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Acknowledgment of Disclosures and Authorization
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment. You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
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My Dad is in long term care and on hospice. I am his guardian and am learning as I go along. I missed his Medicaid redetermination deadline after he was only on it for 5 months. I quickly sent in paperwork and documents because we have a 90 day grace period to submit but his coverage was dropped due to the lateness. I’m so scared. I call them often and the first few told me it was processing but then I was told I was missing something and 2weeks later I was told it was the wrong application. I actually had some one tell me it was denied due to being over income limit which can’t be the case because nothing has changed about his income. Then the next person couldn’t tell and that it was processing. His nursing home has been harassing me. I’m terrified! I can’t sleep or eat. Would they actually kick a man in hospice out until the decision comes through?
What state does he live in? Medicaid rules vary by state. This info is important.
Request a meeting with the nursing-home administrator or business-office manager, not just whoever is calling about the unpaid balance. Tell them:
“His Medicaid redetermination/reinstatement is pending. I need you to document his account as Medicaid pending and work with me to resolve the eligibility issue.”
If the facility actually threatens an involuntary discharge while Medicaid is pending, that's the point where you should contact the state Long-Term Care Ombudsman immediately. CMS's guidance on this particular issue is unusually clear.
If Dad's Medicaid eligibility determination is actually pending, a Medicaid-certified nursing home cannot simply discharge him for nonpayment while Medicaid is deciding his eligibility. CMS specifically addresses this situation in its nursing-home regulations and guidance.
That said, stop relying on repeated telephone conversations with different Medicaid workers. You've already been told several contradictory things—processing, missing information, wrong application, over income, etc. You need to establish in writing exactly what the status of his case is, what was submitted, what (if anything) is missing, and whether his case is being treated as a late renewal/reconsideration or as a new application.
Keep copies of absolutely everything you submit and proof of when it was submitted. As his guardian, I'd also ask the nursing home's business office/social worker to help you straighten this out. Medicaid-certified nursing homes routinely deal with residents whose Medicaid applications are pending.
If his income and assets truly haven't changed and he qualified only five months ago, an alleged “over-income” denial deserves investigation. There may be an administrative/documentation problem rather than an actual change in eligibility. And don't let the nursing home intimidate you into personally agreeing to pay his bill. You are his guardian; that doesn't make his nursing-home debt your personal debt. His funds are used according to the Medicaid rules, but don't sign anything accepting personal financial responsibility.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Request a meeting with the nursing-home administrator or business-office manager, not just whoever is calling about the unpaid balance. Tell them:
“His Medicaid redetermination/reinstatement is pending. I need you to document his account as Medicaid pending and work with me to resolve the eligibility issue.”
If the facility actually threatens an involuntary discharge while Medicaid is pending, that's the point where you should contact the state Long-Term Care Ombudsman immediately. CMS's guidance on this particular issue is unusually clear.
If Dad's Medicaid eligibility determination is actually pending, a Medicaid-certified nursing home cannot simply discharge him for nonpayment while Medicaid is deciding his eligibility. CMS specifically addresses this situation in its nursing-home regulations and guidance.
That said, stop relying on repeated telephone conversations with different Medicaid workers. You've already been told several contradictory things—processing, missing information, wrong application, over income, etc. You need to establish in writing exactly what the status of his case is, what was submitted, what (if anything) is missing, and whether his case is being treated as a late renewal/reconsideration or as a new application.
Keep copies of absolutely everything you submit and proof of when it was submitted. As his guardian, I'd also ask the nursing home's business office/social worker to help you straighten this out. Medicaid-certified nursing homes routinely deal with residents whose Medicaid applications are pending.
If his income and assets truly haven't changed and he qualified only five months ago, an alleged “over-income” denial deserves investigation. There may be an administrative/documentation problem rather than an actual change in eligibility.
And don't let the nursing home intimidate you into personally agreeing to pay his bill. You are his guardian; that doesn't make his nursing-home debt your personal debt. His funds are used according to the Medicaid rules, but don't sign anything accepting personal financial responsibility.
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