50+ Lifestyles

Your Advocacy Connection

By Kathy Nitz
GolderCare Solutions

How Will You Keep Mom Safe in Long-term Care?

When considering long term care for your loved-one, often times “safety” is not discussed in the general public. However, it should be! There are long lists of injuries to residents in long term care and sometimes even death. Who provides the oversight of these situations? This creates quite a dilemma!

Our society has the belief that if you pay more, you get more or better service. The Nursing Home industry is a completely different entity. Often times people will not utilize Medicaid because they feel their family member will be “warehoused” or given less attention or even ignored. Not so! Read on as I discuss these important points:

The Myth: Mom will get better treatment and care if she pays privately rather than utilizing Public Benefits (Medicaid) to pay for her care.

The Reality: Most facilities and agencies are short-staffed. This can lead to unintentional inadequate or poor-quality care.

The Risk: Mom’s health, safety, and even her life. Short staffing can lead to urinary tract infections if briefs are not changed often enough. Short staffing can lead to poor nutrition if aids do not have time to assist feeding residents. Short staffing can lead to medication errors when nurses are juggling too many residents. Short-staffing can lead to exposure to the harsh elements if a memory care resident elopes (let’s themselves outside) due to inadequate supervision.

The Remedy: Independent oversight and supervision greatly deters a provider’s temptation to short-staff an individual patient’s care.

The Primary Provider of independent oversight: Federal and state regulators (‘Surveyors’) who make both announced and unannounced inspections of facilities. Facilities are given stars for their compliance with regulatory rules.

Achilles’ Heel of regulatory scheme: Surveyors focus their attention on the care provided to Medicaid patients and largely ignore that provided to private-pay patients. Medicaid beds are subject to much heavier regulation than Private-Pay beds.

Primary Solution: Access Medicaid benefits ASAP to gain that extra level of regulatory oversight. This usually means utilizing Accelerated Eligibility Strategies under the
Medicaid rules.

Source of Primary Solution: GolderCare specializes in Accelerated Eligibility Strategies and Medicaid Timing calculations.

Alternative Solution: Purchase independent oversight privately. Utilize professional Patient Advocates or Care Managers to provide supervision and oversight, together with any advocacy needed. This is Private Pay x2 – (1) paying privately for care and (2) paying privately for professional patient advocacy or care management. Those who decide to pay the private-pay rate for care should also be financially prepared to pay privately for oversight and supervision of that care.

Source of Alternative Solution: GolderCare specializes in Total Patient Advocacy and Care Management.

Ultimate Question: How will you access the professional oversight needed to maximize Mom’s safety and quality of care? Will you utilize the Medicaid strategy? Or will you hire private professional services to do so? Either way, we at GolderCare will be happy to assist you and Mom!

Medicaid is not always the determining factor for care. Everyone should receive competent, kind and compassionate care. We will discuss Patient Advocacy in upcoming articles. Call your Patient Advocate first!

Kathy Nitz is the Lead Benefits Advocate for GolderCare Solutions. She uses her wealth of knowledge and experience in benefits planning to advocate for seniors and those who are disabled. You can reach GolderCare at (309) 764-2273 and learn more at www.goldercare.com.