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Frequently Asked Questions

  

Assisted Living

  • Is there a publication that will answer most of my questions about Assisted Living?

    Yes, there is! The Ombudsman Program can send you a hard copy of this publication called, "Assisted Living in Maryland: What You Need to Know" with a list of all the Assisted Living Homes in the county when you call with your information. You may also view this material by visiting the Maryland Assisted Living Guide online.

  • What is Assisted Living?

    Assisted Living facilities provide services in a less-institutional or home-like setting to meet the needs of adults who require assistance with daily living activities. The following are examples of activities of daily living:

    • Bathing
    • Dressing
    • Grooming
    • Mobility
    • Taking Medications
    • Eating

    Some Assisted Living Facilities also assist residents with laundry, errands, appointment scheduling, and transportation. The services and the fees for all services should be clearly documented in the contract.

  • Who licenses the Assisted Living Facility?
    The Office of Health Care Quality (OHCQ) of the Department of Health and Mental Hygiene (DHMH) licenses all assisted living homes. Although, the regulatory oversight for homes with 4-16 beds has been largely delegated to the Anne Arundel County Department of Aging (DOA) Housing Program. All homes must follow the licensing procedure delineated in COMAR 10.07.14.06
  • How often are homes surveyed?

    Homes are evaluated yearly for license renewal and complaint investigations are conducted as needed. Additional monitoring and investigations are conducted to ensure regulatory compliance. Statements of survey and complaint deficiencies are available at each facility. OHCQ and DOA also have copies of the surveys. DOA and/or OHCQ are available to address complaints.

  • Who determines the level of care an Assisted Living program can provide?

    The assisted living provider requests to be licensed for a certain level of care. The levels are high (3), moderate (2), and low (1). There is an assessment tool completed by the provider and physician to determine each resident's level of care.

  • Are there nurses in Assisted Living?
    Every Assisted Living Facility is required to employ a "Delegating Nurse" who visits the home once every 45 days to review each patient's chart, medications, and overall condition. The delegating nurse is also "on-call" for any other needs. Some assisted living homes choose to employ a nurse(s) to work on-site daily and in some cases, around the clock seven days a week. All consumers should understand how much nursing oversight is available in each home, particularly for those consumers with high level of medical needs.
  • How do I pay for Assisted Living?
    Assisted Living services are largely paid by the resident or other private source. Financial help is accessible through the Medicaid Home and Community Based Waiver. Residents must be financially and medically eligible and the provider must accept Medicaid reimbursement. Currently, there is a significant waiting list for this program. To enter your name on the waiting list call 1-866-417-3480. If you are currently in a nursing home, you may apply immediately by contacting the Department of Aging and Disabilities. There is also a Subsidy Program available to residents who qualify and the subsidy is accepted in most homes serving 4-16 residents. There is a waiting list for this program and you can obtain more information by calling the Housing Program at the Department of Aging and Disabilities. If possible, it can save you much grief if you can estimate when you will run out of funds and ensure you enter your name on any waiting lists long in advance.
  • The Assisted Living Home wants me to sign a contract, do I need an attorney?
    We do recommend that you have an assisted living contract reviewed by an attorney, if possible. If you qualify, you may be able to get your contract reviewed at a sliding scale fee by Legal Aide Bureau. You may call the Legal Aide Bureau at 1-800-367-7563 The Ombudsman Program may be able to answer simple questions about your contract, especially if you feel the contract is asking you to waive some of your rights.
  • Do I have rights in Assisted Living?

    Yes you do! The Older Americans Act has given all long-term care residents a law to support their rights. Anytime, you feel your freedoms are being restricted, please call us and we will talk to you about your options for addressing the problem. All calls are confidential. You can see a list of some of your rights by visiting:

  • How will I get to my medical appointments or run my errands?

    Some Assisted Living Homes will provide transportation and some residents of assisted living will keep their car if they are still able to drive. In the case that the home you choose does not have transportation, you may call the Department of Aging Transportation at (410) 222-4464 for more information about the program. The Assisted Living should assist you in obtaining transportation if you need the assistance.

  • What if I have more questions?

    Anne Arundel County Department of Aging and Disabilities, Information Assistance Program can be reached at (410) 222-4464 or 1-800-492-2499 or (410) 222-4355 (TTY).

 
Nursing Homes

  • Is there a publication that answers the most common questions?

    Yes, the Ombudsman will send out an information packet with a list of nursing homes in Anne Arundel County and a booklet called, "Guide to Choosing a Nursing Home", that contains extensive answers to the questions listed below. 

  • What is the Ombudsman role in assisting with nursing home placement?

    The Ombudsman cannot choose a facility for you or recommend a certain facility. The Ombudsman can ensure you have access to information that will help you make an informed decision. An Ombudsman can help you identify factors that are important to you in finding a nursing home. For instance, what facilities are in a certain geographic area? What services do the different facilities provide? What funding sources do they accept? What is the population like in the nursing home? How did the facility perform during their last inspection (state survey)?

  • How do I choose a nursing home?
    As mentioned above, there are many things to consider when finding a nursing home. Call the local Ombudsman to discuss the facilities in the area and to discuss any questions or concerns about nursing home placement. Often, choosing a nursing home must be done quickly because a loved one is being discharged from the hospital, therefore it may be helpful to look at the following links online to narrow your search.
     
    • This brochure has a consumer guide for choosing a nursing home.
    • Medicare.gov Has information on long-term care as well as a nursing home compare that will allow you to compare nursing home surveys in a given area.
    • The Maryland Attorney General website provides a guide called "Nursing Homes: What You Need to Know".
  • What is a nursing home survey?

    A survey is a compilation of deficiencies (violations of the regulations) completed by Maryland State surveyors on an annual basis. The survey can be used as a measuring tool for quality care, but should not be relied on without additional information. A smart consumer will look at the deficiency reports and ask questions about how those issues have been corrected. Deficiencies are ranked in severity from "no harm" to "actual harm". Do not just look at the number of deficiencies - always consider the severity.

  • How do I pay for nursing home care?

    Most nursing homes are licensed to accept payment from Medicare and Medicaid. Commercial insurance and Medicare only pay for short-term stays in nursing homes. Medicaid or medical assistance pays for long term care in nursing homes. To be eligible for Medicaid, there are certain financial and medical requirements. Some individuals may have the medical needs, but have too many assets at the time of application, and will have to spend down until they meet the financial criteria. For more information about Medicare benefits: www.medicare.gov. If you have a long term care insurance or commercial insurance, please contact your benefits representative for more information since all policies are not the same. For information about Medicaid, you can contact the long-term care unit at Department of Social Services of Maryland Legal Aid Bureau. For information on Medical Assistance, please go to the following website: http://www.peoples-law.info/Home/PublicWeb

  • What are the rights of residents in nursing homes?
    The 1987 Federal Nursing Home Reform Law required nursing homes to “promote and protect the rights of each resident.” Every nursing home resident should have a dignified existence, and the resident rights are written to help ensure that they do. To see the specific rights, please refer to the following websites:

    http://www.nccnhr.org
    This website provides the fact sheets from National Citizens Coalition for Nursing Home Reform (NCCNHR). Click on the residents rights to review the information.

    www.dsd.state.md.us/comar/
    The state law for resident rights in nursing home can be found in the Code of Maryland Regulations 10.07.09.08. You can search by title. The nursing home regulations are found in Title 10.
  • What is a care plan?
    The care plan is developed by an interdisciplinary team – nurse, nurse aide, activities and dietary staff, and social worker, with critical input from the resident and/or family members. All participants discuss the resident’s care at a Care Plan Conference to make certain that all medical and non-medical issues, including meals, activities, therapies, personal schedule, medical and non-medical issues, including meals, activities, therapies, personal schedule, medical and nursing care, and emotional needs are agreed upon and addressed. Resident and family member concerns should be listened to by staff and addressed in the care plan. A good Care Plan Conference takes time. It should not be rushed and could take at least 1 hour. Every 90 days after development of the initial plan, or whenever there is a big change in a residents physical or mental health, a Care Plan Conference is held to determine how things are going and if changes need to be made. For more information go to www.nccnhr.org and select “Assessment and Care Planning.”
  • Who provides transportation to appointments for residents in nursing homes?
    A nursing home is required to arrange for transportation for follow up doctor’s appointments, treatments and dialysis services. If the nursing home resident needs someone to accompany him or her and a family member or friend cannot, then a nursing home staff member should accompany them. Transportation to medical appointments is paid for by Medical Assistance and some insurance companies. In addition, the Department of Aging and Disabilities also provides transportation to these types of appointments without cost.
  • Can I choose my own physician in the nursing home?

    Maryland law states a nursing home resident can “choose an attending physician, if the physician agrees to abide by nursing home policies and procedures and the regulations” in the COMAR (10.07.09.08, number 6.) Residents can also see physicians in their offices if they do not have privileges at the nursing home.

  • Can I choose which pharmacy will provide my medications?

    Maryland law states that a nursing home resident can “choose a pharmacy to obtain medications.” (COMAR 10.07.09.08, number 7.)

  • Can I self-administer medications?

    Maryland law states a nursing home resident can “self-administer drugs if the interdisciplinary team determines that the practice is safe.” (COMAR 10.07.09.08, number 12).

  • Can I receive hospice service in a nursing home?

    Residents in nursing home can receive hospice services. Depending on your insurance, hospice care can be paid for if there is a hospice benefit and the resident has been given a terminal diagnosis within six months or less of life expectancy. Medicare will pay for the hospice services provided by a hospice agency, but will not pay for room and board in the nursing home. If a resident has Medicaid, Medicaid will pay for the services provided by the nursing home staff. For more information about the Medicare benefit, go to www.medicare.gov

  • Where can I find information about advance directives?

    An advance directive is a document that states who may make health care and/or financial decisions and what type of life-sustaining care is desired. It is the patients decision as to who will be able to make decisions for them in the event that they are unable. A patient can choose to give the decision-maker power immediately or only after two physicians have stated that the patient cannot make their own decisions. Regardless of which option is chosen, a patient cannot make their own decision or rescind the document at any time by telling their healthcare provider of their wishes. For more information, see www.oag.state.md.us/sitemap.htm and refer to the health policy development section for more information.

  • What if I have another question?

    Call the Ombudsman office at (410) 222-4464. If we don't have the answer, we will find it for you!