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Frequently Asked Questions

  1. What is assisted living?
  2. How can I identify a good assisted living facility?
  3. How do I choose an assisted living community that is right for my loved one?
  4. How is assisted living paid for?
  5. What levels of care can an assisted living facility provide?

What is assisted living?
Assisted living is a residential care option for individuals who typically can no longer live independently. It provides or coordinates services to meet residents’ individualized needs in ways that promote their independence and reflect their personal choices.

Assisted living is a state regulated and monitored residential long term care option. Assisted living provides or coordinates oversight and services to meet the residents’ individualized scheduled needs, based on the residents’ assessment and service plans and their unscheduled needs as they arise.

A resident has the right to make choices and receive services in a manner that promotes dignity, autonomy, independence, and quality of life. These services are disclosed and agreed to in the contract between the provider and resident. Assisted living does not generally provide ongoing, 24-hour skilled nursing care.

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How can I identify a good assisted living facility?
Regardless of the size or look of the facility, the foundation of a quality assisted living residence lies in its philosophy, practices, administration, and staff. You want to be sure that the administration’s philosophy and practices are truly resident-centered. You also want to know that they have well-trained, qualified direct care staff and have sufficient numbers of them to meet residents’ promised and unscheduled or emergency needs. The “feel” of the environment should be warm and inviting; with administrators, staff, residents, and family members interacting in a caring, respectful manner.

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How do I choose an assisted living community that is right for my loved one?
The first step is to make an accurate and honest assessment of what your loved one’s physical, financial, mental and lifestyle needs are. If help is needed with this assessment, consider consulting a private geriatric care manager. These are trained professionals in the field of human services, experienced in assessment, and knowledgeable about assisted living choices in the area where they practice. Their knowledge can be an invaluable resource in helping make the right choice. Contact the National Association of Professional Geriatric Care Managers for referrals.

The next step is for you and your loved one to visit a number of these facilities. Consider the proximity to those who will be visiting the most. The closer the facility, the more likely that visits will be more frequent. Ask lots of questions. Talk with residents about the facility. What do they like or dislike? Talk with staff. Are they friendly and knowledgeable? Ask to eat a meal there. Is the food good? Are there meal choices? Does the environment feel like a “good fit” for meeting your loved one’s physical and social-emotional needs; does it feel like a community of friends that you’d like to visit often.

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How is assisted living paid for?
Most individuals pay privately for assisted living. For some seniors, there are ways to reduce out-of-pocket costs, as described below.

Long-Term Care Insurance
Many long-term care insurance policies cover assisted living. The amount of coverage and conditions vary. Check the policy carefully.

Medicaid Home and Community Based Services Waiver for Older Adults
This state program provides financial assistance to eligible older adults to remain in a community setting even though their disabilities would warrant placement in a long-term care facility. Most Medicaid-covered services for long-term care are provided in a nursing home setting. The Medicaid Waiver allows eligible persons to receive supportive services in their own homes or in assisted living facilities. Applicants must be at least 50 years of age and must meet financial and medical eligibility criteria.

Senior Assisted Living Group Home Subsidy
This state-funded program provides monthly assistance with some of the cost of assisted living for individuals who meet income eligibility and other requirements, when funds are available. In order to qualify, the individual must be 62 years of age or older and must meet income and asset requirements.

Medicare and Medical Assistance
Medicare does not pay for assisted living. Maryland Medical Assistance covers much of the cost, but only if the resident qualifies for the Medicaid Home and Community-Based Waiver for Older Adults.

Tax Deductions
If you pay out-of-pocket for assisted living, you may qualify for a tax deduction. Contact your local IRS office for more information.

Reverse Mortgages
A reverse mortgage allows a homeowner to convert some of the equity in his or her home to cash. This money may be used to pay for assisted living. Generally, to qualify for a reverse mortgage, one of the borrowers must be living in the home. Therefore, this may be an option for couples, if one spouse remains at home. The home is used as collateral and will be sold to pay the loan. Consult an attorney before pursing this option. For more information, visit the website of the National Center for Home Equity Conversions. In addition, you may contact your bank or credit union for other financial options that may be helpful with the cost of assisted living.

Veterans Pension; Aid and Attendance Benefit
This benefit is available to Veterans (or the surviving spouse) who meet eligibility requirements to include: having served 90 days in the service, served 1 day during war time, is over the age of 65, and is in need of Aid and Attendance.  For more information, contact Veterans Affairs or find out more at www.veteranaid.org

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What levels of care can an assisted living facility provide?
Assisted living facilities are licensed to provide care at one of three levels. The levels correspond to the amount of care the resident needs. Level 1 is for residents who need a low level of assistance. Level 2 represents moderate care needs, while Level 3 designates a high level of care. An example of a resident at Level 3 is a resident with dementia who needs help with all daily activities, and has a complex schedule of medications. Homes that are licensed for Level 2 or 3 may admit residents who need care at lower levels.

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