If you’re starting to research assisted living communities for a parent or relative, you’ve no doubt got your hands full evaluating locations, determining your budget, perhaps helping to sell the family home. Wading through a sea of unfamiliar terminology is the last thing you need to add to the picture (what IS a conservator, exactly…?). Well, we’re here to help! Here’s a list of the key terms that are likely to crop up in your decision process:
ACCREDITATION: There are three levels of credentialing in eldercare facilities: licensure, certification, and accreditation. Licensure is a basic requirement for any facility to open, and is awarded once inspection is passed. Although usually pertaining to an individual, organizations may also be certified. The certification, issued by a state or country watchdog arm, usually addresses business licenses, staff background checks, accounting procedures, and insurance coverage. Accreditation is the highest credentialing level, and one that organizations volunteer to be considered for. In addition to meeting certain performance standards, accredited organizations are normally required to demonstrate ethical business practices and positive community involvement. These determinations are made by an outside group that makes multiple visits to the facility, reviewing materials, and interviewing staff, residents, family members, and board members.
AMBULATORY CARE – Ambulatory care is defined as any medical care provided on an outpatient basis, including diagnosis, observation, treatment, and rehabilitation services. So, for example – diagnostic tests like blood work, skin biopsies, or endoscopy; treatments like sutures, vaccinations, or nebulizers; rehabilitation services like working with balance or mobility problems. Many chronic conditions in the elderly can be successfully managed through ambulatory care that does not require hospitalization.
CONSERVATOR – simply put, a conservator is a guardian or protector appointed by a judge to manage the finances and/or healthcare and living arrangements of someone diminished by physical or mental impairment. Conservators are appointed by a court-designated investigator who determines not only their suitability as guardians, but also verifies the specific needs of the conservatee. Ongoing court-supervised evaluations are put in place. And a conservator can be removed upon the approved request of the family, for failure to perform duties, or if the court determines their role is no longer necessary.
DURABLE POWER OF ATTORNEY – a durable power of attorney document designates a proxy to make health care decisions for a patient who is no longer able to do so. This surrogate is directed to function as “attorney-in-fact” and make all determinations with regard to treatment, including the ultimate decision to cease medical intervention. This role includes having full access to medical records; full visitation rights; the ability to fire medical staff administering substandard treatment; and enforcing a patient’s healthcare wishes in court, if necessary.
It’s important to note that if a valid living will is present, the person with durable power of attorney can never contradict the terms of that document. Rather, the proxy’s role is to address situations and decisions not covered in the living will, or to step in should that document be invalidated.
MEDICAID – Medicaid is a government-sponsored health and medical services program for patients with low incomes and few resources. Primary oversight of the program is handled at the federal level, but each state establishes its own eligibility standards; determines the nature, duration, and scope of treatments; establishes the rate of payment, and administers its own Medicaid program.
States do, however, face certain federal mandates in order to receive Medicaid funds. For a full list of mandatory service requirements, click here.
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