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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.
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I acknowledge and authorize
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I consent to the collection of my consumer health data.*
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I consent to the sharing of my consumer health data with qualified home care agencies.*
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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:
I have been looking after (POA/HCS) the individual and his wife for over 2 years. The wife passed recently and we were in a call (by appointment) with SSA attempting to get the $255 death benefit sent. During the call the SSA rep (English appeared to be her 2nd language) claimed that my uncle was not answering appropriately (not true from what I heard) and that someone would need to be appointed representative payee. It seemed like she was forcing the requirement despite the facts at hand, using my uncles inability to understand a SE Asian accent and his need for the benefit payment.
Sendhelp, You touched on the fundamental question: How often can SSA require me to jump through a hoop?" I have responsibilities to my immediate family to continue to provide an income from my continued employment.
Joann29, yes, yes, and because SSA requires it. Geewiz, your link provided a bit more than PUB 10076, thanks. I still didn't see a definitive reporting cycle.
I am completely understanding of the need for surveillance. Apparently, the couple had been victimized multiple times before I got involved. A car dealer, a reverse mortgage company, and many home service providers had helped the couple to run their net worth to a significant _negative_ value.
I am, by nature, wary of bureaucracies including the SSA.
On the bright side there are no other family members fighting me for control of the situation as can often be seen when assets are involved.
Is this any help? http://www.disability-benefits-help.org/faq/how-to-fill-out-form-SSA-623 Is your uncle receiving disability pay or is he over 65 receiving retirement benefits. This form seems to be for disability pay.
The SSA-623 form pertains to being a rep-payee, and is not available online.
"All forms are FREE. Not all forms are listed. If you can't find the form you need, or you need help completing a form, please call us at 1-800-772-1213 (TTY 1-800-325-0778) or contact your local Social Security office and we will help you. If you download, print and complete a paper form, please mail or take it to your local Social Security office or the office that requested it from you."
Responsibilities of a rep-payee are wide and far-reaching after a time. It seemed simple at first. Will you be having access to ALL of the SS recipients income, have that person's cooperation, and be able to report All income to SS as it changes? Will you be able to handle reporting medical and disability changes to SS, as well as obtaining medical reports from doctors concerning the disability? Seems they can ask just about anything, and require a timely response. imo.
I have already been to https://www.ssa.gov/forms/ and found "Representative Payee Report - Not available online - contact your local Social Security office"
SSA requires you to visit in person with the beneficiary when applying. I would like to preview the form before taking time off work, trotting my 91 YO uncle across town.
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 have been looking after (POA/HCS) the individual and his wife for over 2 years. The wife passed recently and we were in a call (by appointment) with SSA attempting to get the $255 death benefit sent. During the call the SSA rep (English appeared to be her 2nd language) claimed that my uncle was not answering appropriately (not true from what I heard) and that someone would need to be appointed representative payee. It seemed like she was forcing the requirement despite the facts at hand, using my uncles inability to understand a SE Asian accent and his need for the benefit payment.
I have already read the SSA 15 page guide to being a representative payee at https://www.ssa.gov/pubs/EN-05-10076.pdf
Sendhelp, You touched on the fundamental question: How often can SSA require me to jump through a hoop?" I have responsibilities to my immediate family to continue to provide an income from my continued employment.
Joann29, yes, yes, and because SSA requires it.
Geewiz, your link provided a bit more than PUB 10076, thanks. I still didn't see a definitive reporting cycle.
I am completely understanding of the need for surveillance. Apparently, the couple had been victimized multiple times before I got involved. A car dealer, a reverse mortgage company, and many home service providers had helped the couple to run their net worth to a significant _negative_ value.
I am, by nature, wary of bureaucracies including the SSA.
On the bright side there are no other family members fighting me for control of the situation as can often be seen when assets are involved.
http://www.disability-benefits-help.org/faq/how-to-fill-out-form-SSA-623
Is your uncle receiving disability pay or is he over 65 receiving retirement benefits. This form seems to be for disability pay.
"All forms are FREE. Not all forms are listed. If you can't find the form you need, or you need help completing a form, please call us at 1-800-772-1213 (TTY 1-800-325-0778) or contact your local Social Security office and we will help you. If you download, print and complete a paper form, please mail or take it to your local Social Security office or the office that requested it from you."
Responsibilities of a rep-payee are wide and far-reaching after a time. It seemed simple at first. Will you be having access to ALL of the SS recipients income, have that person's cooperation, and be able to report All income to SS as it changes? Will you be able to handle reporting medical and disability changes to SS, as well as obtaining medical reports from doctors concerning the disability? Seems they can ask just about anything, and require a timely
response. imo.
SSA requires you to visit in person with the beneficiary when applying. I would like to preview the form before taking time off work, trotting my 91 YO uncle across town.
Or look on their online web site