ElderLaw News

ElderLaw News is a weekly e-newsletter that brings you reports of legal developments and other trends of vital interest to seniors and their advocates. This newsletter is brought to you by The Estate Planning & Elder Law Firm, P.C., William S. Fralin, Esq., President.

Screenings for Nursing Facility Entry

Entering a nursing facility from a hospital or from the community can be a confusing and stressful time for any individual and the individual’s family.

When you are assisting an individual to move into a facility, you may be overwhelmed with information.

If an individual is expected to enter a nursing facility from a hospital for a rehabilitation stay and you are unsure if the individual will be able to return home, then it is important that you have a conversation with the case manager or discharge planner at the hospital. If the individual does not have the funds to pay privately for the individual’s care for a period of six months, then the case manager or discharge planner should complete a screening for long-term care placement. The screening tool is called a Universal Assessment Instrument (UAI). It is important that this screening occur while the individual is in the hospital, and that the UAI is given to the facility in which the individual will be placed. The case manager or discharge planner is the person who has the ability to complete this screening while the individual is in the hospital. You should discuss the available placement options within the long-term care system in your area. You should also visit some of these facilities.

If an individual is entering a nursing facility from home or another community setting and the individual does not have the funds to pay privately for his or her care for a period of six months, then you should contact your local Department of Social Services to request a screening. In this situation, a social worker and a public health nurse will come to the individual’s home to conduct the screening. It is important to plan ahead as much as possible, because most localities operate on a “first come, first served” basis and will conduct the screenings in the order in which they receive the requests. Some localities may take a minimum of four weeks before the screening can be done.

As stated in the Pre-Admission Screening Provider Manual, Chapter IV, the pre-admission screening is used to determine whether an “individual needs nursing facility services and, when appropriate, authorizes the nursing facility or community based long-term care.” This screening is the first level of authorization for Medicaid reimbursement for nursing facility level of care. Therefore, the screening is a critical part of the planning process.

If your family member has the funds to pay privately for care for six months or longer and commits to pay privately for care for this period of time, then a pre-admission screening is not required. If a screening is conducted and your family member is not immediately placed, then the UAI is valid within the following time frames:

-- Zero to Six Months: Screenings are valid and do not require updates.

-- Six to Twelve Months: Screening updates are required.

-- Over Twelve Months: A new screening is required.

The attorneys and elder care coordinators at The Estate Planning & Elder Law Firm, P.C. can assist you with these processes.

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The Estate Planning & Elder Law Firm, P.C.

The Estate Planning & Elder Law Firm, P.C. is an elder law firm. We represent older persons, disabled persons, their families, and their advocates. The practice of elder law includes estate planning, estate and trust administration, powers of attorney, advance medical directives, titling of assets and designations of beneficiaries, guardianships, conservatorships, and public entitlements such as Medicaid, Medicare, Social Security, and SSI, disability planning, income tax planning and preparation, care management, and fiduciary services. For more information about The Estate Planning & Elder Law Firm, P.C., please visit our website at http://www.chroniccareadvocacy.com.

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This newsletter is not intended as a substitute for legal counsel. While every precaution has been taken to make this newsletter accurate, we assume no responsibility for errors, omissions, or damages resulting from the use of the information in this newsletter. The Estate Planning & Elder Law Firm, P.C. thanks the law firm of Hook Law Center for their input to this newsletter.

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