White Paper
Take the Intimidation out of Long Term Care Policies
October 2015
Table of Contents
Abstract 1
1. Why is Long Term Care Intimidating 1
2. Long Term Care Defined 1
2.1 Activities of Daily Living 1
2.2 Types of Long Term Care Services 2
3. Parts of a Long Term Care Policy 2
3.1 Application 2
3.2 Amendments 3
3.3 Face Page 3
3.4 Schedule Page 3
3.5 Definitions 3
3.6 Benefits 4
3.7 Limitations and Exclusions 4
3.8 Premiums 4
3.9 Claims 4
3.10 General Provisions 5
3.11 Policy Riders 5
4. In Summary 5
5. How will your use case bring value to IGATE business/vertical 5
6. References 5
7. About the Author 5
Abstract
Many people find reading insurance policies to be intimidating. The language set in insurance contracts
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Today’s healthcare system has evolved so that the insured has many options to select from when they determine that Long Term Care may be necessary. Long Term Care services range from care in facilities to informal care in a home. There are facilities that provide comprehensive services. The insured can start off receiving home health care. Then if home conditions change they can move into the facility’s assisted living area. Then if the insured’s condition declines further they can move over to the skilled nursing wing of the facility. Patients that only require supervision or light duty nursing services at home may opt for a private care giver versus having a licensed home health aide. To support the growing population of children caring for both their parents and their own children additional care services have been created. Examples are adult day care and respite care. Adult Day Care attends to the needs of the patient while the primary caregiver is at work. Respite care is designed to give the caregiver a break by attending to the patient while the caregiver is temporarily away. A final Long Term Care Service addressed by most insurance policies is Hospice Care. Hospice Services may be provided either in a home or in a Facility. Hospice care is considered end of life care for a patient that has been deemed terminally ill. It is designed to provide a person with pain and symptom management while attending to their emotional and spiritual
Recommendation-hospice to evaluate. Palliative care will continue to
Home Instead Senior Care – Culpeper, VA is a team of hardworking and dedicated caregivers in Culpeper Virginia who supports and serves seniors with outmost respect and compassion. Founded in 1994, this company has been in the home care industry for more than 20 years and has grown to 62,000 caregivers. These skilled and well-trained healthcare professionals provide the best home care solutions to seniors not only in the United States but in other parts of the world. Home Instead Senior Care offers personalized home care solutions as each client has different requirements and preferences. These services include respite care, hospice care support, household duties, personal care, and companionship services.
inally, Title VII provides support for programs to ensure protection of the rights of older adults, including the Long-Term Care Ombudsman Program and elder abuse prevention services. The Long-Term Care Ombudsman Program is required to investigate and resolve complaints made by or on behalf of nursing facility residents or other institutionalized populations. Title VII funds are allocated based on the state’s proportion of residents age 60 and
California Supreme Court Clarifies Long Term Care Act’s Application to Release of Confidential Information The California Supreme Court has clarified the application of the Long-Term Care Act’s disclosure requirements in consideration of Welfare and Institutions Code section 5328’s general prohibition against the release of information contained in the course of providing treatment to mentally ill and developmentally disabled individuals. In State Dept. of Public Health v. Superior Court (2015) 60 Cal.4th 940, the Supreme Court considered the issue of whether the disclosure requirements of the Long-Term Care Act (LTCA) or Welfare and Institutions Code section 5328 applied where a public records request was made for health records. The case involved the Center for Investigative Reporting, a news organization investigating the treatment of mentally ill and developmentally disabled in state owned health care facilities, which issued a public records request to the Department of Public Health (DPH) for copies of all citations issued to the facilities it was investigating.
The proposed program will address the needs of minorities 65 and older at the time the program is implemented. Those taking part in the program would not loose any of the health benefits they are receiving from Medicaid under the current SSI health benefits insurance program. As well the person or persons must prove that they cannot afford to reside in a traditional long term care facility, such as a nursing home or assisted living, without incurring out of pocket cost. To be eligible, the individuals must be African American, U.S. citizen, reside in the state of Mississippi, and have a median $650 SSI income. As well they are not required to liquidate there asset’s and must reapply every year to reevaluate their eligibility.
Management of Care Case Study Josepha is working on a medical surgical unit with three other RNs and one LPN. There is also a male and a female patient care tech. Josepha has been a nurse for four months, and after completing two months of orientation she takes a full assignment as a registered nurse. Josepha feels that the assignments she receives are not always fair, as she tends to get the most challenging clients.
One particularly horrifying event that occurred was in August 1970 when residents in a nursing home in Baltimore died from salmonella food poisoning. The unconcern for the seriousness of this incident shown by writers of the Washington Post demonstrated a need for federal regulations for the standard of care given by nursing homes. Thus, in 1971 President Nixon and the Department of Health, Education, and Welfare (HEW) established the Office of Nursing Home Affairs (ONHA) to oversee any programs involving nursing homes. The Long-Term Care Ombudsman Program was one initiated by ONHA to “improve the quality of care in America’s nursing homes and to respond to complaints submitted… about abuse and neglect of nursing home residents” (Hunt & Nadell, 2007,
Individual sessions were tailored to the caregiver and their needs, which included things like learning techniques for behaviors, and promoting better communication. The family sessions were with family members the caregiver suggested, the Alzheimer’s patient was not included in the sessions. The support groups were for ongoing emotional support and education within a peer group. The telephone counseling was available for support or crisis when the caregiver needed it and as much as they needed over the course of the
Hi Al, long-term care insurance is design to pay for nursing homes and home health care. The insurance provides adequate cost-benefit from the increasing cost that associated with health issues such as chronic and Alzheimer’s disease, strokes and those can no longer live on their own. Overall, purchasing long-term care is meant to protect you against the financial consequences of the high cost of increasing life expectancies and the resultant rise in the chance that you may eventually need some level of care. Moreover, it is important to obtain this type of policy while you are healthy enables you to receive health discounts in addition to marital discounts if you are married. With that being said, if you are in good health you can save up
Long-term care facilities have become home to some individuals due to loss of capacity for independent living which normally caused by some illness that result in them not being able to care for themselves or to perform any daily living activities, such as cooking, eating, bathing, and toileting. Now as an administrator of a long-term care facility, I am responsible to make sure that everything runs smooth; in another word I play most important role in the facility. I am in charge of everything that goes on including patient admissions, facility policies, laws, finances, facility maintenance, residential care and staffing. A number of ethical issues can and will arise in a long-term care facility, such as providing patient care, dealing with
Educating the staff on alternatives is essential to reduce the use of restraints such as providing a quiet environment and fall precaution measures. Additionally, care must be individualized and we encourage visits from family and friends. The caregivers must give priority to respect for the dignity of the residents. I agree the family and care giving team must work together in the decision-making process. Have a good
Hospice care covers a wide range of services that is focused on the person dying and their family, contrary to that of hospital care which is primarily concerned with treating the disease. Patients are able to receive hospice care in
Consequently, the discussion about nursing home abuse and neglect should never be a topic of discussion to discuss. Mainly, because unfortunate occurrences of neglect and abuse in nursing homes across America should have never happened and/or occurred in the first place. Unfortunately, it does happen. When reading Pozgar’s and Santucci’s Chapter Six: Criminal Law- Healthcare, it is sickening to not only read, but also grasp in clear-cut detail of the repeated instances of nursing home abuse and neglect.
On March 15, 2016 at 4:34 am, I was notified by Elisha Smalls that she had discovered red spots on her arms and mid back and had an itch. The employee was instructed to leave the facility and see her physician as soon as possible and to follow-up regarding the visit. At 11:14am, the employee called back and stated she had chicken pox and was in contact a resident in ALF that had shingles. It was discovered that the employee di d work with the resident on 02/24/2016 and 02/25/2016.It was discovered on February 24, 2016; a resident in Assisted Living did exhibited signs and symptoms of possible shingles. The resident was seen by the Nurse Practitioner, Jody Eblen for a rash with pain, the resident was started treatment with antibiotics on
Every decade our population gets older and a whole new generation of seniors comes along with a new set of attitudes and expectations as to what they want from an assisted living facility. And now that people are living longer, there is a much greater need for these facilities. They can provide a refuge to many family members that may become severely burdened by the arduous task of taking care of a loved one who can no longer take care of themselves. When simple tasks such as bathing and feeding become near impossible to manage alone, not to mention driving to the store and shopping, decisions about placement into a home become paramount. Most important to the family members is the ability of the facility to provide the adequate care that is needed for their loved ones.