Are you sure you want to exit? Your progress will be lost.
Who are you caring for?
Which best describes their mobility?
How well are they maintaining their hygiene?
How are they managing their medications?
Does their living environment pose any safety concerns?
Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
Which best describes your loved one's social life?
Acknowledgment of Disclosures and Authorization
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment. You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
✔
I acknowledge and authorize
✔
I consent to the collection of my consumer health data.*
✔
I consent to the sharing of my consumer health data with qualified home care agencies.*
*If I am consenting on behalf of someone else, I have the proper authorization to do so. By clicking Get My Results, you agree to our Privacy Policy. You also consent to receive calls and texts, which may be autodialed, from us and our customer communities. Your consent is not a condition to using our service. Please visit our Terms of Use. for information about our privacy practices.
Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
Remember, this assessment is not a substitute for professional advice.
Share a few details and we will match you to trusted home care in your area:
You don't have to pay it back. Medicaid will delay approval of your mom/dad for a period of time. During that time, if mom/dad has no money then the family who received the money should be taking care of her/him.
They will be ineligible for payment of Medicaid covered NH services but will be in the Medicaid program if the state determines a penalty. Yeah, total double-speak!!
If when you apply for Medicaid for NH, the state has concerns based on the financial documents provided and required within the Medicaid application or information they discover from state records (for real property like homes, land, vehicles), then the state can do a transfer penalty inquiry. The inquiry will be pretty specific as to the time, the property and amounts that mom/dad or their family have to provide details about.
If you don't provide to the state documentation or information requested that makes plausible sense, then the state can do a "transfer penalty". This is totally sticky to get into. The state isn't going to kick mom to the curb per se. But the NH can use the contract you or someone signed when mom entered the NH to go after you or whomever for payment while there is a transfer penalty. This could be a whole lotta money.
The penalty is based on whatever is your state's daily Medicaid for NH room & board rate. Like for Texas, it's about $ 145.00 a day. Which is low. The transfer penalty has a whole formula in how it's done and it's totally loco to try to figure out. The details will be somewhere within your states Dept of Health & Human Services website. But whatever the case, what the penalty means is that mom/dad, although accepted in the Medicaid program, is ineligible for the state to pay for their NH care through Medicaid. For even more fun, the NH will get a letter notifying them that mom/dad has a penalty.
If mom/dad are already in the NH and entered the NH Medicaid Pending, then the NH will require SOMEONE to either private pay for mom/dad for all the time and until the transfer penalty is paid up OR mom/dad will get the dreaded "30 Day Notice". If that happens you are totally toast on getting in another NH too. Like Much Hated said, they end up back living with family. Or if it gets really bad, they can be made a ward of the state and then the state takes over their care and decides where mom will live. And it won't be the place she was at but more likely get moved to a NH in another county where they are desperate to fill beds. Family has no say as mom is now a ward of the state. Not pretty. This is pretty extreme and most of the time, someone in the family does private pay and works out something with the NH or mom moves in with family till the penalty runs out.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
If when you apply for Medicaid for NH, the state has concerns based on the financial documents provided and required within the Medicaid application or information they discover from state records (for real property like homes, land, vehicles), then the state can do a transfer penalty inquiry. The inquiry will be pretty specific as to the time, the property and amounts that mom/dad or their family have to provide details about.
If you don't provide to the state documentation or information requested that makes plausible sense, then the state can do a "transfer penalty". This is totally sticky to get into. The state isn't going to kick mom to the curb per se. But the NH can use the contract you or someone signed when mom entered the NH to go after you or whomever for payment while there is a transfer penalty. This could be a whole lotta money.
The penalty is based on whatever is your state's daily Medicaid for NH room & board rate. Like for Texas, it's about $ 145.00 a day. Which is low. The transfer penalty has a whole formula in how it's done and it's totally loco to try to figure out. The details will be somewhere within your states Dept of Health & Human Services website. But whatever the case, what the penalty means is that mom/dad, although accepted in the Medicaid program, is ineligible for the state to pay for their NH care through Medicaid. For even more fun, the NH will get a letter notifying them that mom/dad has a penalty.
If mom/dad are already in the NH and entered the NH Medicaid Pending, then the NH will require SOMEONE to either private pay for mom/dad for all the time and until the transfer penalty is paid up OR mom/dad will get the dreaded "30 Day Notice". If that happens you are totally toast on getting in another NH too. Like Much Hated said, they end up back living with family. Or if it gets really bad, they can be made a ward of the state and then the state takes over their care and decides where mom will live. And it won't be the place she was at but more likely get moved to a NH in another county where they are desperate to fill beds. Family has no say as mom is now a ward of the state. Not pretty. This is pretty extreme and most of the time, someone in the family does private pay and works out something with the NH or mom moves in with family till the penalty runs out.