The Connecticut Assisted Living Association
The Connecticut Assisted Living Association (CALA) is pleased to offer this guide for consumers highlighting Assisted Living as a senior housing and supportive service option for older adults in Connecticut.
CALA, a statewide membership association comprised of Assisted Living providers, serves as a resource to the public, state and local officials, and the media. This consumer guide is intended to be a means for disclosure about topics such as what Assisted Living is, how it differs from a nursing home, and the requirements for residency.
Your Questions Answered
Are you or a loved one considering a move to a senior living community? Here are some of the more frequently and rarely asked questions by residents and answers for your consideration.
Frequently Asked Questions
What is the difference between assisted living and nursing home care?
Assisted living, often called a social model, supports less intensive care needs, while a nursing home, often called a medical model, supports more intensive care needs. Most nursing homes also provide short-term skilled rehabilitation, in addition to a long-term care living option.
Assisted living communities are typically licensed to provide non-skilled nursing, and other support services to residents whose medical conditions are chronic and stable. In Connecticut, Managed Residential Communities, or, MRC, are allowed to provide nursing oversight, medication management, and personal care assistance to residents through an affiliate Assisted Living Service Agency. As a resident’s care needs increase, outside agencies such as home care, physical, occupational therapy or hospice agencies, which hold licenses to deliver medical services, are frequently brought into the community to provide the more intensive skilled care. Residents living in an MRC must be capable of participating in or at least partially directing the maintenance of their basic daily activity needs because their living unit is a private domain, the staff being merely invited guests.
In contrast, a nursing home as a long-term care living option is a custodial setting, meaning that the room to which you are assigned is not your private domain, and staff may intrude at any time. Nursing homes are permitted to provide extensive skilled nursing, under the medical supervision of a practicing physician, and nursing homes are equipped to perform near constant monitoring of residents. Any resident or prospective resident of a Managed Residential Community who needs near constant medical oversight, and extensive personal care assistance due to significant physical or cognitive impairment or medical conditions that are unstable, would likely be more appropriate to be admitted into a nursing home.
Colebrook Village offers a continuum of community-based senior living. We do all we can to help our residents to remain independent as long as possible.
What is the distinction between independent living, assisted living, and memory care living?
In Connecticut, a senior living community which seeks to be able to provide services such as prepared meals, transportation or group social activities, must meet the criteria as a “Managed Residential Community”. All residents who reside within an MRC are considered independent to the extent that they must be capable of participating in or at least partially directing the maintenance of their basic daily activity needs because their living unit is a private domain. This rule is altered somewhat for memory care residents in light of the significant cognitive support those residents receive, but even residents of the memory care units must be able to participate in their activities of daily living.
An MRC offers private apartments and select common area amenities to mainly seniors who have a range of needs from being fully independent and not in need of personal care assistance, but desirous to reduce those instruments of daily living like cooking, cleaning and home maintenance, to somewhat independent seniors who live independently but are in need of personal care assistance with daily living activities such as with grooming or bathing. Memory care is characterized as specialty care reserved to those who have significant memory loss. Residents who reside within a memory support unit may depend on staff to help them with decision making but must otherwise be able to participate in or at least partially direct their daily living activities.
What is the cost of assisted living and will Medicaid fund it?
At Colebrook Village, residents pay for assisted living services as additional costs to the base residency fees they incur for renting an apartment and receiving other core services. The costs of assisted living care vary depending on the extent of care needed except that for the most part, the cost of care provided in the Egis neighborhood is all-inclusive. Medicaid is insurance for persons who are very low income, and although the state does provide some reimbursements to senior living communities which accept Medicaid, Colebrook Village is a private–pay model which does not receive any form of government assistance. The VA offers a benefit but it goes directly to the resident who can use it to augment the costs of their stay.
Does Medicare cover any portion of my long-term care?
Medicare is insurance for seniors or some disabled citizens, which traditionally covered only acute injury or illness which is an injury or illness that was unexpected. Medicare does not cover expenses which are characterized as long-term care which is medical care to treat the impacts of an ongoing chronic illness. Medicare will provide coverage for certain items of chronic care or preventive care delivered by your primary care physician or allied health care provider; however, many seniors are unaware that Medicare covers preventive and some chronic care services and often do not seek access to such care. Our staff includes Medicare advocates who help residents get needed insurance coverage where coverage is available.
What is going to happen if I must move from assisted living to a nursing home?
Although our staff are well-trained and receive the resources to help our residents remain independent for as long as possible, inevitably there are times when a resident’s care needs become too extensive for our social model of care to handle, even with outside agency help. Our staff works with families to understand illness trajectory and financial means so that if a resident must move into a nursing home, they have the appropriate legal and financial plans in place.
How do I obtain Veteran’s Affairs’ benefits to help pay for senior living?
A veteran or a spouse of a veteran may receive a tax-free stipend from the Veteran’s Administration to augment the costs of long-term care including home care and assisted living expenses under certain circumstances. There are separate tests for financial eligibility and health status eligibility which are soon to mirror the eligibility thresholds used by Medicaid. Our staff works closely with agents approved by the Veteran’s Administration and local elder care lawyers to seek and receive up to $2,000 in monthly Aid and Attendance benefits for our residents.
Rarely Asked Questions
What is an elimination period under long-term care insurance coverage, and what if I have difficulty paying it?
Long-term care insurance has a form of deductible called an elimination period. Coverage under long-term care insurance begins as specified in the policy after an assessment reveals the need for assistance with activities of daily living, and most policies require you to pay the first 90 days, and in some cases 120 days, out-of-pocket as your deductible. Our staff works with insurance professionals and our residents to create a plan to reduce the overall financial burden during that initial elimination period.
If I want to access savings accumulated in an individual retirement fund to pay the cost of assisted living, will I incur taxes and penalties?
Many older adults have a primary savings individual retirement account such as an IRA or 401k which accumulated pre-tax. Ordinarily, upon liquidation of a tax-deferred retirement plan, income taxes and early withdrawal penalties are owed to the IRS except in certain instances where a resident can receive a tax deduction when the retirement funds accessed are used to pay for long-term care, including some or all of the costs of assisted living care. Our staff works with some of the finest elder care attorneys in the area who work with seniors to ensure that they receive the maximum tax deductions when cashing in retirement funds to finance a stay at our community.
If I want to cash in life insurance to help pay for assisted living care, is cashing in my policy the best option?
There are several ways to access whole life insurance policies, and in certain circumstances, a “life settlement” is the best approach. With a life settlement, a company will actually purchase your policy at a discount, but for older adults, the amount you receive, although discounted on your remaining life expectancy, is usually of significantly higher value than simply receiving the stated cash-value upon liquidation. Our staff works with financial planners who deal with life settlements, a method of selling as opposed to cashing-in a life insurance policy.
What if my son or daughter is willing to assist my financial obligations at a senior living community, can he/she deduct any of my residency fees on his/her taxes?
Some residents may need help to pay for monthly fees at our retirement community. In certain circumstances, a family member can contribute to the monthly fees at an assisted living or memory care support neighborhood and receive a tax deduction. Our staff works with area legal professionals who can help advise our residents as to any favorable tax deductions available if a son or daughter wants to help their parent pay for long-term care expenses.
Can I use proceeds from a reverse mortgage to finance a stay in a senior living community?
If you had previously taken a reverse mortgage against the equity in your home, you could use proceeds from your line-of-credit to fund your stay within a senior living community, but care must be taken so you do not trigger a mortgage default. If you are contemplating taking out a reverse mortgage to finance a stay in a senior living community while you place your home on the market, this option may prove to be more expensive than using other more traditional means. Our staff works with area professionals to ensure that our resident is making an appropriate choice to use financing as a means to augment the fees of an assisted living stay.
What if I need to sell my home to augment the costs of senior living but will incur a capital gains tax, what can I do to avoid a tax?
Many prospective residents are faced with a difficult decision of needing to sell a home to help with assisted living costs but will incur hefty capital gains taxes if they do. Our staff works with area professionals who can give you tax advice on how to avoid a capital gains tax while tapping into home equity to help pay for the costs of an assisted living community.