Old People's Clubs and $$

Question 1

What levels are care are offered at senior living facilities

Answer 1

Independent Living
Assisted Living
Skilled Nursing Care
Memory Care Facility

Question 2

What is required for Medicare A to cover rehab?

Answer 2

3 night inpt hospital stay required w/in 30 days admission into Skilled Nursing Facility for short term rehab

Question 3

how many days will medicare A cover rehab 100%

Answer 3

1-20 days

Question 4

How much will you pay with medicare A if you stay in a rehab facility for 21-100 days?

Answer 4

$157.50/day

**this may be covered by other insurance the pt has

Question 5

With Medicare A coverage Resident must participate w/ daily ___ in order for Medicare A to cover stay. Weekly goals are set each week→ once resident has met all goals possible, Medicare will give a ___ day discharge notice

Answer 5

PT/OT

5

Question 6

Medicare Part B covers ____ rehab services including home health PT/OT services

Answer 6

outpatient

Question 7

With Medicare B a Yearly cap of $_____ (including deductible and coinsurance amounts) are offered for outpatient rehabilitation services

Answer 7

$1900

Question 8

What will medicare not pay for once >$1900 has been reached?

Answer 8

PT
speech-language pathology
occupational therapy

Question 9

What coverage can a pt use if they have not has a 3 night inpt stay if they require PT/OT/Speech

What will the pt be responsible for paying?

Answer 9

Medicare B ($1900 cap applies)

room and board (~$270/night)

Question 10

____ Do not require 3 night inpatient hospital stay to cover skilled nursing facility (SNF)

Answer 10

Medicare replacement plans

Question 11

What do Medicare replacement plans require ___ and ___ submitted for approval prior to skilled nursing facility admission.

what are examples?

Answer 11

prior authorization and clinicals

PT/OT eval
H&P
Meds
FL2

Question 12

Authorization for Medicare replacement plans is granted for ___ days at a time→ Clinicals must be submitted every ___ days by facility in order to replacement plans to pay for SNF
**same answer for both!

Answer 12

7

Question 13

What procedures are included in the Medicare Bundle?

Answer 13

joint replacements

Trauma

Question 14

how many days are included in the medicare bundle plan?

Answer 14

7 days to send them home

Question 15

Is a 3-day inpt stay required to qualify for the Medicare bundle?

Answer 15

no

Question 16

what is needed when applying for Medicaid

Answer 16

ID
POA
Money (bring it all..bonds, safe deposits, trust funds, 401 K, cars, property--> 5 year Financial Hx) 
Insurance policies 
Prepaid burial contract 
VA claim #

Question 17

With medicaid…
- Get to keep $___/mo for personal use
- May have up to $____ total for personal use (more could affect Medicaid eligibility)
- ___ coverage need to be changed w/ Medicaid
Residents w/ Medicaid qualify for ___ plans w/ no monthly fee (can call or go online to sign up)

Answer 17

$30
$2,000
Rx
Part D

Question 18

How does NC define assisted living?

Answer 18

1. group housing for 2+ unrelated adults
2. 1 meal/day + housekeeping
3. personal care services

Question 19

What are 3 examples of Types of Assisted Living

Answer 19

• Adult Care homes
• Group homes for developmentally disabled adults
• Multiunit Assisted Housing w/ Services