Long-Term Care

Introduction

This brochure provides information about long-term care providers who offer healthcare and other types of support in the home or in a residential facility.  The services they offer might be needed temporarily, like during recovery after a hospital stay, or a person may need ongoing care and support.

The type and level of care needed will determine which long-term care provider can best serve you or your loved one.

Topics in this Brochure Include

Adult Day Care Centers

Adult Family Care Homes

Assisted Living Facilities

Continuing Care Retirement Communities

Home Health Agencies

Homemaker and Companions

Hospice Providers

Nurse Registries

Nursing Homes

Choosing a Long-Term Care Provider

Financial Resources

Important Phone Numbers

Adult Day Care Centers

Adult Day Care Centers provide programs and services for adults who need a protective setting during the day.  Participants live in their own homes, which can be a private home, assisted living facility, adult family care home, or another type of group home, and come to the day care center during certain hours of the day.

An adult day care center can be a freestanding program or services can be offered through a nursing home, assisted living facility, or hospital. 

The basic services include, but are not limited to:

• Leisure and social activities
• Self-care training
• Nutritional meals
• A place to rest
• Respite care (temporary supervision of an adult, giving relief to the primary caregiver)

A center might offer additional services such as health assessments; counseling; speech, physical and occupational therapy; modified diets; transportation; and referrals for follow-up services.  If you need these types of services, ask the adult day care center if they are provided.

Adult Family Care Homes

Adult family care homes provide full-time, family-type living in a private home for up to five elderly persons or adults with a disability, who are not related to the owner.  The resident may have their own room or may share with another person.  The owner lives in the same house as the residents. 

The basic services include, but are not limited to:

• Housing and nutritional meals
• Personal care (help with bathing, dressing, eating, walking, physical transfer)
• Give medications (by a nurse employed at the home or arranged by contract) or help residents give themselves medications
• Supervise residents
• Arrange for health care services
• Provide or arrange for transportation to health care services
• Health monitoring
• Social and leisure activities

A resident can also contract with a licensed home health care provider for nursing and other health care services, as long as the resident continues to meet the requirements to reside in an adult family care home.

Assisted Living Facilities

Assisted living facilities provide full-time residential living in the least restrictive and most home-like setting.  Facilities can range in size from one resident to several hundred and can include individual apartments or rooms that a resident has alone or shares with another person.

The basic services include, but are not limited to:

• Housing, nutritional meals, and special diets
• Personal care (help with bathing, dressing, eating, walking, physical transfer)
• Give medications (by a nurse employed at the facility or arranged by contract) or help residents give themselves medications
• Supervise residents
• Arrange for health care services
• Provide or arrange for transportation to health care services
• Health monitoring
• Respite care
• Social and leisure activities

An assisted living facility may employ or contract with a nurse to take vital signs (blood pressure, pulse, respiration, and temperature), manage pill organizers and give medications, give prepackaged enemas from a doctor’s order, and keep nursing progress notes. 

A resident can also contract with a licensed home health care provider for nursing and other health care services, as long as the resident continues to meet the requirements to reside in an assisted living facility.

Along with a standard license, an assisted living facility might have one or more of the following special licenses: Extended Congregate Care, Limited Nursing Services, or Limited Mental Health. More information on these special licenses can be found in the brochure Assisted Living in Florida.

Continuing Care Retirement Communities

Continuing care retirement communities offer different levels of care, allowing residents to move from one level to another, as their needs change.  The community can include independent living apartments or houses, as well as an assisted living facility and/or a nursing home.

You can read more information on assisted living facilities and nursing homes in those sections of this brochure. The Florida Department of Financial Services (DFS) monitors continuing care retirement communities related to financial matters. You can find a list of these communities on their website MyFloridaCFO.com or call the DFS toll-free number (800) 342-2762.

Home Health Agencies

Home health agencies provide health care services in a private home, assisted living facility, or adult family care home. Services may include:

• Nursing visits
• Give medications or help the patient give themselves medications
• Physical, occupational, respiratory, and speech therapy
• Home health aide services – help with personal care (bathing, dressing, eating, walking, physical transfer)
• Homemaker / companion services – companionship, housekeeping, shopping, help with meal preparation, trips outside the home
• Nutritional guidance
• Medical social services
• Medical equipment and supplies

Homemakers and Companions

Homemaker and companion companies provide services in the home.  These services can be offered by a homemaker/companion company, or by a home health agency, nurse registry, or hospice.  Services may include:

• Companionship
• Housekeeping
• Shopping and help with meal preparation
• Trips outside the home

Hospice Providers

Hospices provide services in a private home, assisted living facility, adult family care home, hospital, or hospice facility for patients who are terminally ill.  The staff is specially trained to help the patient and family members who are dealing with death and dying.  Services may include:

• Nursing, physician, social work, and pastoral services
• Bereavement counseling (dealing with the grief of death and dying) for the patient and family
• Physical, occupational, speech, and massage therapy
• Home health aide and homemaker/companion services (as described in the Home Health Agency section of this brochure)
• Nutritional counseling
• Home medical equipment and supplies
• Respite care

Nurse Registries

Nurse registries arrange private contracts for nurses, certified nursing assistants, home health aides, and homemakers/companions to provide services to patients in a private home, assisted living facility, or adult family care home.

Nursing Homes

Nursing homes are residential facilities where a person lives or where a person can stay temporarily.  A temporary stay may be for respite care or recuperation after being in a hospital.  Services include:

• Nursing care 24-hours a day
• Case management and health monitoring
• Personal care (help with bathing, dressing, eating, walking, or physical transfer)
• Nutritional meals and special diets
• Physical, occupational, and speech therapy
• Social activities
• Respite care

Choosing a Long-Term Care Provider

If you or a loved one needs services from a long-term care provider you may want to compare several providers, to see which one will best serve your needs. The following resources can help in your search:

• You can use Facility Locator on FloridaHealthFinder.gov to find providers in your area. After you have a provider or list of providers, click on a provider name to find the address, phone number, and driving directions. The profile page also includes the administrator and owner, a link to inspection reports, and emergency actions and/or legal sanctions (where applicable).
  
  Additional information available on the profile page includes:
  
  • The counties served by home health agencies, homemaker and companions, and hospices
  • Links to comparison tools like the Nursing Home Guide, the hospice satisfaction survey, and federal comparison tools for Medicare certified nursing homes and home health agencies
  • Nursing home information also includes current daily rates, payment forms accepted, and special programs and services
  • Home health agencies will indicate if they are Medicare and/or Medicaid certified
  You can also include most of these particular categories in your search option on the first page of Facility Locator by clicking Advanced Search before clicking the Search button.
• Call the toll-free Elder Care Helpline at (800) 963-5337 for a list of long-term care providers and other elder services.
• The Florida Department of Elder Affairs also has information on adult family care homes and assisted living facilities at FloridaAffordableAssistedLiving.org. The site provides a variety of information, including “Find-a-Facility” where you can look for a facility based on location, cost, services provided, and housing preferences.
• You can find more information and tips in the consumer brochures Home Health Care in Florida, Assisted Living in Florida, and Nursing Home Care in Florida

Questions You May Want to Ask a Long-Term Care Provider

Following are topics you might want to discuss with the provider, along with any other questions you may have.

• Ask for a written description of the cost and services and ask that they be clearly explained.
• Ask what type of payment is accepted. Long-term care services may be paid by private funds or some insurance policies. If the person and the provider are eligible, services might be paid in full or in part by Medicaid, a Medicaid waiver program, Optional State Supplementation (OSS is a cash assistance program to help pay for room and board costs at an assisted living facility or adult family care home), Medicare, or other government programs.
  
  To find out if you might be eligible for help from a government program see the “Financial Resources” section below.
• Nursing homes are required to provide full-time nursing care.  However, other types of long-term care providers may offer only limited nursing services, periodic nursing visits, or no nursing services.  If you or a loved one needs nursing care, ask the provider what kind of nursing services they offer.

Financial Resources

The following resources might be helpful when you or a loved one are ready to choose a long-term care provider and want to research programs that might help pay for some services.

• If you have a long-term care insurance policy, or are considering buying one, find out exactly what it covers, under what conditions you can receive coverage, any restrictions that might apply, and what you need to do when coverage is needed.  The Florida Department of Financial Services regulates insurance in Florida.  For questions or to request their consumer materials, call the toll-free number (800) 342-2762 or view the website MyFloridaCFO.com.
• The CARES Program (Comprehensive Assessment and Review for Long Term Care Services) provides assessment of seniors or persons with disabilities to see what services they need and what programs are available.  To learn more call the Florida Department of Elder Affairs toll-free number (800) 963-5337 or view their website ElderAffairs.state.fl.us/doea/cares.
• The SHINE Program (Serving Health Insurance Needs of Elders) is for seniors and people with disabilities and provides counseling on Medicare, Medicaid, long-term care insurance, prescription assistance programs, and other health insurance issues.  To learn more call the Florida Department of Elder Affairs toll-free number (800) 963-5337 or view their website FloridaShine.org.
• The Florida Department of Children and Families takes applications and determines who is eligible for the Florida Medicaid Program, Medicaid Waiver, and Optional State Supplementation (OSS). Call the toll-free number (866) 762-2237 or view the website DCF.state.fl.us.
  
  Some residents in assisted living facilities and adult family care homes may be eligible for Optional State Supplementation or a Medicaid Waiver program. Some other long-term care providers may participate in the Florida Medicaid Program or Medicaid Waiver. If you are covered by Medicaid, ask the provider if they are eligible to serve Medicaid patients and if the services you need are covered by Medicaid.
• If you have Medicare and you need home health services covered by Medicare, ask the home health agency if they are Medicare certified. Hospices can serve Medicare patients. An ongoing stay in a nursing home is not covered by Medicare. However, under certain limited circumstances Medicare may pay for short-term rehabilitative care in a nursing home. If you have Medicare ask the nursing home if they accept Medicare patients. To learn more about Medicare call the toll-free number (800) 633-4227 or TTY (877) 486-2048, or view the website Medicare.gov.
• The Florida Agency for Persons with Disabilities helps people with developmental disabilities, including supportive living and Medicaid waiver.  View the website apd.MyFlorida.com, which includes a list of area offices, or call the toll-free number (866) 273-2273.
• The Florida Department of Veterans’ Affairs (VA) provides information and services. The VA also operates an assisted living facility, nursing homes, and has contracts with other long-term care facilities. Call them at (727) 319-7400 or view the website FloridaVets.org.
• For people 55 years or older, the National Council on Aging has a website with referrals to government programs that provide help with the cost of medical care and other needs. View the website BenefitsCheckUp.org.

Important Phone Numbers

If you are concerned about the care or treatment you (or a loved one) are receiving from a long-term care provider, you can contact one or more of the following:

Agency for Health Care Administration –  To file a complaint against health care providers listed in this brochure call the toll-free number (888) 419-3456. You can also file a complaint online at AHCA.MyFlorida.com/contact/what_happens.shtml. To file a complaint against a continuing care retirement community, concerning financial matters, call the Florida Department of Financial Services toll-free number (800) 342-2762.

Disability Rights Florida –  To report that a staff member of a health care facility has not made reasonable accommodations to meet your specific needs or has discriminated against you because of a disability, call the toll-free number (800) 342-0823 or view the website DisabilityRightsFlorida.org.

Florida Abuse Hotline –  To report abuse, neglect, or exploitation of children, elderly, or adults with a disability call the toll-free Abuse Hotline at (800) 962-2873 or view the website DCF.state.fl.us/programs/abuse/.

Long-Term Care Ombudsman Council –  Helps residents who live in assisted living facilities, adult family care homes, and nursing homes with their concerns and civil rights.  Call them toll-free at (888) 831-0404 or view the website Ombudsman.MyFlorida.com.

Additional Consumer Brochures Include:

A Patient’s Guide to a Hospital Stay

Assisted Living in Florida

End-of-Life Issues – A Practical Planning Guide

Florida Medicaid - A Reference Guide

Health and Human Services Programs

Health Care Advance Directives

Home Health Care in Florida

Nursing Home Care in Florida

Patient Safety

Understanding Prescription Drug Costs

Note: This brochure is not designed to offer medical or legal advice. Please talk with your doctor for medical advice and an attorney for legal advice.

Information in this brochure is current as of July 2011.

This brochure may be copied for public use.  Please credit the Agency for Health Care Administration for its creation.

If you have comments or suggestions, call (850) 412-3730.