What is Medicaid?
Medicaid is a federal government program run by each individual state. It provides health coverage for some low income people, the elderly and those with disabilities who meet eligibility criteria. There are different eligibility rules for single, widowed and married individuals. Medicaid is available for those living in the community and to residents of a nursing home. Nursing Home Medicaid is a specific division of Medicaid that once approved pays for long term custodial care for an individual living in a Medicaid certified nursing home.
Those applying for nursing home Medicaid require the assistance of a designated representative. This person will need to be able to answer all eligibility questions and have access to the individual’s financial records. A Durable Power of Attorney or able bodied spouse would be considered designated representatives.
For married individuals Medicaid considers the combined assets of both spouses when determining eligibility. Typically one spouse is still living in the community and the other is living in a nursing home. Medicaid allows the community spouse to keep the home in which they live in, its contents, their automobile and a certain amount of the couples combined assets.
All nursing home Medicaid applications require a financial look back. This is when Medicaid examines the applicant’s financial records during the previous 5 years. Any gifts of money, transfers of assets or properties sold or transferred will be reviewed. Medicaid will determine if these are considered valid or invalid transfers. An invalid transfer may result in a delay of nursing home Medicaid coverage.
Due to the complexities of the Medicaid process, hiring a Medicaid Attorney or Agency to assist the designated representative are advised.
What is a PRI/Screen?
A PRI/Screen (Patient Review Instrument) is a medical evaluation assessment that is required by NYS prior to admission to a nursing home. The PRI/Screen can be completed by a certified nurse. Home Care Agencies may be able to provide this nurse if requested. There is a fee involved when having a PRI/Screen completed at home. Once completed, the PRI and Screen will determine the cognitive and physical abilities of an individual and a score is given based on these findings. A nursing home or assisted living can look at this score and determine if the patient is at an appropriate level for the type of care the facility is able to provide. This evaluation is also a good tool for family to start looking for an appropriate level of care for their loved one since this evaluation is an objective review of what level of care the individual is scoring and needs. Once completed, the PRI/Screen is valid for 90 days unless there is change in the health status of the individual.
How long does a patient stay in rehab?
The average length of stay is 15 days. However some patients need much less time or some need more in order to achieve their goals. This is all based on individual progress.
How often does a patient receive therapy?
Therapy is available seven days a week. Program frequency and duration will be determined by an occupational and physical therapist. Generally programs are 6 times per week with 2 sessions per day.
Are therapists assigned to patients?
Yes. After the initial evaluations are completed and a plan of care has been established, an occupational and physical therapist will be assigned to the patient so they may oversee the entire rehab process.
What therapy services are available?
Physical, occupational and speech therapy.
Do I need a referral?
Yes – you must provide a prescription for therapy from your doctor prior to receiving services. We will periodically check in with your referring physican to update them on your progress.
Will I have a co-pay?
It depends on your insurance coverage and your current plan. It is best to give your insurance company a call prior to making an appointment to discuss possible co-pays or deductibles.
What kind of therapy services are provided?
We offer physical, occupational and speech therapy services in an outpatient setting.
How do I make an appointment?
You can speak with our receptionist at (716)759-7680 to make an appointment. She will ask for information regarding your current insurance policy, referring physican name and reason for visit.
How many times a week can I expect to attend therapy sessions?
It depends on the reason for your visit. Patients are typically treated 1-3 times per week.
Assistive Living (Sacred Heart Home)
Will I be able to keep my independence?
Yes at SHH we respect and encourage you to stay independent within your ability. We promote your wellness by offering enrichment programs, community trips, religious services and individually guided activities. We have a Physical therapist that will help you maintain a strong gait and improve safety awareness so you keep your mobility independent.
Will the staff help me with my needs?
Yes absolutely. You may have assistance with hygienic care, we help you keep your room clean and tidy with our maintenance and housekeeping staff and assist in personalized laundering of your clothing. Health service staff is on 24/7, so you are never without someone to assist you.
Will I be able to keep in close contact with my family and friends?
When you decide to join us at Sacred Heart Home, we encourage visitors and consider them an important part of your life. Our dining services offer private dining and guest trays for a very modest fee. The case manager is available to help you with any part of this transition.
Will I have any say in the workings of the facility?
Yes. We have an active resident council, concerns, suggestions and compliments are listen to and when appropriate acted upon. This council is a protected and safe venue to speak with the administrative team.
Will I need a new Doctor?
You may keep your community physician. We do have a medical group of physicians and nurse practitioners who address most of our residents medical needs. They also work with the Brothers of Mercy Rehab Clinic, so if you do need rehab, the continuity of care exists without a gap. Since this medical group routinely sees residents at Sacred Heart Home, it helps to minimize the families need to transport their loved one to a community physician for routine care.
What type of apartments do you have?
We have 2 types of one bedroom apartments; a suite which accommodates one person, and a larger one bedroom which accommodates couples.
I am single, but could I apply for the larger 1 bedroom apartment?
If you meet the income requirements, you may apply for either size apartment.
What about activities? Do I have to participate?
We have an activity calendar with a range of activities for those who want to participate. Residents may socialize with others as often as they wish, or not at all. That’s your call.
What if I need a higher level of care?
The Brothers of Mercy Wellness Campus offers all types of senior living options and, based on certain criteria, we do our best to ensure that your needs are met on every level at one of our communities.
What type of services do you offer?
Although we do not offer any type of care or services at the senior apartments, you may bring in meal service, medical services or any other type of services you would bring into a private home.
Is there an entrance or application fee?
There is no entrance fee at Montabaur Heights. We do require a $50 Application Fee to cover administrative costs and background checks. Once your application has been accepted, an amount of one month rent holds the apartment of your choice. Upon move in, the Reservation Fee is credited to your security deposit, which is one month’s rent. The Reservation Fee may be non-refundable after 60 days.
How does the meal plan work at Montabaur Heights?
Daily breakfast is served in the main dining room. Also included in the monthly rent is your choice of Lunch or Dinner with table service. Our flexible meal plan is designed to accommodate your preference for a mid-day or evening meal.
Can the dining plan accommodate special dietary needs?
Absolutely. Our staff will meet with you to discuss your specific needs and provide options for your unique situation.
What if I require elevated levels of care?
As a resident of Montabaur Heights, you will receive priority access to all higher levels of care offered on the Brothers of Mercy Wellness Campus:
Supported living in our Sacred Heart Adult Home. Rehabilitation, skilled nursing or palliative care in the Brothers of Mercy Nursing and Rehabilitation Center.
What is the “Snow Bird” Discount?
Many Western New Yorker’s enjoy visiting family or taking a break from the cold weather during the winter. If you’re one of those Snow Birds, Montabaur Heights will discount your monthly rent $500 for every full month that your apartment is unoccupied, up to a maximum of $1500 every 12 months. Speak to our Senior Living Consultant for all the details.
Can Montabaur Heights provide moving assistance?
We can refer you to third party providers who can provide guidance with downsizing, estate sales, selling your current home, as well as help you move into Montabaur Heights. Please let our Senior Living Consultant know if you would like information about these services.
What is the policy for pets at Montabaur Heights?
We understand that pets are considered part of your family and can be essential for your emotional well-being. Montabaur Heights has dedicated apartments in the building for small dogs (under 25 pounds) and other pets. A one-time non-refundable pet fee of $250 per unit is required and a nominal fee of $25/month will be added to your monthly rent.