MATURE MARKET HEADLINES POSTED 5/13/99
Assisted Living Offers Cure for Elder Care Limbo
Nearly 80% of the care provided to the nation's elderly comes from family members. Eventually, those family caregivers find themselves in what I call "eldercare limbo". The level of care, eventually needed by the elder parent, is too burdensome to be provided in a home setting, yet the eldercare needs are not extensive enough to require a nursing home setting. The eldercare limbo has created the need for supportive services such assistance with meal preparation, dressing, bathing, supervision of medications. The senior living industry has been quick to fill this void between home and nursing home by creating what is now known as the Assisted Living Facility. Ironically, while the family welcomes this much needed resource, the family caregiver is often ill-equipped to make informed decisions about this new Assisted Living marketplace.
As with any new industry, the Assisted Living Industry is so busy meeting the demands of growth, that it has neglected a vital consumer education role necessary to inform family caregivers about their services. In fact, research by the U.S. Government's General Accounting Office (GAO) estimates that less than half of consumers who are considering the Assisted Living care option are knowledgeable about the product. And only one in four of those facilities surveyed by the GAO routinely provide consumers with written contracts prior to their decision to apply for admission. As a result, new admissions may not be fully aware of how much help they will receive, the costs of all services, or when they might be forced to leave the facility due to erosion of health status.
In response to the void in consumer education, Senator Chuck Grassley, Chairman of the U.S. Senate Special Committee on Aging, has developed guidelines to help family caregivers safely negotiate the pitfalls of the Assisted Living industry.
GET READY
- Plan. Don't wait for a crisis.
- Identify the facilities in your area.
- Shop around, tour, and compare facilities.
- Interview the administrator and talk to staff.
- Ask for written material describing the facility.
- Re-visit the facility on weekends or evenings.
- Have an attorney review the contract prior to signing.
BE PREPARED
- Know the cost associated with each level of care.
- Examine your finances. Monthly rates range from $1,000 to $4,000.
- Determine how family members will participate in cost-sharing.
- Include the elder in the planning and decision-making process.
In addition to Senator Grassley's excellent list, let me add one more suggestion. Tap the expertise of professional counselors when necessary. As caregivers, know and accept your physical and emotional limitations. There will come a time to let go of the caretaker role. Denial of your limitations can lead to anger, frustration, and guilt. Those emotions can potentially lead to elder abuse. Although family members are the most likely elder caregivers, so are family members the most common emotional, financial, and physical abusers of the elderly. Know and respect your limitations. The effect will be a better quality of life for both you and your loved one.
See related articles in the AgeVenture archives.
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AgeVenture News Service, www.demko.com
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Extra Cards Are Bad Deal Says Social Security
Kenneth S. Apfel, Commissioner of Social Security, commended the U.S. Attorney's action to file a civil suit in U.S. District Court in the Southern District of New York against Federal Record Service Corporation.
Filed in Manhattan federal court, the suit alleges that Federal Record Service misleads and defrauds the public through solicitations for services that purportedly assists people in obtaining Social Security cards for newborns or replacement cards for newlyweds. Federal Record Service charges citizens a $15 fee for services that can be obtained for free from the Social Security Administration (SSA). Many consumers have complained that the mailings led them to believe that they were being contacted by SSA or a company affiliated with SSA.
"For far too long, Federal Record Service has been picking the pocket of the American public through deceptive practices in an effort to sell an unnecessary service," Commissioner Apfel said. "Today's action by the U.S. Attorney proves that the Federal Record Service can run, but it can't hide from the law."
In the suit, U.S. Attorney Mary Jo White charged that Federal Record Service, in their solicitations for a fee, convey the false impression that their services are approved, endorsed, or authorized by SSA. The suit further alleges that the solicitation fails to inform the consumer that Social Security numbers are generally assigned as a part of the birth registration process and that newlyweds can obtain a replacement card to change their names without charge by dealing directly with SSA.
U.S. District Judge Barbara S. Jones, U.S. District Judge for the Southern District of New York, issued a temporary restraining order directing Federal Record Service to cease disseminating the solicitations, freezing the corporation's assets, and authorizing the U.S. Postal Service to detain incoming mail from consumers. Judge Jones has scheduled a hearing on May 13, 1999 at 10 a.m. to determine what further action is appropriate.
SSA's Office of the Inspector General (OIG) has been instrumental in investigating and compiling information relating to Federal Record Service solicitations. "We have received more complaints against Federal Record Service Corporation than any other company in the history of the OIG, SSA," James G. Huse, Jr., Acting Inspecting General, SSA, said. "Today, we are taking aggressive action to stop Federal Record Service Corporation from misleading the public with deceptive Social Security-related solicitations."
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AgeVenture News Service, www.demko.com
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Chiropractors and APTA Spar Over Physical Therapy
It's about pain, professional turf, and freedom of speech. Sounds like the television movie of the week. However, this event is between two professional groups who both claim the right to use the term "physical therapy" to describe their services. Between these two groups is the justice system trying to sort out the constitutional issues involved. And surrounding the entire event is a ring of American consumers, people in pain who are looking for a little relief. But it's going to be harder to find therapeutic relief these days. Because there's some confusion regarding where to turn for help.
The American Physical Therapy Association (APTA) and several chiropractors in Pennsylvania are waging war over who has the right to advertise or bill for their services as "physical therapy". At stake are fees that are currently reimbursable under insurance programs, public and private, because these services are defined as "physical therapy". On the one hand, physical therapists claim "physical therapy" as their professional domain. Chiropractors argue that they should be free to advertise that they offer "physical therapy" because they use such procedures as mechanical stimulation, massage, and mobilization. Well, the Pennsylvania Supreme Court recently found in favor of the APTA.
The Pennsylvania Supreme Court emphatically rejected the chiropractors’ argument that they were free to tell consumers that they provide "physical therapy." The Court said that while there is indeed some overlap in the procedures used by chiropractors and those used by physical therapists, the differences between the two professional groups are substantial. Chiropractors, said the court, are not the equivalent of physical therapists.
The Court noted that Pennsylvania for many years has regulated physical therapy as a separate profession and concluded that no longer is physical therapy understood to be merely a generic term for physical treatment. The Court said that "it would mislead the public if chiropractors were permitted to advertise that they offer physical therapy, where, as occurred here, the advertisements did not indicate the very limited scope of therapy that they offer."
The Pennsylvania Constitution permits the state to prohibit "misleading or deceptive advertising," and the Court held that allowing chiropractors to advertise that they perform "physical therapy" would mislead the public into believing that chiropractors are actually licensed and able to perform the full range of such therapy.
The decision of the Pennsylvania Supreme Court does not necessarily end the litigation over the issue of chiropractors’ advertising. The chiropractors may seek to have a federal court invalidate the prohibition against using the term "physical therapy" on the ground that it violates the free speech clause of the First Amendment to the U.S. Constitution.
AgeVenture News Service plans to follow this story for our readers. So stay tuned for future updates.
See related articles in the AgeVenture archives.
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AgeVenture News Service, www.demko.com
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Weiss Guy Solves Long Term Care Insurance Puzzle
Medicare doesn't cover the expenses of long-term care for millions of senior citizens and baby boomers, cautions Weiss Ratings Inc, an independent provider of insurance ratings and analyses. As a result, consumers must piece together a complex puzzle combining Medicare, Medigap, and long term care insurance. Weiss recommends that consumers combine private and public insurance coverage for total protection. This combination of coverage includes three areas: skilled nursing care, home health care, and community-based care.
SKILLED NURSING CARE COVERAGE
Medicare covers only the first 20 days of skilled nursing care. Medigap pays the coinsurance amount for the 21st to the 100th day. Private long-term care insurance is needed for any nursing care that extends beyond 100 days. Of course, there are conditions that must be met in order to qualify for the Medicare and Medigap coverage. But here's the point. At best, Medicare and Medigap are short-term solutions.
HOME HEALTH CARE COVERAGE
Medicare and Medigap coverage is both limited and conditional when it comes to home care. Neither allows for really long stays at home. Therefore, after taking full advantage of your Medicare and Medigap benefits, consumers wishing to stay at home as long as possible should buy a comprehensive, long-term care policy that includes coverage for home health care.
COMMUNITY-BASED CARE COVERAGE
Medicare and Medigap offer no coverage for community-based care. As a result, consumers are advised to purchase a long-term care policy. Those who can afford it, should get coverage for as many different types of community-based facilities as possible to maximize their future options. Long-term care generally covers the following types of community-based facilities: adult day care centers, continuing care retirement communities, and assisted living facilities.
For a fee, consumers can obtain a customized report listing long-term care policies from Weiss Ratings by calling 1-800-289-9222. Consumers may also request a free copy of the "Guide to Health Insurance for People with Medicare" from the Health Care Financing Administration at 1-800-638-6833.
See related articles in the AgeVenture archives.
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AgeVenture News Service, www.demko.com
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Dr. David Demko, Editor
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