This is written to alert families of a gap in service that seems to be related to the system and occurs repeatedly.
The families senior was experiencing memory issues so they moved him from his home and placed him in an assisted living dwelling. The family then goes to the county and speaks with a benefits specialist. The county explained that when the seniors checking and savings account balance falls below 2 thousand dollars he would be attached to a care management organization (CMO), who would then pay for his care.
The senior resides in an assisted living facility for 18 months at 5600.00 per month. On the 18th month the seniors checking and savings account balance is fallen below 2 thousand dollars. In the last 18 months the seniors home went to foreclosure and the contents of the home were assumed by the bank and sold through a contracted firm on the banks behalf.
After the 18th month the family and senior have multiple meetings with the county benefits specialist for the next 4 months. The county assures the family and the senior he qualifies for programming that will pay to keep him in an assisted living facility.
The senior continues to reside in the assisted living facility and be billed the 5600.00 per month he cannot pay. From the time the seniors checking and savings account fell below 2 thousand dollars and the (CMO) care management organization was able to begin service is a 4 month gap. The senior now owes 5600. times 4 months a balance of 22,400.00 to the assisted living facility. The senior is now given a notice of being behind in payments and having 30 days to vacate the assisted living facility. Kicked out.
The county benefits specialist explains that they are not a valid pay source. The State of Wisconsin has lifted authority from the counties and placed with (CMO's) care management organizations who serve regions, multiple counties. The (CMO) care management organization explains that they could not by law provide payment for service prior to the senior being enrolled in the program. The assisted living facility explains that their policy and proceedure require them to serve notice on deliquent bills and they hate to see you go. The senior explains he is totally out of money and frustrated because he has followed through on all the advice he has been given.
So the gap appears to be the time that occurs from when the senior is out of money and eligible for county programming to the time he is actually enrolled in a CMO care management organization. This is written only to give the reader a sense of how this gap seems to repeatedly reoccur.
Home Care Path provides non-medical in home custodial care for seniors in south central Wisconsin. Valueing home and human life.
Monday, February 21, 2011
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