4 Medicare Myths Around Long-Term Care

Maybe you’re looking forward to freeing yourself from private health insurance premiums when eligibility for Medicare, the federal health insurance program, kicks in at age 65. Or, perhaps you already have Medicare and assume that all your healthcare costs are covered, even in-home care and long-term care costs.4 Medicare Myths Around Long-Term Care

Unfortunately, both of these misconceptions could cost you big money in expenses, medical bills and prescriptions because you lack adequate coverage, even if you’re enrolled in Medicare.

4 Medicare Myths Debunked

“The biggest myth out there is that all people need is Medicare,” says Adam Hyers, a Medicare insurance broker in Columbus, Ohio. “Many people think that the government will take care of them, not only in the short run but in the long run too. Then they miss other items they might need, like a Medicare supplement or prescription drug plan, which help provide a good foundation but aren’t designed to pay for long-term care expenses.”

Are you up to speed on what Medicare covers, additional insurance you might need and under which circumstances Medicare pays — or won’t pay — for in-home care? If not, don’t wait to learn about Medicare coverage during a medical crisis.

The average U.S. national median cost for long-term care is around $50,000 annually for a home health aide, $48,000 for an assisted living community and $89,000 for a skilled nursing semi-private room, according to the Genworth 2018 Cost of Care Survey.

Many people purchase long-term care insurance to cover long-term care expenses. Others think they can rely on Medicare for long-term health needs. However, that incorrect assumption can be a costly mistake.

Here are four common Medicare myths debunked to help you make healthcare and insurance choices:

1. Medicare covers all health expenses.

You probably need more than Medicare Part A, which is free for most people at age 65 if they or a spouse paid into Medicare long enough while working. Did you know, however, that there are four parts to this federal health insurance, and they’re not all premium-free?

  • Part A, which is free for most people, offers basic hospital coverage with a deductible of 1,364 (2019 cost) per benefit period for inpatient care in hospice, a hospital or skilled nursing residence. Part A also pays for home health services but only under specific conditions.
  • Part B has a standard premium of $135 (2019 cost) a month and offers medical insurance for medically necessary services such as ambulance services, doctors, some medical equipment and outpatient procedures. Part B also covers preventative services like annual checkups, certain screenings and lab tests. The deductible for Part B is $185 (2019 cost) per year. After you meet your deductible, Medicare pays 80% of the Medicare-approved amount, and you must pay 20%.
  • Part C (Advantage) combines Parts A, B and sometimes D into one plan offered by private insurance companies that charge their own premium rates.
  • Part D is optional and offers coverage for prescription costs not covered by Parts A and B.

Many people think that Medicare Part A covers nearly everything regarding a hospitalization. That’s not true, says Steven Tibbits, a Medicare insurance agent with Medicare Health Plans in Salt Lake City, Utah.

“Part A comes with a deductible of more than $1,000 and mostly just covers your room,” says Tibbits. “Doctors, surgeons, testing and many other fees are covered under Part B and accompanied by coinsurance.”

2. Medicare covers most in-home long-term services.

Don’t count on Medicare when it comes to long-term in-home care, says Hyers. Medicare doesn’t cover non-medical, personal services and covers only in-home care ordered by a doctor such as skilled care from a nurse, occupational therapist, physical therapist, speech therapist or social worker. However, Medicare covers skilled in-home care ordered by a doctor for up to only 21 days.

Medicare typically pays 100% of the approved amount for covered in-home skilled nursing and therapy services and 80% of the approved amount for covered medical equipment.

3. Medicare will pay all my residential skilled nursing costs.

Not so. Medicare pays the first 20 days at a skilled nursing residence with zero copays in 2019. For days 21-100, Medicare pays a portion, and the beneficiary is responsible for the leftover amount of $170.50 per day. However, you can purchase a Medigap insurance policy through a private insurance broker to cover that difference. Don’t wait until you need a Medigap policy, though.

“We get people who call wanting to sign up for Medigap because they’re going to be responsible for that amount,” says Garrett Ball, a Medicare insurance broker and owner of 65Medicare.org, a private Medicare resource. “Unfortunately, that’s often not possible. There’s a Medigap enrollment period to sign up for a plan but if you don’t, it’s difficult to get later.”

4. I don’t need long-term care insurance because I have (or will have) Medicare.

Many people believe that long-term care is always covered by Medicare with just a daily copay. However, “Long-term care is not a covered benefit by Medicare,” says Tibbits. “Long-term insurance plans can be incredibly expensive but can also be very useful.” Read more about long-term care insurance here.

Find out more information about Medicare at Medicare.gov and A Place for Mom’s “Public Pay Resource Guide: Medicaid and Medicare Government Funding for Senior Housing and Care.”

Reprinted from A Place for Mom.


Older Americans Lose Billions to Scams

Despite progress, law enforcement still struggles in its fight against elder fraud

Senior Woman Giving Credit Card Details On The Phone

Older adults lose an estimated $2.9 billion each year to financial scams, according to a Senate committee report released this week.

Law enforcement struggles to fight these scams because it’s “like playing a game of whack-a-mole,” said Sen. Susan Collins (R-Maine), who chairs the Special Committee on Aging, before a Wednesday hearing on fighting elder fraud. “Many scams are perpetrated by criminals operating from foreign call centers, beyond the reach of state and local law enforcement and thousands of miles from the seniors whom they victimize,” she said.

As part of the hearing, the committee released its 2019 report on the top 10 scams targeting seniors in 2018. The most prevalent scam, out of more than 1,500 complaints to the panel’s hotline, involved Internal Revenue Service (IRS) impersonators who conned people into coughing up tens of millions of dollars. In descending order of frequency, the report lists: unsolicited calls, including robocalls; sweepstakes and Jamaican lottery scams; computer tech-support scams; elder financial abuse; grandparent scams; romance scams; Social Security impersonation scams; impending lawsuit scams; and identity theft.

Call AARP’s free Fraud Watch helpline at 877-908-3360 to speak with volunteers trained in spotting scams. 

Although criminals continue to invent new ways to separate older people from their money, law enforcement has had some success in its anti-fraud efforts. According to Collins, the largest sweep of elder fraud cases in U.S. history last February led to criminal charges against more than 200 defendants whose victims had lost more than a half billion dollars. And in 2016, five call centers in India were taken down; as a result, 24 coconspirators in the United States were sentenced to prison and ordered to repay millions of dollars in restitution.

According to the committee, scams persist because fraudsters gain the trust and cooperation of victims by harassing or seducing them. The Senate committee urges people to hang up if they receive a suspicious call and then call its toll-free Fraud Hotline, 855-303-9470.

To identify and avoid scams, the committee suggests remembering these tips:

  • Con artists force you to make decisions fast and may threaten you.
  • Scammers disguise their real phone numbers, using fake caller IDs.
  • Fraudsters sometimes pretend to be a government agency, such as the IRS.
  • Con artists try to get you to give them personal information, like your Social Security number or account numbers.
  • Before giving out your credit card number or money, ask a friend or family member for advice about the situation.
  • Beware of offers of free travel.

Reprinted from AARP.ORG

What the Shutdown Means for Filing Taxes

IRS says it will recall staff to process returns on time

IRS 1040 tax form with the words The IRS said Monday it will begin processing tax returns on Jan. 28 and pay refunds as scheduled, despite a partial government shutdown now in its third week.

Financial experts have said that taxpayers should prepare to file returns even during the shutdown, knowing that refunds could be affected. But the IRS said Monday it will recall a significant portion of its workforce, currently furloughed as part of the government shutdown, and will process refunds as it normally does.

During previous federal government shutdowns, refunds were not processed.

“We are committed to ensuring that taxpayers receive their refunds notwithstanding the government shutdown,” said IRS Commissioner Chuck Rettig. “I appreciate the hard work of the employees and their commitment to the taxpayers during this period.”

Taxpayers who usually file early in the year should file as soon as they have all of the necessary documentation for a complete and accurate return, the IRS said.

For most taxpayers, Monday, April 15, 2019, is the filing deadline to submit 2018 tax returns. Because of the Patriots’ Day holiday on April 15 in Maine and Massachusetts taxpayers who live in those states have until April 17, 2019, to file their returns, the IRS said.

Software companies and tax professionals will accept and prepare tax returns before Jan. 28, then will submit the returns when the IRS systems open later this month. To minimize errors and for faster refunds, the IRS “strongly encourages people to file their tax returns electronically,” the IRS said.

Tax preparers have been concerned about this tax season even without the government shutdown because it is the first tax season that changes resulting from the Tax Cuts and Jobs Act of 2017 will be in effect.

“IRS employees have been hard at work over the past year to implement the biggest tax law changes the nation has seen in more than 30 years,” Rettig said. Passage of the tax overhaul caused changes in 400 IRS forms, and the agency has revised its tax withholding tables and changed tax rates and brackets.

How to Better Advocate for Your Parent or Senior Loved One

As your parents age, you will likely experience a subtle yet significant change in the dynamics of your family and relationship. Stepping into the role of caregiver for your senior loved one may not be what you had envisioned when you were younger, however, for many adult children, this shift in the parent-child relationship is part of their reality.How to Better Advocate for Your Parent or Senior Loved One

The role of a caregiver can look very different depending on the needs of your loved one, but acting as an advocate is often a primary responsibility. Read more about how to become a better advocate for your parent during this time.

How to Advocate for Your Parent or Senior Loved One

The role of caregiver for a parent or senior loved one can vary greatly depending on their health and needs, from accompanying them to medical appointments to providing hands-on, personal care – all while striking a balance between supporting their best interests and empowering them to remain the primary decision-maker.

The American Association of Retired Persons (AARP) describes the role of an advocate as an individual who will “ensure the best life possible for our family and friends when they are vulnerable.”

This includes several importance factors, such as:

  • Ensuring they receive appropriate, high-quality and timely services and support
  • Helping manage personal affairs, such as financial, health and legal matters
  • Representing their best interest when they are unable to represent themselves
  • Understanding wishes for care and quality of life – and ensuring these wishes are followed

Family Communication Is Key

An area that families tend to struggle with is striking the balance between assisting a parent or senior loved one to make the best choices for themselves and taking over the decision-making process entirely.

It is important to remember that although the responsibilities of giving and receiving care may have reversed, the child does not become the parent and the parent does not become the child. Rather, the senior parent is an adult, capable of choice, who simply needs assistance and support.

Communicating with your senior loved one in a compassionate and respectful manner will set a positive tone and encourage them to be receptive of your help. Keep in mind that “listening is just as important as speaking” when communicating with a loved one and will allow you to better understand their desires, feelings and thoughts.

Ways to Advocate From a Distance

If you live at a distance from your senior loved one, you can still be an informed and supportive advocate.

There are ways that you can play an active role in their life, even if you live far away:

1. Check in regularly.

Set a specific time each day or week to check in with your parent or senior loved one to ensure that they are being well cared for and that nothing significant has changed with their health. Keeping conversations enjoyable and light will allow you to garner key information about how they are doing and feeling, without coming across as an interrogation.

2. Have a plan.

Try to have two plans in place: one for day-to-day matters, such as medication management and meal preparation and another in case of an emergency. An emergency action plan should outline important details about who will be the first to respond in the event of an emergency, as well as important medical wishes.

3. Know where to access important information.

PBS suggests keeping a “care notebook” that contains your parent or senior loved one’s important health information in a central location. Hard copies (or information on where to locate originals) of contact information, financial records and personal documents are important items to consider including in this notebook.

4. Learn what help is available.

PBS also suggests educating yourself on the care and services that are available to your loved one in their specific area. This can include home support, nutritious meal programs, transportation assistance or volunteer services – to name a few options.

5. Stay connected.

Communicating with the people who make up your parent or senior loved ones’ circle of care is the most important aspect of staying connected and being informed of their health status when you live at a distance. Connecting with local family members and friends, formal caregivers and neighbors regularly will allow you to hear multiple perspectives about your loved one’s overall well-being.

Advocating for your loved one does not need to be an additional burden or responsibility if you follow the above steps.

Reprinted from A Place for Mom


Social Security Scams

Social Security Scams

Social Security numbers are the skeleton key to identity theft. And what better way to get someone’s Social Security number than by pretending to be from Social Security?

The Social Security Administration (SSA) estimates that scammers call thousands of Americans every day, looking to wangle personal information, steal benefits or both. It’s a common form of government impostor scam, in which fraudsters pose as government officials to get you to send money or give up personal and financial data for use in identity theft.

The Federal Trade Commission (FTC) reported a surge in late 2018 in scams involving fake SSA employees calling people with warnings that their Social Security numbers had been linked to criminal activity and suspended. The caller asks you to confirm your number so he or she can reactivate it or issue you a new one, for a fee. This is no emergency but a ploy to get money and personal data: Social Security does not block or suspend numbers, ever.

This con is sometimes executed via robocall — the recording provides a number for you to call to remedy the problem. In another version, the caller says your bank account is at risk due to the illicit activity and offers to help you keep it safe.

On the other hand, you might get a call from a supposed SSA representative bearing good news — say, a cost-of-living increase in your benefits. To get the extra money, you just have to verify your name, date of birth and Social Security number. Armed with those identifiers, scammers can effectively hijack your account, asking SSA to change the address, phone number and direct deposit information on your record and thus diverting your benefits.

Consumer Reports warns of another trick with an ironic twist: Fraudsters send out emails that appear to be from SSA and instruct you to click a link to register for a free service that protects you from Social Security fraud. It’s actually a garden-variety phishing scam, designed to guide you to a fake government website that will steal your information.

With a little vigilance, Social Security scams are not difficult to identify and avoid.

Warning Signs

  • You get an unsolicited call from someone claiming to work for SSA. Except in rare circumstances, you will not get a call from Social Security unless you have already been in contact with the agency.
  • The caller asks for your Social Security number — again, something an actual SSA employee wouldn’t do.
  • A call or email threatens consequences, such as arrest, loss of benefits or suspension of your Social Security number, if you do not provide a payment or personal information.


  • Do hang up if someone calls you out of the blue and claims to be from SSA.
  • Do be skeptical if a caller claims to be an “officer with the Inspector General of Social Security.” Scammers appropriate official-sounding and often actual government titles to make a ruse seem authentic.
  • Do set up a My Social Security accountonline and check it on a monthly basis for signs of anything unusual, even if you have not yet started collecting benefits.
  • Do install a robocall-blocking app on your smartphone, or sign up for a robocall-blocking service from your mobile network provider.


  • Don’t call a phone number left on your voice mail by a robocaller. If you want to contact SSA, call the customer-service line at 800-772-1213.
  • Don’t assume a call is legitimate because it appears to come from 800-772-1213. Scammers use “spoofing” technology to trick caller ID.
  • Don’t give your Social Security number or other personal information to someone who contacts you by email. SSA never requests information that way.
  • Don’t click links in purported SSA emails without checking them. Mouse over the link to reveal the actual destination address. The main part of the address should end with “.gov/” — including the forward slash. If there’s anything between .gov and the slash, it’s fake.

Medicare Scams

Five tips to help you avoid being taken advantage of as you shop for medical coverage

Buttons on a keyboard that read scam alert

As Medicare’s 60 million beneficiaries pore over their choices for coverage for everything from medical services to prescription drugs, government officials warn that this is prime time for fraudsters to try to scam older consumers.

“Do your research and use trusted sources,” advises Jason Adler, assistant director of the Federal Trade Commission’s Midwest regional office. The FTC monitors the latest ploys that criminals use to get people’s Social Security or credit card numbers and other personal information that can help them cheat Americans. Adler says the best place to get information about your Medicare coverage or enrollment is either Medicare.gov or by calling the Medicare hotline at 800-MEDICARE (800-633-4227).

Navigate coverage options, prescription rules and more at our Medicare Resource Center.

Here are some common scams and Adler’s tips on how to thwart them.

Scam 1 

Someone calls claiming to be from Medicare and says your Medicare number and credit card information are needed to sign you up for health coverage.

Solution: Hang up the phone. “Anyone calling saying they’re an official Medicare agent selling you insurance is a scammer,” Adler says. Medicare does not call beneficiaries to sign them up.

Scam 2

Someone calls saying you have to sign up for a Part D Prescription Drug plan or you’ll lose your Medicare coverage.

Solution: That pitch is “just not true,” Adler assures. So hang up the phone. Buying a Part D plan is completely voluntary, he says, and has nothing to do with the rest of your Medicare coverage.

Scam 3

Someone calls claiming to be a Medicare representative and says your billing information must be confirmed to keep your coverage active.

Solution: Again, hang up. Medicare employees will not cold-call you and are not allowed to ask for payment information on the phone or online.

Scam 4

An alleged insurance agent or broker calls to offer you a great deal on a Medicare supplemental insurance (or Medigap plan) or a Medicare Advantage private insurance plan.

Solution: This one is a little trickier. Listen to the person’s pitch and ask for information in writing. If the agent is sending you an email, Adler says to make sure you have a virus scanner on your computer and don’t click on a link that sends you to an unfamiliar website. You can also call your state insurance department to make sure that the company the caller says he represents is legitimate.

Chances are, if the caller is a scammer, once you start asking questions and refuse to turn over any personal or credit card information, the individual will hang up.

Scam 5

Someone calls asking for your new Medicare number to update your account and to send you the latest open enrollment information.

Solution: Stop. Do not give out your new Medicare number over the phone. Earlier this year, Medicare began mailing out updated cards that have an 11-character identifier that replaces Social Security numbers.

“We’ve seen scammers calling consumers saying that they need their information so they can get their new Medicare card or that they have to pay a fee to get their new card,” Adler says. “Those things are false.”

Medicare cards are free. New cards have been mailed to enrollees in 33 states and the District of Columbia and are in the mail to consumers in the other 17 states. If you haven’t received your card, you can go to the Centers for Medicare and Medicaid Services’ new Medicare card website to check on the status of the mailing to your state as well as to sign up for an email alert when your card is mailed.

Scams related to Veterans

Veterans Day was this past weekend, and we want veterans to know that scammers go to great lengths to target their money, their benefits, and their commitment to current and former soldiers.

How It Works:

Targeting veterans can take many forms:

  • The Update Your Military File Scam: A caller claims to be from the Department of Veterans Affairs and asks to “update” your information, but really is hoping to get personal information to steal your credit.
  • Veterans Choice Program (VCP) Scam: Scammers set up a phone number nearly identical to the number veterans dial to find out if they are eligible to use approved health care providers outside of the VA system. A recorded message or a person answering the phone tells the caller of a rebate he can get by supplying credit card information. Make sure to dial the correct number for the VCP: 1-866-606-8198.
  • Charity Scams: A caller claims to be raising money for disabled veterans or veterans with cancer. They play on sympathy to try to evoke an immediate response. But often, the so-called charity is not registered with the government and/or uses most of the money to raise more funds and pay their salaries.
  • The Cash for Benefits Scheme: Predatory lenders target veterans in need of money by offering cash in exchange for future disability or pension payments. These buyouts are typically a fraction of the value of the benefit.
  • Employment Scams: Con artists post bogus job offers to recruit veterans on various online job boards. The scammer may use or sell your personal information provided in the job application. It’s likely a scam if you have to pay to get the job, you need to supply credit card or banking information, or the ad is for “previously undisclosed” federal government jobs.

What You Should Know:

  • If you are a veteran, you are unfortunately a target, so be mindful of this reality in your day-to-day transactions.
  • The Veterans Administration will never call you, e-mail or text you to verify or update your information.
  • The old adage applies here – if it’s too good to be true, it usually is.

What You Should Do:

  • Check out charities at  www.charitynavigator.org before giving any money. Make donations directly to the veterans’ organizations you know.
  • Only work with VA-accredited representatives when dealing with VA benefits; you can search for them online at the VA Office of General Counsel website.
  • Visit aarp.org/veterans to download your copy of the AARP Watchdog Alert Handbook: 9 Ways Con Artists Target Veterans. 


Many people have registered with the FTC National Do Not Call Registry, however it will not stop all unwanted calls.  The “Do Not Call” registry prohibits sales calls so you may still receive political, charitable, debt collection and informational calls, as well as telephone survey calls.  In addition, companies may still call if you have recently done business with them or if you have given written permission to call you.  If you ask a company not to call you again, it must honor your request. ( record the date of your request).

There is also a website, www.nomorobo.com where you can register your landline phone for free that will stop most robocalls that you still might get after registering with the FTC.  If a robocaller dials your number, your phone will ring once and Nomorobo will intercept the call.

A mobile application for your cell phone is available for $1.99 a month, but there is no charge to register a regular landline phone.

P.S. I have used Nomorobo on my own landline and it works like a charm.  One ring and Nomorobo intercepts the call.


Hi-tech Scams

Beware of these dangerous hi-tech scams  

By now, most of us know about the most obvious scams — we avoid phishing emails, letters from Nigerian princes, phone calls from guys claiming to represent Microsoft’s tech support, and we sometimes even remember to check the ATM for the presence of a skimmer. But there’s a whole new generation of scams out there, with criminals hoping to catch you unaware with an innovative con. Here are some dangerous ruses to watch out for.

One-ring phone calls. If you’ve ever heard your phone ring once or twice and stop and then return the call to see who it was, then you’re the target audience for this particular con. Scammers use auto-dialers to randomly call vast banks of phones, but they only allow the target phones to ring once or twice before disconnecting. The expectation is that some people will return the call to see what they missed. And though the Caller ID might look like a typical U.S. number, The Federal Trade Commission says that in reality, they’re connecting to a premium service (like an adult entertainment number) that charges an exorbitant per-minute fee — as much as $9 per minute, plus a $20 international calling charge. The remedy? Don’t call back a number you don’t recognize. But be especially wary of area codes that include 268, 284, 473, 664, 649, 767, 809, 829, 849 and 876, since these are known offenders from the Caribbean.

Sticky ATMs. Skimmers are old news. There’s a new way criminals are trying to get at your credit card, and it’s at least as challenging to detect. Instead of inserting a device into the mechanism that swipes your card, criminals are starting to use adhesive to inhibit the operation of certain buttons on the keypad, meaning you can’t complete your transaction after inserting the card — and using foil in the mechanism to block the credit card from popping back out. Customers who run into these machines leave their card behind, and criminals waiting nearby then use a tool to complete the transaction and take your card as well. The good news, though, is that often there is a solution. According to police, the scam works because many people don’t realize they can perform many of the same actions on the touch screen as on the keypad. So if you’re stymied by the hardware try the screen instead.

Fake funerals. Fake funerals notices are the newest breed of email scam that include poisoned links. Once again, the FTC is on hand to provide a warning: In a nutshell, criminals send fake funeral notices, often mimicking real funeral homes. The email doesn’t indicate whom the service is for, so recipients have to open the included link for details. And of course, the link is malicious and pushes malware onto the PC.

Scam Refunds. If you’ve been bitten by ransomware or a similar crime, in which your PC is held hostage by malware unless you pay a ransom fee, you might now be targeted by a new scam — this time, promising to refund your money. As reported by Identify Theft 911, an ID theft management company, emails have been found in the wild that purport to be from Microsoft or other large tech companies and offer a refund for any losses you had from previous malware. The catch? You need to provide financial information so the refund can be direct deposited. Criminals assume that if you fell for malware once, you might be naive enough to pay a second time.

Reprinted from CBS Moneytalk. https://www.cbsnews.com/news/beware-of-these-dangerous-hi-tech-scams/#


Senior Living Contract

Senior living contracts (also called admission or residency agreements) come in many different forms depending on the community, type of care and your state. Though, no matter what type of senior living contract you’re entering into, it’s important to ensure you fully understand it before signing on the dotted line.Looking at the Details of a Senior Living Contract

Since most senior living contracts are full of industry and legal terms, it can be difficult to understand the complete terms of the agreement, which is why it’s beneficial to have an attorney review it on your behalf. See how you can take a more in-depth look at the details of a senior living contract and read other tips from A Place for Mom’s Legal Expert, Stuart Furman Esq.

How to Look at the Details of a Senior Living Contract

According to Furman, most families do not consult with an attorney before signing a senior living contract because they’re in a moment of crisis – there’s an available spot and the senior living community needs to know if they’ll take it right now. Other reasons include families becoming overwhelmed or not realizing that some aspects of the contract are negotiable.

Furman says that while some elements of a contract – like involuntary discharge – are not negotiable, others – like mandatory arbitration – might be.

“People don’t think they can change the terms,” he says, “but an attorney will help you understand what you’re signing, what the terminology really means and what is and isn’t negotiable.”

Key Things to Consider Before Signing a Senior Living Contract

When it comes to senior living contracts, here are some key things that you should understand before signing:

1. Cost of Living Increases

According to Furman, cost of living increases are often negotiable. The care provider should give adequate notice of a price increase, but it’s good to get that notice in writing.

If you don’t see anything in your contract about cost of living increases then ask the provider when the price will go up and how much notice they will give you. Then ask them to add these terms into the contract.

In addition to these areas, the American Bar Association has an excellent article called “Admissions Contracts for Senior Housing” about how to evaluate the different types of contracts out there. The publication also has a comprehensive list of questions you should ask about:

  • Accommodations and fees
  • Health care and services
  • State regulations and requirements
  • The care provider
  • The rights of residents

2. Involuntary Discharge

An involuntary discharge is when a resident is forced to leave their community against their wishes. Failure to pay rent is one reason for an involuntary discharge, but there are other health-related situations that are often out of the resident’s control. For example, a resident who has tuberculosis (TB) may be forced to leave their community due to the risk they pose to other residents.

No matter what type of senior living care you’re receiving, the community must meet state regulations which govern discharge situations. Furman, who specializes in elder law in the state of California, states that “Title 22” is a regulation that has defined prohibited conditions in which a resident can’t stay at a lower level of care than they need. In other words, if your care needs exceed the level of care that your community can offer, then you can’t stay. For example, if a resident has a gastric tube then they would need a skilled nurse (registered nurse) on staff to care for them. If their existing community doesn’t have skilled nurses then they may be forced to move. A review of what conditions would force an involuntary discharge and options if that occurs may be a valuable inquiry so that the family can be ready for any future healthcare event.

While certain terms of discharge are not negotiable, beware when this part of the contract is left too vague. Consumer Reports suggests that terms of discharge should be as specific as possible. Furman points out these terms are often left open because discharges happen on a case-by-case basis and a community is bound to follow state regulations. If you feel the contract you’re considering is too vague then ask for clarification or examples.

3. Mandatory Arbitration

A mandatory arbitration provision (sometimes called forced arbitration) is common in senior living contracts. This provision requires disagreements to be settled by a third party arbiter and not in court.

What is arbitration? According to Furman, arbitration was created as a process to help backlogged courts. Essentially, it’s a mini-trial that’s not public and is more relaxed when it comes to rules surrounding the evidence that’s allowed to be presented. Historically, arbitration typically helps the defendant because it limits post action rights and it’s done privately.

If you find a mandatory arbitration clause in your contract Furman recommends crossing it out. This is an area that is often negotiable. Consumer Reports also suggests striking this clause from the contract before signing it, saying that “there’s little risk that your loved one won’t be admitted if you try this. If the management insists that arbitration is mandatory, you can decide whether it’s worthwhile to agree.”

4. The Type of Contract

In continuing care retirement communities (CCRCs) or life plan communities, there are often three types of contracts:

  • Type A contracts are also known as extensive or life care contracts. In this type of contract, a resident pays a monthly, pre-determined service fee throughout their life, no matter the type of services they need or care they require.
  • Type B contracts are also known as modified or modified fee-for-service contracts. In this type of contract, residents pay an entry fee as well as some of the costs for assisted living and skilled nursing when this care is required.
  • Type C contracts are also known as fee-for-service contracts. In this type of contract, residents pay an entry fee as well as the full cost for assisted living and skilled nursing care when this care is required.

The best type of CCRC contract and fee structure will depend on your financial situation as well as your current and anticipated health care needs. McKnight’s Senior Living shares that Type A and C contracts have become more common in CCRCs over the past decade.

When it comes to a senior living contract, like all things, it’s critical that you understand what you’re signing. If you’re on a waiting list for an assisted living, memory care or independent senior living community, then ask for their standard contract so you have time to review it before space becomes available, because you’ll have very little time to do so once a spot is ready for you or your loved one.

Most senior living care providers will be happy to oblige because when you understand what you’re signing, you’ll have fewer disagreements and disputes in the future, which is a win-win for all involved.

One last thing: once you do sign the contract, ensure you get a copy and use it to hold your care provider accountable to the agreements they’ve made to you.

Reprinted from A Place for Mom.