SAN LUIS OBISPO COUNTY Senior Information Guide

Health Services
advocacy for facility residents, information about Advance
Health Care Directives and witness the forms for care
facility residents.
As much as possible, it is important to involve the older
person in the decision-making process. If nursing home
care is the best solution, enlist the help of your physician
and any friends or relatives who have used nursing
home services in your area. Call the Long Term Care
Ombudsman or the Area Agency on Aging for lists of all
facilities in SLO County as well as a checklist to use in
making a selection.
Local business are available that provide free placement
assistance through tours of local facilities and provision of
a Guide for Senior Living.
Uncover Any Hidden Costs
Nursing homes bill residents for two types of charges:
daily rates for room, board and some nursing services;
and extra charges for any service not included in the
basic rate, such as therapies, wheelchairs, dental care,
hand-feeding or care for incontinent residents.
It is important to know that federal regulations require
any nursing home that participates in Medicare or Medi-
Cal to provide complete information about basic rates
and all extra charges.
Find out whether your private health insurance covers
any or all of the costs of nursing- home care; most do
not. If, however, you are counting strictly on Medicare or
Medi-Cal, be certain you know exactly what services will
and will not be covered before you sign a contract with
any nursing home.
HICAP (Health Insurance Counseling and Advocacy Program)
can assist you in understanding your insurance
policy. Contact them for free one on one counseling.
HICAP has counseling sites throughout San Luis Obispo
County.
What Happens If the Money Runs Out?
Nursing homes that are licensed for Medicare and Medi-
Cal cannot require residents to move out if savings are
exhausted and they qualify for Medi-Cal. It is wise to contact
your local social services offi ce as soon as possible to fi nd
out the requirements for Medi-Cal eligibility. To learn more
about eligibility for Medicare/Medi-Cal coverage of nursing
homes, see Financial section. LTC Ombudsman can help
with improper eviction.
Admission Agreement
Know the Contents of Your Contract
The admission agreement between a nursing home and its
residents constitutes a legal contract. Older persons and
their families should understand fully all of the agreement’s
provisions, including the right to negotiate new terms and
their right to sue if the agreed terms are violated. A lawyer’s
54 2007-2009 SAN LUIS OBISPO COUNTY SENIOR INFORMATION GUIDE
review of any nursing home agreement before it is signed
can point out possible future problems.
Nursing homes usually require that someone sign as
Responsible Party for the resident. This is generally the
person checking the resident into the nursing home. This
person can be the resident, a spouse or other member
of the family, a friend or an associate. The Responsible
Party is usually the fi rst person contacted if the resident
has a change in condition or an emergency. This is not
the same as Cosigning. Generally, the Responsible Party
is not required to pay any costs to the facility. Review the
admissions agreement to be certain that you are not also
signing as a Cosigner which is not a legal requirement in
California. Signing as a Cosigner may obligate you to pay
for any costs not covered by insurance or the resident’s
private funds.
In even the most reputable nursing homes, residents
have complaints about services or living conditions. The
resident and/or a family member should fi rst discuss the
complaint with the nursing home’s staff. Often the complaint
can be resolved quickly. If not, contact the local
LTC Ombudsman whose role is to resolve problems in the
nursing home.
Rehabilitative/Therapeutic Services
Rehabilitation centers provide professional restorative care
designed to help people who have been disabled due to
illness, accident, or injury. Rehabilitation services fall into
three categories: (1) inpatient hospital care, (2) inpatient
transitional care (not available in San Luis Obispo County),
(3) outpatient care (the patient visits the facility for treatment
but does not stay overnight), and (4) home health
services or home health care (treatment is given in the
patient’s home).
Medicare may pay for medical rehabilitation costs if the patient
has the potential for rehabilitation, the expectation for
improvement is reasonable and certain types of skilled care
are required. Medicare Part A covers inpatient services;
Part B covers 80% of outpatient costs and in home services.
A physician’s referral is required. Medicare covers the full
cost of in-home visits by rehabilitation therapists when the
patient is homebound, has rehabilitation potential and the
agency making service available is a Medicare Certifi ed
Home Health Agency.
EOC Health Screening
Provides screenings for blood pressure, anemia, hemoccult
stool test, blood sugar levels, total cholesterol (lipid panels
by appointment only) and nutritional counseling at locations
throughout the county. Also provides glaucoma and hearing
testing by eye and hearing specialists. Health education,
nutrition information and supportive counseling and referrals
are also available.