Transitioning from assisted living to a nursing home

Assisted living or personal care facilities are often a transitional living option for a senior who is no longer able to live independently in their own home and requires some assistance with activities of daily living. When the senior’s level of care need increases beyond that which an assisted living or personal care facility can provide, it often becomes necessary to transition the senior to skilled nursing care. This transition can be drastic for some depending on the facility the senior is being moved to. Skilled nursing care is a high level of medical care providing 24/7 assistance with health care and activities of daily living. This care must be provided by or under the direct supervision of licensed health professionals. Skilled nursing care is the most expensive level of care. However, unlike an assisted living facility, in Pennsylvania Medicaid will pay for skilled nursing care, if the individual meets the eligibility requirements.

Assisted living and personal care facilities offer living accommodations with the addition of assistance with some activities of daily living. Examples of the assistance that may be offered include medication management, housekeeping, meals, laundry, transportation, social programs, and assistance with dressing and grooming. The primary difference between an assisted living or personal care facility is how they are licensed. The terms used to be used interchangeably until 2011, when Pennsylvania began to distinguish between the two. An assisted living facility does all that a personal care facility does but also provides some skilled health care services to supplement the personal care. There are also differences in the regulations on not only the offering of services, but also the accommodations and building.

Below are some tips to consider when transitioning a love one from assisted living or personal care to a skilled nursing facility:

(1) Tour the facility and if possible have a meal there. It is important to not only see where your loved one will be staying but to sample the food.

(2) When transitioning from assisted living or personal care to a skilled nursing facility, one of the hardest changes is often moving from a private room to a shared room. Most are unable to afford a private room in a nursing home and Medicaid usually will not cover the cost of a private room. When looking to see which facility to place your loved one in, you can inquire as to how the spaces are separated.

(3) Ask the nursing home staff if they have any tips to help make the transition smoother from the different facilities.

(4) Ask the facility if they have a list of items they recommend that your loved one bring with them to make the space feel more personal. The transition from assisted living or personal care to skilled nursing can be challenging, but preparation and utilizing the available resources can help ease your loved one into their new living environment. It is also important to prepare your loved one for this transition by having a conversation with them regarding the change. Finally, consider consulting with an elder law attorney on how best to qualify for Medicaid.

The legal advice in this column is general in nature, consult your attorney for advice to fit your particular situation.

The transition from assisted living or personal care to skilled nursing can be challenging, but preparation and utilizing the available resources can help ease your loved one into their new living environment.

Rebecca A. Hobbs, Esquire is licensed to practice in the Commonwealth of Pennsylvania and is certified as an Elder Law Attorney by the National Elder Law Foundation as authorized by the Pennsylvania Supreme Court. She is a principal of the law firm of O’Donnell, Weiss & Mattei, P.C., 41 High Street, Pottstown, and 347 Bridge Street, Phoenixville, 610-3232800, www. owmlaw. com. You can reach Ms. Hobbs at rhobbs@ owmlaw.com