Retirement/Assisted Living Homes

  • Q: What are the different types of custodial care settings in California?

    • A: Large (hotel-like) and small (home-like) settings, both considered Residential Care Facilities for the Elderly (RCFEs).

  • Q: What are the typical services offered in assisted living homes?

    • A: Meals, activities, transportation, medicine, dressing, bathing, and sometimes help for incontinent or wheelchair-dependent residents.

  • Q: Can assisted living homes accept residents with advanced dementia or Alzheimer's?

    • A: Usually not, due to fire safety guidelines. Specialized wings or wanderguard bracelets may be available for some.

  • Q: What are the typical living accommodations in assisted living homes?

    • A: Furnished rooms with private bathrooms, sometimes suites or two-bedroom accommodations.

  • Q: What are the typical costs for assisted living homes?

    • A: Shared room: $2,500-$3,500/month + level of care; private room: $3,500-$5,000/month + level of care. One-time entry fees may also apply.

  • Q: Do assisted living homes accept SSI/SSP payments?

    • A: Some do, but many are not willing to accept the low payment.

  • Q: What are the licensing requirements for assisted living homes?

    • A: They must be licensed by Community Care Licensing (CCL) and adhere to Title 22 guidelines.

Residential Board and Care Homes

  • Q: What are Residential Board and Care Homes?

    • A: Small family homes licensed to provide care to 4-6 residents.

  • Q: What services do Residential Board and Care Homes offer?

    • A: Custodial care, meals, activities, medication, shopping, and transportation.

  • Q: What types of residents are typically accepted in Residential Board and Care Homes?

    • A: Non-ambulatory residents, those with incontinence, advanced dementia, Parkinson's, Alzheimer's, or high physical care needs.

  • Q: Can Residential Board and Care Homes accept residents with skilled nursing needs?

    • A: Usually not, but exceptions may be granted for certain conditions.

  • Q: What are the typical costs for Residential Board and Care Homes?

    • A: Shared room: $3,000-$4,500/month; private room: $3,500-$7,000/month.

Skilled Nursing Facilities (SNFs)

  • Q: What type of care do SNFs offer?

    • A: 24-hour skilled nursing care by licensed professionals.

  • Q: What services are provided in SNFs?

    • A: Care for bedridden residents, IV or g-tube care, and rehabilitation services.

  • Q: What are the typical costs for SNFs?

    • A: $150-$300 per day, plus ancillary charges.

  • Q: What are the licensing requirements for SNFs?

    • A: They must be licensed by the Department of Health Services and adhere to Title 22 and OBRA guidelines.

Continuing Care/Life Care Communities

  • Q: What type of care do Continuing Care Communities offer?

    • A: Minimal services, custodial care, and skilled nursing.

  • Q: What are the typical costs for Continuing Care Communities?

    • A: May require a large entry fee and monthly charges.

CalAIM Overview

  • Q: What is CalAIM?

    • A: A 5-year, $6 billion initiative to rebalance LTSS and streamline care delivery for Medi-Cal recipients.

  • Q: What are the two components of CalAIM?

    • A: Enhanced Care Management (ECM) and Community Supports (CS).

  • Q: What are the goals of CalAIM?

    • A: Improve care coordination, integrate services, facilitate community resources, improve health outcomes, address social determinants of health, and decrease inappropriate utilization.  

Enhanced Care Management (ECM)

  • Q: What is ECM?

    • A: A collaborative and interdisciplinary approach to provide comprehensive case management for high-need Medi-Cal recipients.

  • Q: What are the goals of ECM?

    • A: Similar to the overall goals of CalAIM, focusing on improving care coordination, integrating services, and addressing social determinants of health.

Community Supports (CS)

  • Q: What are CS?

    • A: Optional services offered by MCPs to help members avoid or substitute hospital or SNF admission.

  • Q: Can MCPs choose which CS to offer?

    • A: Yes, MCPs can pick and choose CS and can change their offerings every six months.

  • Q: What are some examples of CS?

    • A: Housing transition navigation services, housing deposits, housing tenancy and sustaining services, short-term post-hospitalization housing, recuperative care, day habilitation programs, caregiver respite services, nursing facility diversion/transition, community transition services, personal care and homemaker services, environmental accessibility adaptations, medically supportive food/meals, sobering centers, and asthma remediation.  

  • CalAIM CS Referral Package Overview

  • Q: What is Connections Care Home Consultants?

  • A: A CalAIM CS Provider for SNF Diversion/Transition to RCFE/ARF in specific counties.

  • Q: What does the CS Referral Package do?

  • A: It submits an authorization request to the MCP for the member to receive CS.

  • Q: Who pays for the "assisted living" portion of a RCFE/ARF?

  • A: The MCP pays for the "assisted living" portion. The member is responsible for the "room and board" portion.

  • Eligibility Requirements

  • Q: What are the eligibility requirements for SNF Transition to RCFE/ARF?

  • A: Resided in a SNF for at least 60 days, willing to live in RCFE, and able to safely reside in RCFE with appropriate supports.

  • Q: What are the eligibility requirements for SNF Diversion to RCFE/ARF?

  • A: Interested in remaining in the community, able to safely reside in RCFE with appropriate supports, currently at medically necessary SNF level of care or at risk of premature institutionalization, and meets the criteria to receive those services in RCFE/ARF.

  • Q: What is the member's responsibility for "room and board"?

  • A: The member is responsible for paying the "room and board" portion of the RCFE/ARF.

  • Authorization Request

  • Q: How long does the MCP have to determine CS approval or denial?

  • A: The MCP has five business days.

  • Q: What steps are involved in the referral process?

  • A: After the referral package is submitted, Connections will inform the member of the determination and, if authorized, begin the process of providing information and referral to RCFEs/ARFs.

  • CS Referral Package Instructions

  • Q: What are the required documents for the CS Referral Package?

  • A: Declaration of Eligibility, HIPAA Form, Freedom of Choice Waiver, CalAIM Participant Liability Waiver, RCFE Physician's Report (602), Room and Board Payment Attestation, Facesheet Diagnostic Codes, and Community Support Referral Form.

  • Q: What is the purpose of the RCFE Physician's Report (602)?

  • A: It provides an evaluation of the participant's needs and suitability for RCFE/ARF placement.

  • Q: Can I request an expedited review?

  • A: Yes, you can request an expedited review and provide a reason for the request.

 

Adult Day Health Care Services

  • Q: What are adult day health care services?

    • A: Community-based programs for functionally and/or cognitively impaired adults, providing respite care for caregivers.

  • Q: What kind of care do these services provide?

    • A: Both custodial and skilled nursing care.

Licensing and Oversight

  • Q: Who licenses and oversees assisted living and RCFE settings?

    • A: Community Care Licensing (CCL), a branch of the Department of Social Services.

  • Q: Who licenses and oversees skilled nursing facilities?

    • A: The Department of Health Services.

Medicare and Medi-Cal

  • Q: What is Medi-Cal?

    • A: California's version of Medicaid, providing health and long-term care for eligible low-income individuals.

  • Q: What does Medi-Cal cover?

    • A: Health care services, including physician visits, prescription drugs, hospitalization, x-ray, adult day care, and nursing home care.

  • Q: What is Medicare?

    • A: A federal health insurance program available to individuals 62 or older or disabled for at least 24 months.

  • Q: What does Medicare cover for skilled nursing facility care?

    • A: Up to 100 days with co-payments after 20 days. Coverage is for skilled nursing care, not personal or ongoing care.

Other Relevant Terms

  • Q: What is a deficiency report?

    • A: A report indicating infractions in a nursing home.

  • Q: What is In Home Supportive Services (IHSS)?

    • A: A non-medical long-term care program providing assistance with housework and personal care in the home.

  • Q: What is an ombudsman?

    • A: An organization that responds to complaints against skilled nursing facilities.

  • Q: What are senior centers?

    • A: Community-based organizations providing social and recreational activities for seniors.

  • Q: What is Social Security Supplemental Income (SSI)?

    • A: A program providing a minimum monthly income for aged and disabled individuals with limited income and resources.

Custodial Care

  • Q: What is custodial care?

    • A: Assistance with activities of daily living like dressing, bathing, eating, and transferring.

  • Q: What are some examples of people who might need custodial care?

    • A: Individuals with dementia, Alzheimer's, or physical disabilities.

Skilled Nursing Care

  • Q: What is skilled nursing care?

    • A: Specialized care provided by trained professionals for complex medical conditions.

  • Q: What are some examples of skilled nursing care?

    • A: Assistance with IVs, g-tubes, tracheotomies, ventilators, and wound care.

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How does Connections work?

 

Choosing the Right Setting

  • Q: Why do some patients with custodial care needs end up in SNFs?

    • A: Lack of awareness of alternative settings, assumption that SNFs provide the highest level of care, and financial limitations.

  • Q: What are alternative settings for patients with custodial care needs?

    • A: Assisted living facilities and residential board and care homes.

  • Q: Which setting might be better for patients with custodial care needs?

    • A: Home-like settings with high staffing levels, such as residential board and care homes, might be more suitable for patients without skilled nursing needs.

Licensing and Oversight

  • Q: Who is responsible for licensing and overseeing assisted living, residential care facilities, and other similar settings?

    • A: The Department of Social Services Community Care Licensing Division.

  • Q: What are the requirements for these facilities?

    • A: They must adhere to Title 22 guidelines for care provided, staffing, and physical environment.

Our Services

  • Q: What kind of service do you provide?

    • A: We are a no-cost care home referral agency.

  • Q: How does the referral process work?

    • A: We conduct an intake, visit care homes, and provide a customized list of options.

Our Process

  • Q: What information do you collect during the intake process?

    • A: Care needs, timeframe, geographic preference, and budget.

  • Q: How do you evaluate care homes?

    • A: We visit care homes, monitor quality through follow-up calls, and inquire about availability, resident care needs, and monthly rates.

  • Q: How long does it typically take to receive a list of care homes?

    • A: Usually within 1/2 hour.

Additional Information

  • Q: Do you charge a fee for your services?

    • A: We charge a placement fee from the facility if you select one of our recommended homes.

  • Q: Can you help me find a care home in a specific area?

    • A: Yes, we can help you find care homes based on your geographic preference.

 

VA Aid and Attendance Benefit.

 

Eligibility for Survivors Pension

  • Q: Who is eligible for a VA Aid and Attendance benefit as a surviving spouse?

    • A: Qualified surviving spouses and unmarried dependent children of wartime Veterans who meet certain income and net worth limits.  

  • Q: What are the eligibility requirements for a VA Aid and Attendance benefit for surviving spouses?

    • A: Not remarried after the Veteran's death, Veteran had a non-dishonorable discharge, and Veteran's service meets specific requirements based on the date of entry into active duty.

  • Q: What are the eligibility requirements for a VA Aid and Attendance benefit for children of deceased wartime Veterans?

    • A: Unmarried, under 18, under 23 and attending a VA-approved school, or unable to care for oneself due to a disability that began before age 18.

Wartime Periods Recognized for VA Aid and Attendance Benefits

  • Q: What wartime periods are recognized for VA Aid and Attendance benefits?

    • A:

      • Mexican Border period: May 9, 1916, to April 5, 1917

      • World War I: April 6, 1917, to November 11, 1918

      • World War II: December 7, 1941, to December 31, 1946

      • Korean conflict: June 27, 1950, to January 31, 1955  

      • Vietnam War era (for Veterans who served in the Republic of Vietnam): November 1, 1955, to May 7, 1975  

      • Vietnam War era (for Veterans who served outside the Republic of Vietnam): August 5, 1964, to May 7, 1975

      • Gulf War: August 2, 1990, through a future date to be set by law or presidential proclamation

Eligibility by Veteran for VA Aid and Attendance Benefit:

 

    • Eligibility for Veterans Pension

    • Q: Who is eligible for a Veterans Pension?

    • A: Wartime Veterans who meet certain age or disability requirements, and who have income and net worth within certain limits.  

    • Q: What are the eligibility requirements for Veterans Pension?

    • A: Non-dishonorable discharge, income and net worth within limits, and service during a recognized wartime period.

    • Q: What are the age and disability requirements for Veterans Pension?

    • A: At least 65 years old, permanent and total disability, nursing home placement due to disability, or receiving Social Security Disability Insurance or Supplemental Security Income.

    • Wartime Periods Recognized for Veterans Pension

    • Q: What wartime periods are recognized for Veterans Pension?

    • A:

    • Mexican Border period: May 9, 1916, to April 5, 1917

    • World War I: April 6, 1917, to November 11, 1918

    • World War II: December 7, 1941, to December 31, 1946

    • Korean conflict: June 27, 1950, to January 31, 1955  

    • Vietnam War era (for Veterans who served in the Republic of Vietnam): November 1, 1955, to May 7, 1975  

    • Vietnam War era (for Veterans who served outside the Republic of Vietnam): August 5, 1964, to May 7, 1975

    • Gulf War: August 2, 1990, through a future date to be set by law or presidential proclamation