to us, so we get that. And then revenues that we take in from private care management, which is very little. We’re still working on our private market, but we are available to come out to those people that can afford to pay. We can meet people at any point. We provide care management to the general population, and we have about five different programs that we manage. The main one that brings in revenue is CAP/DA, and that’s the Community Alternative Program for Disabled Adults. That is a Medicaid program, and if there’s two in the home, the beauty is it just looks at one person’s income. They do have to be nursing home level and do have to have family support. So they can get some hours of help, which we call in-home aid hours. They also get supplies and the person that comes from the agency of their choice can help them do the things that they need to have done in order to be able to live in the home. That’s a Medicaid state program that we manage.

 

Other Programs

We also manage a respite program, which is very close to my heart because I get to manage that one. We recognize that family caregivers who are caring for members in their house 24 hours a day, 7 days a week need a break. There’s a statistic floating out there that around 40% of caregivers pre-decease the person they’re caring for. It’s very important, but it’s an easy program to set up and get going. We served about 40 families last year and were able to give those family care givers the break they needed. We allocate out and give a voucher for these families to choose in-home aid from one of the 50 providers that we have to adult day health out at Life Enrichment.

The other program allows us to serve the people who fall through the cracks. There are many individuals who cannot get Medicaid, yet they may make $1 or $50, to $100 over the Medicaid guideline. They can also have care management under what’s called Community Care Management. If the individual is 60 or above, a nurse and a social worker can come out, evaluate his/her situation, and see what the individual needs to link him/her with the necessary services.

ACCESS is an impressive networking group that spreads and shares ideas among members that is prompted by a passion for senior and elder care. Individuals – even seniors – who are interested in being a part of this group can call Care Solutions, which is the portal of entry for care giving and elder care. This was formed by ACCESS and the project took 10 years. The number is 980-487-4777. Callers will speak to a live person, not an answering machine.

It only costs $10 a year to participate, which is an excellent fee for the benefits that are awarded in being a part of this fantastic group. Many people don’t know about these programs, and they are overwhelmed by how to care for their senior loved ones. They’re overworked and stressed, and sometimes the world of medical benefits can be a complicated systems to navigate. Fortunately, there are people like Jane and the members of ACCESS who are trying to make elder care that much easier and more enjoyable for everyone involved.

Call me if you have any questions:

Greg McIntyreGreg_Full
Elder Law Attorney
McIntyre Elder Law
123 W. Marion Street, Shelby
704-259-7040

Video: Importance of Pre-Need Funeral Planning

in Elder Law TV by Greg Leave a comment

Special guest, Cecil Burton, talks about the importance of pre-need funeral planning and how it is an important part of an overall estate plan. Pre-Need Funeral Planning is an allowable expense under the NC State Long-Term Care Medicaid rules as it is in other states as well.

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In Home Care: Alternative Care Options Part II

in Articles by Greg McIntyre Leave a comment

In this next feature in my Alternatives to Nursing Home Care series, I have the privilege of highlighting Bayada Home Health Care thanks to the interview I conducted with Amber Mitchell, the Client Services Manager of the Shelby faction of Bayada.

Bayada, as some of you might know, sends people in-home to take care of individuals such as seniors as opposed to sending them to an assisted living or a nursing home. Last week, I was lucky enough to interview Suzi Kennedy – the internationally renowned expert on adult day care and Life Enrichment Centers – to talk about one alternative to nursing home care. Amber was able to graciously provide another alternative, and I am proud to showcase our conversation below.

 

1. What is in-home care?

In-home care can be medical or non-medical services that Bayada can provide to the clients to ensure that while they remain home, they are safe. Bayada is equipped to provide pretty much anything that a hospital or a facility can in the home. It is our mission to keep people in the home, because we know that is where they truly want to be, in the comfort of their own home. Our vision is to help people live safely and comfortably at home with independence and dignity.

 

2. What are some of the services that Bayada provides?

Bayada provides a range of services to adults and children of all ages to assist with adult nursing and assisted care. The services that are mostly medical include the following:

  • Rehabilitation services
  • Hospice (in some areas)
  • Home health
  • Physical, occupational, and speech therapy

 

However, we realize that not every individual might require in-home medical care; some of our clients who are senior citizens simply want someone to help them get up in the morning, get dressed, and be on their way to starting their day. When it comes to services around the house, Bayada is available 24/7 to provide the following:

  • Bathing and dressing
  • Administering of medication
  • Breakfast
  • Housekeeping, such as laundry and other miscellaneous chores
  • Errands, such as help with buying groceries
  • Prescription pick-up
  • General company (some clients simply want someone to read with them)

 

In order to determine the best possible care that an individual requires, Bayada will send an agent into the client’s home and develop a detailed care plan. These are tailored to the individual to maximize the level of care he/she receives. We have worked the entire gamut, from individuals who want only a few hours of company a day, to people who have required constant, hands-on attention due to having a tracheotomy and being placed on a ventilator.

 

3. What are the rates, and how are the services paid for?

Normally the standard rate for personal care services is $23/hour. We do have special discounts if you pay privately. We can offer a discount that cuts the rate to $18.25 per hour, which is lower than the national average. There are also other options for payment. We accept Medicaid through the CAP/DA program, we accept the VA Aid & Attendance program, and if you have a long-term policy that will pay for our services, then we accept that as well. We also accept private payment.

When it comes to providing therapy to an individual as part of the home health care, Medicare will pay for the physical therapy clients receive during home visits. Those visits are usually a few times a week for an hour or so a day. Medicare will not, however, pay for custodial care, which is where a CNA would go in with the bathing and personal care.

 

4. Say I have a loved one who is already in a care facility. Can Bayada still work with him/her?

Yes. In that case, two Bayada offices can come in and help provide services: one is the Bayada Home Health Visit Office, located in Gastonia. It is important to note that they service the Gastonia area. They could come in and provide the medical services, such as physical therapy. The second office to become involved would then be our office in Shelby, where we send the CNA out and provide services for bathing and all personal care. So that takes care of the two components: the medical and the custodial.

We currently have several families who have sought our services so that their loved ones do not have to be completely alone in those facilities. We can provide a CNA to sit with them and keep them company for a few hours, and also provide that extra one-on-one care if they should need it.

 

5. How can people contact you if they want to ask any questions?

Bayada has over 300 locations in the United States, so it is fairly easy to find a location that is close to you.

If you’d like to call the Shelby, NC, office, call (704) 669-4000.
If you would like to come in and have an in-person discussion about care plans, stop by at
1105-3 East Dixon Blvd. in Shelby.

We can also send a clinical manager to your home for a sit-down and talk with your family, should the individual seeking care have trouble traveling.

Visit our website at www.Bayada.com for further information.

If you would like to sit down and discuss your current plan and situation with me, I would be glad to help you out. Give us a call at the office so that we can schedule a time to chat: 704-259-7040.

Call me if you have any questions:

Greg McIntyreGreg_Full
Elder Law Attorney
McIntyre Elder Law
123 W. Marion Street, Shelby
704-259-7040

Live WOHS Radio – Great show featuring Jane Wright from Care Solutions.

in Elder Law TV by Greg Leave a comment

Jane is not only a champion of her cause and employer, Care Solutions but she is also the president of Cleveland County ACCES, a group of professionals dedicated to helping seniors.

Interview: Choosing and Paying for Nursing Home Care

in Elder Law TV by Greg Leave a comment

Greg sits down with nursing home expert, Kris Thompson, Executive Director at Peak Resources, to talk about what to look for in a nursing home and how to pay for care… and much, much more.

#theelderlawguy

Adult Day Care and Life Enrichment – Alternative Care Option

in Articles by Greg McIntyre Leave a comment

Adult Day Care

One of the more recent options for care has emerged in the form of Adult Day Care centers, which are not only relegated to senior citizens, but individuals who have special needs, as well. I consider myself lucky to be a friend of Suzi Kennedy from the Life Enrichment Center of Shelby, North Carolina. When it comes to taking care of special needs individuals and seniors, Suzi and the people that she works with through the Life Enrichment Center have been upheld as national examples of how to create a system of adult day care that really and truly works. Not long before publication of this book, I had the pleasure of sitting with Suzi to chat about the Center’s history as well as the impact of adult day care in this country. Due to the magnitude of her work, I would be especially honored to dedicate part of this chapter to highlighting what she and the Center have done over the past few decades.

 

Life Enrichment Center: The Beginning

Every success story has an interesting background that cannot be ignored. Suzi, originally from New York, moved down South and began teaching nurse aid classes at a community college. When she took her students to the nursing homes to complete the clinical part of her course, she realized something: most of the elderly patients that they encountered were only in these nursing home facilities because they had no other alternative. There was no one to care for them around the clock at home, and in order to ensure they got the attention they needed, their families had entered them into these facilities. This was in the 1970s, meaning back then there were no assisted living homes, according to Suzi. Nursing homes, at least during that time, seemed the only viable option for elder care.

Suzi got to thinking and tried to come up with some alternatives, but at each turn, she was told that her ideas fell under the category of home healthcare, a practice that was already in full swing. She knew that something besides home healthcare could be done, but she didn’t know what. Then one night, after watching a television program on nursing homes, she saw an adult day care center in California mentioned in the credits. It was then that it hit her: adult day care was the way to go. This lit a fire in Suzi; she called the center, collected some information, and later joined a North Carolina state association of adult day care providers. Not long after, Suzi spoke with the minister of John Knox Presbyterian Church here in Shelby, and they opened their doors for the first time as Life Enrichment Center.

 

Growth and Recognition

1980 was the year that Life Enrichment Center received their first participants: one man and one woman, and they would come to the center twice a week. A year to the day, however, the Center was logging an average daily attendance of 12 people, which – according to Suzi – in the history of adult day care, that’s unheard of. With that level of participation, they opened their doors five days a week and continued to flourish as a not-for-profit organization. In order to have more of an impact on the community, Suzi and board decided that they would accept different types of funding so that they could serve people who had a variety of funding streams, such as Medicaid. To this day, Suzi swears that was one of the best decisions they ever made, thanks to the enormous positive effect it had on their ability to reach more people in need; not just the elderly, but younger individuals with special needs.

Not long after, the Life Enrichment Center was honored with a $500,000 grant from the Robert Wood Johnson Foundation, and was one of only 16 centers in the United States to receive that recognition. One of the main reasons they were chosen was due to the incredible work that Suzi was doing with Alzheimer’s patients. She and a few other people forged the path in the realm of what is known as “behavior acceptance”, which is a practice in interacting with Alzheimer’s and dementia patients that validates their emotional needs. For instance, Suzi had interacted with elderly patients who were distraught over the loss of their parents. Though their parents had passed away a number of years ago, these patients – due to their illness – were convinced that their parents had just died. Instead of correcting them, which would cause an even greater emotional turmoil, Suzi would sympathize with them and say, “I’m so sorry to hear that. Tell me about your parents.” This would greatly comfort the patients, and in a short while, their emotional breakdowns would cease to continue. It was due to this groundbreaking practice that the Robert Wood Johnson Foundation recognized them, and with that newly acquired grant money, they were able to expand even further.

 

Life Enrichment Center: Today

At the time of publication, the Life Enrichment Center posted the following hours of operation: 5:30 AM to 6:00 PM. This means that families who care for their elderly loved ones can bring them to the center, leave them there if they have to go to work and carry out their responsibilities during the day, and pick them up after work. Individuals who are cared for at the center receive two meals a day, breakfast and lunch, as well as an afternoon snack.

The center also features total healthcare nurses who are available during the hours of operation and can carry out any medical procedure that’s approved by the nurses that practice. Individuals at the center can take part in speech, occupation, or physical therapy. The center boasts five levels of care, and at the time of publication, the top charge per diem is $68.

So to recap on the benefits of this center: families who are caring for a senior citizen or a special needs individual can drop them off at the center in the morning, where they will be taken care of in terms of medical attention, therapy, food, and other activities, and they can be picked up in the evening to go home and eat dinner with their families. This is a tremendously positive option for households that want an alternative to nursing homes and assisted living facilities.

There are currently two Life Enrichment Center locations: one in Shelby, the other in Kings Mountain. If you would like to contact the Shelby Center, feel free to call them at (704) 484-0405. To contact the Kings Mountain Center, give them a call at (704) 739-4858.

If you would like to sit down and discuss your current plan and situation with me, I would be glad to help you out. Give us a call at the office so that we can schedule a time to chat: 704-259-7040.

Call me if you have any questions:

Greg McIntyreGreg_Full
Elder Law Attorney
McIntyre Elder Law
123 W. Marion Street, Shelby
704-259-7040

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