Client Champion Script

Question 1

What are the four things you’re qualifying for with a new referral?

Answer 1

1. Has a Need for ALF
2. Understands what ALF is and what’s available at what cost and what that looks like
3. Has money and access to money
4. Not working with any other agency, or have agreed to stop working with another agency.

Question 2

What are the four questions to ask when qualifying for “has a need for ALF”?

Answer 2

1. Can you tell me a little more about what’s going on with the patient/familymember? [Let caller talk]
2. Why can’t you return home? [based on the answer to this question, ask the next]
3. Are you familar with and have you considered in-home caregiving? [explain, as needed - see flashcard “Describe in-home caregiving services”]
4. Are you familar with assisted living? [Describe - see flashcard “Describe ALF”]

Question 3

Describe in-home caregiving services

Answer 3

In-home caregiving is where a certified caregiver comes to your home to provide assistance with all of your living needs (feel free to explain the details of that). This is a private pay service; insurance does not cover this cost. The cost of in-home caregiving is $30/hour. So the cost of care for in-home caregiving for 8 hours/day will be over $7000/month.

Is this a solution that would work for you?

Question 4

Describe ALF

Answer 4

Assisted living is a home-like environment where you’ll get support for activities of daily living - things like help getting dressed, bathing, using the bathroom, getting meds on time and accurately. All the meals are made and provided, as well.

There are two flavors of assisted living. In both settings you will get support with activities of daily living. one is the smaller residential setting - it’s like someone takes their house and convert it to a licensed facility. The second is is hotel-like environment - envision a Hyatt hotel with a lobby, onsite restaurants, and hotel rooms.

Assisted living is private pay - it’s not covered by insurance. Smaller communities typically start around $2k/mth for a shared bed and more hotel like communities start around $6k/mth for a private room.

Can you envision assisted living being a solution that can work for you?

Question 5

What are the seven questions to qualify for finances?

Answer 5

1. Tell me about your financial picture?
2. What is your monthly income?
3. Are there any expenses that you must continue to pay?
4. What do you have in way of savings?
5. Do you own your home?
6. Any other assets?
7. Any VA benefits?

Question 6

How do you figure out decision-makers?

Answer 6

Other than you, are there other folks involved in getting to a decision on this?

Question 7

What are the two questions to qualify for prior placement agency or ALF involvement?

Answer 7

1. Are you working with any other placement agencies?
2. Have you looked at any assisted living options so far?

Question 8

Explain how we get paid and why this matters?

Answer 8

There are no cost to you for our services. We get paid when a client transitions to assisted living, and we get paid by the assisted living community.

It’s important to work directly with us and not with any other placement agency, because some communities will not pay our fee if you’ve reached out to them directly, or if there is another placement agency involved.

Are you comfortable working only with us? And if you see or hear about a community that interests you, you can certainly stop in and see it, but be sure to explain to the folks there that you’re working with SilverStay.

Lastly, if you Google around, be cautious about providing your email and name. This can lead to issues with other placement agencies.

Can you make sure that the other folks involved in this decision are up to speed on this?

Question 9

How do you end the call?

Answer 9

Was there anything that I missed? How does what you heard compare to what you thought you’d hear?

Question 10

If a client does not have sufficient funds for ALF, what’s a question to ask?

Answer 10

Do you have any family or friends who can supplement your income?

Question 11

What are the eligibility distinctions between Medicare and Medicaid?

Answer 11

1. 65 yo and not poor: Medicare
2. 65 yo+ and poor: Medicare and Medicaid
3. Poor: Medicaid
4. Not poor and not 65 yo+: Commercial insurance

Question 12

Medicaid finanical eligibility

Answer 12

Less than $1.4k/mth in income and less than $20k in assets

Question 13

What does Medicaid cover?

Answer 13

All typical health insurance situations (PCP, ED, meds, etc) AND long term care (i.e. nursing home)

Question 14

Will Medicare cover long term care (nursing home)?

Answer 14

No. Long Term Care Medicaid pays for long term care (nursing home), and one must meet the financial requirements to by eligible for Medicaid.

Question 15

What does it cost to private pay in a nursing home (long term care)?

Answer 15

At a minimum, $8k/mth

Question 16

We need a list of assisted livings. Can you give me that?

Answer 16

I can definitely point you to a list of assisted living communities.

Can you tell me a little bit about what’s going on?

We can definitely help you in this transiton. We are a placement agency that has lots of data on assisted living outcomes/quality with a team of licensed social workers who can support X in identifying and transitioning to assisted living.

Does it makes sense for us to support X in finding and transitioning to an assisted living community?

Question 17

What does the community fee towards and is it refundable?

Answer 17

The community fee goes towards setting up the room, training caregivers on Xs specific needs, and other expenses associated with a new move in. The fee is generally not refundable.

Question 18

A question that must be asked during the call, preferrably early in the call.

Answer 18

Two alternatives:
What will make our time working together valuable for you?
If this working relationship goes great, what does that look like?

Question 19

Describe the three components of ALF cost

Answer 19

1. ADL needs - see rubric
2. Geography - Add $1k for most counties outside of Baltimore City
3. Room type: Shared vs private room - Add $1k for private room

Question 20

PT has $1.4k/mth and $16k savings; facesheet says Medicare A & B

Answer 20

1. Can someone supplement?
2. Depending on the care needs, it’s possible that some of the savings can go to the monthly rent. For example, PT could be screened for waiver, and perhaps in two years go on waiver.
3. Must be Baltimore City
4. Right thing to do also, is to have PT screened for MA Waiver once in community.
5. How does one accumulate $16k in savings with only $1.4k of savings?
6. Who has access to these funds and can they access them now?

Question 21

How to sell against in-home caregiving

Answer 21

1. Cost: $35 to $40 per hour with typical 4 hour min
2. Reliability: no show and then you’re stuck. Showing up late; leaving early. Have to have video monitoring or some type of verfication system.
3. Scheduling: Have to be on top of organizing schedule.
4. Quality: Not uncommon for CG to spend time on phone, and not working. Are they well versed in what your loved one needs. They will need to be trained.
5. Oversite: CGs are not always the most proactive.

Script to transition to conversation on assisted living: Based on the current situation and what you want for your mom [add some details here based on what you learned], Assisted living is great option to consider and it comes without some of the challenges of an in-home CG. I’d love to share details on assisted living. Does this make sense?

Question 22

How do you figure out our value to a client

Answer 22

1. What are your top priorities right now?
2. What have you tried in the past to solve this issue, and how did it work out?
3. What’s important to you in finding an assisted living?
4. What’s important to you in the transiton to assisted living?
5. How does speed of identifying assisted living options factor in?
6. Do you have any family or friends who are at an assisted living commuinty? How would a referral from one of them affect the process?
7. What would happen if you didn’t address this issue now?

Question 23

If speed to identifying assisted living options is the primary focus, what do you do?

Answer 23

1. How does quality factor into your thinking?
2. Have you thought about the transition and the support you may need there?
3. Other agencies like APFM can get you options in minutes. They aren’t curated for quality and there’s little support during the transiton, but if you are most concerned with speed, then would working with APFM make more sense?

Question 24

How do start a call when returning a voice message?

Answer 24

I would start the call with “Hi Richard, this is Nicole at SilverStay, in Annapolis MD (you might tailor this location based on where they called from) returning your call from last night. You voicemail indicated you’re looking for assisted living for your wife. Is now a good time to talk?” It’s a more direct and to the point. Go right at it. They called us.

Question 25

What is memory care?

Answer 25

In a large community: specialized part of the community for residents with cognitive decline. Locked down, with caregivers trained in delivering hands on care for individuals with complex cognitive needs. Specialized activies. Tends to be separate from the rest of the ALF. Has it’s own dinning and activities area.

Usually $8k+ per month.

In residential: memory care is embedded in the community. Mixture of ALF and memory residents living side by side.