Keeping Your House After Applying for Medicaid

December 22, 2021 macintosh

Dear Tracy:

It looks like my grandfather will soon need skilled nursing. Our family has tried to help my grandmother keep him safe at home for as long as we can, but it’s becoming too dangerous for her to manage. He falls a lot and she is simply not able to help him get back on his feet.

We’ve been researching the costs of nursing homes in central Ohio, and it’s just not feasible for them financially. They live on a very fixed income. Their only real assets are their house and an older car my grandmother still drives. We’ve talked about applying for Medicaid to pay for Grandpa’s care, but we are worried they will take the house and leave my Grandma without a home.

What are the rules about Medicaid, nursing homes, income and assets in Ohio?

Danielle

Dear Danielle:

It sounds like your family is in a tough spot. We hear similar stories from families in your position quite often. Fortunately, the Medicaid laws in Ohio are much more practical than they used to be. The legislature recognizes that leaving a spouse without a home solves one problem for a family but creates another one.

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Applying for Medicaid for a senior? Here’s how to do it.

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Top Facts About Medicaid in Ohio

Here are a few things you should know about Ohio Medicaid:

It will pay for a nursing home for an adult when it is considered to be “medically necessary.” This means the potential resident requires hands-on assistance with at least two of the activities of daily living: bathing, dressing, eating, grooming, transferring, toileting, and taking medication.
Your grandmother will be allowed to keep her car and her home, provided she or a dependent family member still lives in the home.
Your grandmother will also be able to keep some of the income and assets they share. How it works is that the state of Ohio assumes half of the assets your grandparents had at the time of your grandfather’s admission to a nursing home (referred to as the “Community Spouse Resources Allowance” or CSRA) belong to your grandmother and half to your grandfather, subject to a limit that changes annually. In 2022, that limit is a minimum of $27,480 and a maximum of $137,400.
Your grandmother may also be able to keep part of their monthly income if her own income is less than $3,435 per month (2022 rate).
When you apply for Medicaid, Ohio Department of Jobs and Family Services will tell you just how much your grandmother will be able to keep.

If your income is too high, a Qualified Income Trust is an option. See our article for more information.

Hopefully this puts your mind at ease about your grandmother so you can focus on getting your grandfather the care he needs! Please feel free to give me a call at (614) 875-7700 if you have any other questions!

Warm Regards,

Tracy Woods
Patient Financial Services Representative

Assisted Living, Ohio

Assisted Living Costs in Central Ohio

December 22, 2021 Macey Abrams

If you’re looking for information about the cost of assisted living in Columbus, Ohio, you might have a difficult time getting an answer.

That’s because assisted living costs can vary depending on the individual’s needs. However, you can get an idea of the assisted living price ranges from the Genworth Financial Cost of Care Survey 2021.

Assisted Living Costs in Ohio

Cost overview:

2021 Monthly Assisted Living Costs
Columbus, Ohio Median Cost	$4,085 (per month)
National Median Cost	$4,500 (per month)

Some communities may fall above or below these rates based on their services and amenities. For example, communities that offer services like memory care may be closer to the $7,000-$9,000 range per month.

It’s important to keep in mind that the cost of assisted living varies by community and resident.

Assisted Living Costs at The MacIntosh

At MacIntosh, two rates factor into our assisted living costs: the apartment rate and the level of care rate, which is determined by an assessment done prior to the resident’s move-in date.

The apartment rate depends on the size of the apartment. The level of care rate is based on how much assistance the resident needs with things like dressing or medication management.

Together, these rates make up the monthly cost. Depending on your loved one, the monthly rate at a MacIntosh assisted living community can range from $4,000-$5,000.

Explore Assisted Living Options at The MacIntosh »

Included Fees vs. a La Carte Fees

At MacIntosh senior living communities, we offer all-inclusive monthly pricing which include the following services:

Utilities
Weekly linen services
Daily towel service and trash removal
Weekly housekeeping
Suite maintenance
Three daily meals plus snacks
Emergency call system
Activities and scheduled outings
Health assessment by a licensed nurse
Monitoring of health care needs by a physician

The only services that aren’t included are personal laundry and cable, which are available for nominal fees, plus any personal care items.

Other communities may offer what are called à la carte services. That means there may be additional fees for services like the ones listed above. Those fees are required on top of the monthly fees. When you tour communities, be sure to ask what is actually included.

Lifestyle Rate

At MacIntosh, we also offer what we call a “lifestyle rate.” That is a lower rate for people who would like to move to one of our communities for the convenience but also maintain the independent lifestyle they prefer. These individuals don’t require assistance with activities of daily living.

Some older adults prefer this option because it frees them from the hassle of home maintenance. They can live independently while enjoying services and amenities at the community.

Another benefit of this choice is that if you ever do need assistance, you don’t have to move. You can receive assisted living services right where you are.

Paying for Assisted Living

Medicare nor most private insurance policies cover assisted living, meaning many people pay out of pocket. However, if a resident has long-term care insurance or veteran’s benefits, those can be financially beneficial and assist with covering the cost.

At our Whetstone community in Columbus, we also accept the assisted living Medicaid waiver after one year of private pay in assisted living. There are only a few select communities that accept this waiver.

It works like this: if a resident who has moved into Whetstone spends their funds after one or more years of private pay, they can then apply for the assisted living Medicaid waiver. As long as they’re still a good fit, they can remain in assisted living and transition from private pay to the Medicaid waiver.

And don’t worry — most communities (MacIntosh included) will go over the finances of any potential resident in order to determine if they are a good fit and can afford it.

Caregiver Resources, Ohio

6 New Year’s Resolutions for Central Ohio Caregivers

December 20, 2021 Macey Abrams

As we head toward the start of a new year, weary caregivers may be struggling to find ways to lead healthier lives. The demands of caring for a senior loved one can take a toll on both the physical and emotional health of the caregiver.

What can you, as a caregiver, do to start off the New Year on a healthier note?

Here are a few suggestions.

6 New Year’s Resolutions for Caregivers

Seek out help. Some caregivers view caring for an aging parent or senior loved one as their duty and obligation. Asking for help is seen as a sign of weakness or a lack of dedication. Try to remember that a few hours of support a week can keep you healthier over the long haul. Ask yourself: If something happens to you, who will care for your loved one?
Make nutrition a priority. More and more research proves that nutrition plays a key role in living a healthy lifestyle. When you are under a considerable amount of stress, such as that created by caregiving, it is even more important. Make it a goal to eat five to seven servings of fruits and vegetables each day. Besides helping you improve your physical health, the vitamins and minerals found in many fruits and vegetables can also help lift your spirits and boost your mood.
Get moving. Moderate exercise for a combined total of 30 minutes a day can help to improve your physical well-being. Taking a 15-minute walk around the block in the morning and spending another 15 minutes on a stationary bike later in the day can add up to a healthier caregiver.
Stay personally connected. While social media and video chat services are a good way for caregivers to stay in touch, personally connecting with friends and family is also important. Make time to go out with loved ones at least once or twice a month. Talk with your local agency on aging about respite care options if your loved one isn’t safe staying alone while you are out.
Schedule your physical. Caregivers often put their own health on the backburner while caring for a senior loved one. Make it a priority to have a physical and schedule whatever screenings your primary care physician feels are necessary. Prevention and early intervention are an important part of maintaining your ability to care for your aging parent or family member.
Find a support group. For many caregivers, just the idea of having to fit a weekly or monthly support group meeting into their calendar may seem impossible. That is where an online caregiver forum can help. You can connect with your peers in groups like those offered by the Family Caregiver Alliance.

We hope these tips help you make this a healthier year! Need more tips on care for your senior loved one? Call us today at 614.457.1100.

Assisted Living, Ohio

How to Pay with the Ohio Medicaid Assisted Living Waiver

December 17, 2021 Macey Abrams

Dear Jaclyn,

My dad is living at an assisted living community and someone recently told us that the Ohio Medicaid assisted living waiver can help cover the cost. I’ve never heard of this before—could you tell me more about it?

I’m wondering if Dad is eligible and if so, how we can apply.

Sincerely,

Nancy D.

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Dear Nancy,

I’m glad you asked this question. Not many people are aware that the Ohio Medicaid assisted living waiver is available to help pay for assisted living. Not all communities accept it (typically assisted living communities are private-pay), but some communities do and it can be a big help financially for people like your father.

I’ll give you a brief overview of the waiver to get you started!

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What Is a Medicaid Waiver for Assisted Living?

The Ohio Medicaid assisted living waiver provides assistance with the cost of assisted living by covering the cost of care in participating assisted living communities in Ohio. While it doesn’t cover 100 percent of the cost of assisted living, it does help considerably.

To back up a bit, it’s important to understand that paying for assisted living isn’t like paying rent. In addition to room and board, residents are also paying for care services, like assistance with activities of daily living.

So the waiver pays for the care services portion of assisted living, and the residents are then expected to cover the cost of their room and board. That cost is determined by a rate set by the state.

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Who Is Eligible for the Ohio Medicaid Assisted Living Waiver?

To qualify for the waiver, your parent will need to meet financial requirements and be able to show that they need the type of care provided in assisted living.

The financial eligibility requirements do change, so be sure to check with the Central Ohio Area Agency on Aging (COAAA) for the most up-to-date information. To give you an idea, though, Paying for Senior Care shares the financial eligibility requirements for 2022:

“To qualify for any of Ohio’s waiver programs, you must have an income at or below 300% of the SSI Federal Benefit Rate, or $2,523 per month in 2022. You also must have less than $2,000 in countable assets…. If you are married, Medicaid allows your spouse to keep more income and assets.”

How Do You Apply for the Medicaid Waiver?

To apply, your parent will need to:

Apply for Medicaid
Complete an assessment by the COAAA to show that they need assisted living services.

Medicaid Application

When you help your parent apply for Medicaid, you will start by filling out the required paperwork. The paperwork can be provided to you by COAAA or an assisted living community if your parent is currently living in one.

You’ll need to have the proper documents and information as outlined in the application, including:

Age and citizenship verification
Social Security and Medicare cards
Monthly income verification
Private health insurance
Bank accounts and other liquid assets
Life insurance policies
Property tax statements
Guardianship papers (i.e., power of attorney)

Once completed, the application should be submitted to the county department of Job & Family Services.

Level of Care Assessment from COAAA

The level of care assessment can be completed at the same time as the Medicaid paperwork.

First, you’ll let COAAA know that you need an assessment. They will come and visit your parent, and see if they meet the necessary criteria.

If your parent is already in assisted living, chances are they will meet the requirements. The level of care COAAA is looking for is an intermediate level of care, meaning your parent needs hands-on assistance with at least two of their daily living tasks.

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I should also mention that some assisted living communities accept the assisted living waiver right away and others accept it only after 1-2 years of private pay. The ones that accept it upon admission might have a waitlist.

That’s why I recommend starting the application process sooner rather than later because it can take a while to process depending on the documents requested. It’s best to have it ready so you have assistance for the cost of assisted living as soon as you are able.

Medicaid Waiver Assisted Living Columbus Ohio

Do you know if your parent’s assisted living community accepts the waiver? Not all communities do. To find communities that accept it, you can request a list from COAAA.

Whetstone Rehabilitation Center, Skilled Nursing & Assisted Living in Columbus, Ohio is one such community. We accept the waiver after two years of private pay. Located off Route 315 on Olentangy River Road across from Riverside Hospital, we serve Clintonville, Upper Arlington, Worthington and the greater Columbus area.

If you have any questions about the waiver or assisted living, feel free to contact us!

Jaclyn Spalding
Assisted Living Director
Whetstone Rehabilitation, Skilled Nursing & Assisted Living

Caregiver Resources, Ohio

5 Holiday Survival Tips for Central Ohio Caregivers

December 13, 2021 Macey Abrams

The holiday season is a time most of us look forward to all year long. For caregivers, however, the extra demands on their time can make the season feel overwhelming. To help central Ohio caregivers enjoy the holidays this year, we have pulled together a few tips.

Holiday Survival Tips for Central Ohio Caregivers

1. Set priorities early. From work parties to activities at your church or synagogue, the holiday season usually makes your calendar a busy one. For caregivers, the desire to join in may be overshadowed by the responsibilities of caring for your loved one. To make it easier to juggle, decide now what your priorities for this season will be. Is it to spend more time with your own children? Or maybe to participate in more of the holiday events at your church? Picking one or two priorities will help you decide which invitations to accept and which to consider for next year.

2. Be realistic. Give yourself permission to do a little less this year. If you always bring an elaborate dessert to a family holiday gathering, for example, but just the thought of spending all of the time it takes to create it adds to your anxiety, settle for a simple dessert or one you can order from the bakery this year. It doesn’t mean you won’t be able to go back to your homemade creations in the future, it just means you are taking a break from it this year.

3. Investigate local respite services. Respite care comes in many forms. It might be a volunteer visitor from your church, an in-home caregiver from a local senior care agency or a few nights stay at a central Ohio assisted living community. It is a service designed to give caregivers a break. You can use it for just a few hours while you are shopping or for a few nights if you want to travel during the holidays.

4. Accept help. Caregivers often feel caring for their loved one is their obligation. It makes them reluctant to ask for or accept help. One thing to keep in mind, however, is that failing to take time out to care for yourself can lead to a health crisis of your own. If someone offers to help in small ways like running errands or assisting with transportation, accept their offer. If no one in your family offers support, ask them to pitch in. Giving them specific tasks you need help with might be the best way to garner their assistance.

5. Take care of you. We all know that exercise most days of the week and eating a balanced diet are the best ways to stay healthy. But caregivers often put both on the back burner at the holidays: try not to do that this year. Take a quick walk each day and try to eat five to seven servings of fruits and vegetables every day. It will go a long way toward helping you successfully survive the holiday season.

Please contact us if you are a central Ohio caregiver who would like to learn more about using respite care this holiday season!

Long-Term Care, Ohio

7 Tips for Holiday Planning

December 4, 2021 Macey Abrams

If this is your loved one’s first year in a long-term care community, holiday planning can be a stressful time. Even if they’ve lived there for some time, it can still be difficult. Your celebrations will be different from how they were in years past — but “different” doesn’t have to mean “bad.”

Here are some tips to help plan for the holidays with a loved one in long-term care.

Holiday Planning to Make the Most of the Holidays

1. Decorate their room or suite.

Deck out your loved one’s room just like you would their old house. Whether you celebrate Christmas or Hanukkah, make decorating a family affair.

It’s also a good idea to incorporate pictures of previous holiday celebrations. That way, Mom or Dad can be filled with warm thoughts of time spent with family and friends.

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2. Encourage your loved one to join community events.

Senior living communities do everything they can to provide residents with fulfilling and entertaining holiday celebrations. Encourage your parent or loved one to join in the holiday events, from choir group performances to Christmas tree lighting ceremonies to Thanksgiving meals.

Review the community’s events calendar together and share copies with loved ones. Plan to have various family members join your mom or dad for the events that are the most appealing to them. And don’t forget to include the grandkids: Residents love the opportunity to show them off!

3. Create a family visitor calendar for the holidays.

It can be as simple as setting up a private group on Facebook or using Google calendars. Ask loved ones to sign up for various days throughout the holiday season. This helps prevent your loved one from having multiple visitors on some days and none on other days.

4. Prepare family members for any changes in Mom or Dad.

If you have any relatives who live out of town and haven’t seen Mom or Dad since they moved into long-term care, they may not be prepared to see the changes in their loved one. Take some time to have a talk with your relatives and catch them up with any relevant health issues.

For example, if Dad is having memory problems, coach them on how to best communicate with someone who has dementia. If Mom has lost a lot of weight, prepare them for that so they don’t make any surprised comments when they first see her.

Also, consider writing out some instructions on how to get to the room or suite your parent is in. The staff at the community will certainly be glad to help them find the right room, but it can put them more at ease if they have an idea of where they’re going.

5. Talk with your parent about their feelings this holiday season.

Esther Heerema, MSW, advises that you have a conversation with your parent about spending the holidays in long-term care. Hereema is a licensed social worker who has worked extensively with individuals with Alzheimer’s disease.

“You know that phrase about the elephant in the room? Acknowledge it. Your family member may need to process the changes from last year and talk extensively about what she is missing out on this year,” Hereema says. “She also might appreciate hearing that you’ll miss her amazing turkey stuffing that she makes every year, or just that you will be missing her.”

6. Take them home to join your celebrations.

If their health allows it and you live within a reasonable difference from the community, take them home for the big day. If you have other relatives coming to your house to celebrate, ask if they can pick up your parent so you don’t have to fit it in your busy schedule of holiday preparations.

7. Take some time for yourself.

This is the most important rule when planning for the holidays with a loved one in a long-term care community. AgingCare offers these holiday tips for caregivers:

Take a break when you feel yourself getting stressed.
Ask for help from family members and friends.
Make a to-do list to help yourself stay organized.
Simplify your holiday plans. Decide which traditions are too much work and let them go.
Accept imperfection. Feel like you’re not doing enough? Nobody is perfect. Do your best and accept the rest.

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Making the Most of Long-Term Care Year-Round

When seniors are no longer able to live on their own and need daily help, a long-term care community is often the best place for them. The holidays may make you feel a little blue that Mom or Dad is no longer at home, but remember that they are in a place where they’re safe and are being well-cared-for.

Here are a few additional resources that may help during the holidays and year-round:

Visual or Audible: Great Books For Seniors in Long-Term Care

How Often Should I Visit My Loved One in Long-Term Care?

Long-Term Care, Ohio

How to Assess Your Parent’s ADL Ability – and Why It’s So Important

December 1, 2021 Macey Abrams

It is never easy for an adult child to know when it is time for their parent to move to an assisted living or long-term care community. It’s tough to know what to look for and how to evaluate your parent’s ability to live on their own. After all, you’re their child, not their doctor.

One of the ways in which someone’s suitability for an assisted living or long-term care community is evaluated is through an activities of daily living (ADLs) assessment.

Here’s how an ADL assessment works, who can perform an ADL assessment and how you can use some of these tools to get answers.

Why (And How) ADLs Are Measured

Activities of daily living are exactly what they sound like: they’re the things you do from day to day as an independent adult.

Researchers and medical professionals have spent decades defining ADLs and figuring out how to measure them in senior patients. Evaluating ADL ability provides a more concrete way of answering an abstract question — is it okay for this person to be living on their own? They’re also helpful in determining the best way to provide any necessary assistance to seniors.

“ADLs are one of the most important measurements used to determine the level of care an individual requires and what their care plan should entail,” author Carol Bradley Bursack writes in her article, Activities of Daily Living: Why This Measure Matters.

In terms of who provides ADL assessments, your parent can be assessed by their physician, or they may be referred to an occupational therapist. Additionally, if you’re considering an assisted living community or a long-term care community, trained professionals on staff can oftentimes provide an assessment or assist in finding someone who can.

“It is best to have a complete needs assessment conducted by a specialist (geriatric care manager, nurse, occupational therapist or social worker) to fully identify all problems, their root causes and potential solutions,” aging life care professional Carmel Froemke advises.

Activities of Daily Living Assessment for Your Parent

As we mentioned above, an ADL assessment should be completed by a professional. However, if you are wondering whether you should consult your parent’s doctor, there are some standard questions you can ask yourself and your parent to determine if it’s time to call a professional.

If Mom isn’t cooking anymore, how do you know if that’s a sign she needs assisted living or just a simple shift in her interests? If Dad keeps forgetting to take his medicine, does that mean he needs long-term care or is it just a normal sign of aging? Is that something you should go to his doctor about?

If you struggle with those kinds of doubts, you can use these resources to get a better idea of your parent’s needs.

Evaluating Basic ADLs

Initially, it’s important to know that there are two types of ADLs: basic and instrumental.

Basic activities of daily living are physical self-care tasks such as bathing, dressing, toileting and continence, transferring and feeding/eating.

Instrumental activities of daily living are a bit more complex. They include cooking, medication management, shopping, communicating via telephone, managing money and finances, performing housework, laundering clothing and driving or using public transportation.

Here’s a checklist to help evaluate your parent’s basic ADL ability. For each activity, check the column that best fits your parent:

Activity	Can complete without supervision or assistance	Can only complete with assistance
Bathing
Dressing
Toileting
Transferring (getting out of bed or chair)
Continence (control of bladder and bowel)
Feeding (food may be prepared by someone else)

Give one point for every check in the left column. If the check is in the right-hand column, give zero points. People with a score closer to six are more independent. However, if your parent ends up with a score closer to 0, it may be time to talk to a health professional.

How to Evaluate ADLs

As we all know, living on your own involves more than feeding and clothing yourself. If you’re trying to decide whether your parent is okay living on their own or if they need more assistance in a senior living community, you also need to evaluate their ability to complete instrumental ADLs.

You can use this IADL worksheet if you want to see what a medical professional will look at when they assess your parent. Here’s what you should ask yourself when thinking about your parent’s living situation:

Can my parent make phone calls on their own to both familiar numbers and numbers they’ve looked up?
Can my parent complete their own grocery and clothes shopping?
Can my parent prepare or buy their own healthy meals?
Can they keep their house acceptably clean on their own?
Can they do their own laundry?
Can they travel independently?
Can they consistently and accurately take their medications?
Can they manage their financial matters?

If you answered yes to all or most of these questions, your parent is likely still able to live independently. But if they need assistance with some or most of those tasks, that’s when you should talk with your parent about meeting with their physician.

Is Assisted Living or Long-Term Care Necessary?

After your parent’s doctor or another medical professional has evaluated your parent’s ADL ability, it may be time to start looking into assisted living or long-term care options for your parent.

If the doctor feels this is the case, there are a lot of helpful resources to assist in determining which community is the best for your parent. Learn more about the differences between long-term care and assisted living at the MacIntosh.

We hope this has been helpful! As always, contact us with any questions about long-term care or assisted living options at the MacIntosh communities.