RAHSA Question & Answer

Home Health Care generally provides for personal care, some therapeutic services and some light house duties. These services may vary with each program.

Social Adult Day Care generally provides nutrition, social-recreational services, and supervision. Optional transportation services may also be available.

Medical Adult Day Care generally provides the same services as the Social Adult Day Care, as well as some medical and nursing services. Respite Care generally provides for temporary room and board. Other optional services may be available, but these vary with programs.

Senior Housing

Senior Housing choices in the Rochester area feature a wide range of levels of service. Some senior communities offer higher levels of service included in monthly fees, while others provide a minimum level, with services available on an ala carte basis. Independent living often includes a meal plan and housekeeping, while enriched and assisted living programs may also incorporate personal care and assistance with daily living activities. Financial arrangements may be rental, buy-in or life-care plans. Listed here are RAHSA members who provide senior housing.

Comprehensive Care Services

Rehabilitation generally provides for temporary 24-hour care that includes room and board as well as therapeutic, medical, nursing, nutritional, social-recreational and social work services. Other optional services may be available, such as beautician or barber services.

Skilled Nursing Care generally provides for 24-hour care that includes room and board as well as therapeutic, medical, nursing, nutritional, social-recreational and social work services. Other optional services may be available, such as beautician or barber services.

Alzheimer's Special Care Units provides similar services as Skilled Nursing Care and focus these services on the special needs of those with Alzheimer's disease or other forms of dementia.

Terminal Care or Hospice provides for 24-hour comfort care for those who are dying. Services include room and board, as well as medical, nursing social work and other support services. Other optional services may be available, such as beautician or barber services.

5) How do I apply for these services?

Services have different criteria that may include financial resources, physical, social or mental abilities, medical or nursing needs and family situations. Some of these criteria are mandated by governmental or insurance regulations. For example, New York State mandates the completion of a standard evaluation form, called a Patient Review Instrument (PRI) and Screen by anyone seeking admission to skilled nursing care.

6) Who pays for these services?

Medicare is health care insurance available generally for those who are 65 years of age or over. Medicare covers some of the costs of physician care, hospital stays and some medical care. Generally, Medicare will not cover the cost of long term care.

Medicaid is health care insurance for those who are low-income and there are specific financial criteria to gain eligibility. While Medicaid may cover the expenses of some long term care providers, there are some limitations of choice of services. Some providers may not accept Medicaid payment.

Major Third-Party Health Insurance generally covers some or all of the cost for medical care; however, specifics depend upon the type of coverage that an individual has and the types of services sought. Generally speaking, senior housing, social adult day care, skilled nursing care, special care units, and terminal care or hospice are not covered.

Long Term Care Insurance covers the costs of some long term care providers. You should consult your policy to determine which services are covered. Generally speaking, senior housing and social adult day care are not covered.

Private Pay is accepted for most services and there may be a sliding fee scale for some programs. However, the ability to pay alone will not guarantee admission to some services, if other criteria, such as level of abilities, are not met.

7) How do I choose which long term care provider is best for me?

It might be helpful for you to develop a checklist that reflects your own needs and priorities. This checklist might include issues of security, the quality of professional and support staff, proximity to home, family or friends, overall environment or atmosphere (e.g. accessibility, cleanliness), and the quality and reliability of support services. Once you have developed your checklist, call the long term care providers in which you are interested and ask for tours and specific information about their services.You could also obtain the assistance of a case manager.

8) Once the individual is in the program, is there anything else I should do?

Individuals receiving services from long term care providers should expect treatment that assures their rights to privacy, dignity and respect. At the same time, the staff who provide these services have the right to be treated with courtesy and in a professional manner. You may ask the individual long term care provider for a defined list of rights and responsibilities.

Families and friends are an integral part of any care plan. The continued involvement of family and friends helps to develop a partnership in caring with the professional staff. Only family and friends can provide such personalized care for a loved one that reflects the individual's personality. Family and friends are welcome to discuss with the professional staff any changes or observations concerning their loved one which may help in the delivery of services.

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