OFA FAQs

What is an Adult Care Home?

An Adult Care Home provides a room and meals, housekeeping, laundry, medication assistance and personal supervision. These services may be appropriate for adults who do not want to live alone or who cannot safely live alone.

Residents who are not living in a Special Needs Unit are generally free to go into the community. Many Adult Care Homes offer transportation for medical appointments and recreation.

Residents generally must be able to walk independently or with a cane or walker. Assistance may be available with bathing, grooming, dressing, medication and managing money. Adult Care Homes may be able to serve people who are sometimes confused, but generally cannot manage a person who wanders. Dementia or Special Needs Units provide more specialized care.

How do Adult Care Homes differ from Nursing Homes?

Adult Care Homes generally provide a lower level of care and may cost less than nursing homes. Nursing home residents typically need more extensive medical care or assistance with daily activities.

What do Adult Care Homes offer?

Adult Care Homes generally provide a bed, dresser, chair, wastebasket and closet space. Shared and private rooms may be available. Some facilities allow residents to bring furniture, a television, stereo, easy chair, pictures and other personal items.

Are Medicaid or Supplemental Security Income (SSI) accepted to pay for Adult Care Homes?

Adult Care Homes accept private payment. Some may also accept Medicaid or Supplemental Security Income (SSI). Payment options depend on the facility and the individual's financial situation. Check directly with the provider to determine available payment options.

What is the Consumer Directed Program?

The Consumer Directed Program provides services to people with chronic illness or physical disabilities who have a medical need for assistance with activities of daily living (ADLs) or skilled nursing services.

Participants have flexibility in choosing their caregivers. The consumer, or a person acting on the consumer's behalf, assumes responsibility for hiring, training, supervising and, when necessary, terminating the people who provide services.

Are there programs to help family caregivers balance caregiving with other responsibilities?

Yes. The Genesee County Office for the Aging offers a Family Caregiver Support Program that provides information, counseling, support groups and other caregiver services.

Counseling may also be available through HomeCare and Hospice, Horizon Health Services: Batavia Recovery Center, UConnectCare Behavioral Health Services, formerly GCASA, and the Genesee County Mental Health Department.

What services are supported by the Rochester Area Community Foundation's Muriel H. Marshall Fund for the Aging?

Friendly Visiting Program: Provides weekly visits for older adults who have difficulty leaving their homes. Visits offer companionship and social connection.

Transportation Coordination: The Genesee County Office for the Aging helps older adults locate transportation for medical appointments, shopping, personal business and social needs.

Community Action Transportation Services: Provides transportation for rural residents and older adults who require additional assistance during transportation, primarily for medical appointments and shopping. Contact the Office for the Aging's Transportation Coordinator to determine eligibility.

Library Visits: Provides library materials and services to people who are temporarily or permanently unable to visit a library. Residents of senior housing may also receive materials through group loans. Richmond Memorial Library in Batavia provides resources throughout Genesee County with assistance from volunteers.

Handyman Program: Offered through PathStone Corporation for small home repairs focused on safety and accessibility. Intake is completed through the Genesee County Office for the Aging. Labor is provided at no charge, although some material costs may apply.

These ask marshall programs are available to Genesee County residents age 60 and older regardless of household income. For information, call (585) 815-7979 or email askmarshall@co.genesee.ny.us.

Who can receive Home Delivered Meals?

To be eligible for Home Delivered Meals, a person generally must:

• be age 60 or older;
• be homebound or limited because of an accident or illness;
• lack adequate support from family, friends or neighbors; and
• be unable to prepare meals because of circumstances such as inadequate cooking or refrigeration facilities, inability to shop or cook safely, or lack of necessary knowledge or skills.

Where can I find medical equipment loans or help with small accessibility modifications?

Independent Living of the Genesee Region can provide information about medical equipment loans, including canes, walkers, wheelchairs and commodes.

The Handyman Program may also be able to make small home modifications to improve accessibility and safety, including installation of grab bars and railings.

Where can I find a Personal Emergency Response System (PERS)?

A Personal Emergency Response System (PERS) is a device, often worn as a bracelet or necklace, that can be used to call for help after a fall or other emergency. These systems are available from a variety of providers, and funding assistance may be available in some circumstances.

Where can someone seek help for depression, grief or other emotional concerns?

The original guidance recommends discussing concerns with a physician to help determine whether a physical condition may be contributing to symptoms.

Counseling services may be available through Horizon Health Services: Batavia Recovery Center, UConnectCare Behavioral Health Services, formerly GCASA, the Genesee County Mental Health Department, HomeCare and Hospice, the Veterans' Administration of Western New York Healthcare System, and private counselors or psychiatrists.

How does a Certified Home Health Care Agency (CHHA) differ from a Licensed Home Care Agency?

A Certified Home Health Care Agency (CHHA) serves homebound patients who have a skilled medical need. Services may include nursing, physical therapy, speech therapy, patient education, intravenous therapy and wound care.

The source information states that CHHAs generally do not provide custodial care or housekeeping as the only service. It identifies the Genesee County Health Department and Visiting Nurses Association of Western New York as CHHAs and states that Medicare and private health insurance may be accepted.

A Licensed Home Care Agency provides supervised assistance with activities of daily living and may also provide nursing, therapies and other skilled services when authorized by the insurer. Services may include:

• home health aide services, such as monitoring vital signs;
• personal care assistance with hygiene and mobility; and
• housekeeping, cooking, shopping and laundry.

Payment may include Medicare, private health insurance, private payment or other funding sources depending on the agency and service.

Where and for how long can home care be provided?

Home care may be provided in a house or apartment. Services can range from a short visit to extended daily care depending on the person's needs, staff availability and available funding.

Can someone who lives alone receive home care if family members live far away?

Yes. Home care agencies regularly work with families who live outside the area and can help arrange in-home aide services for older adults or people with disabilities.

What does a Medicare-certified hospice program offer?

Hospice focuses on quality of life and provides specialized care and emotional support for people and families coping with serious illness. Care may be provided at home, in a nursing home, in a hospital or in another appropriate setting.

Services may include:

• pain and symptom management;
• skilled nursing;
• home health aide services;
• medical equipment and supplies;
• emotional support;
• grief counseling;
• trained volunteers; and
• respite support for caregivers.

The source information identifies HomeCare and Hospice as the agency providing these services in Genesee County and states that registered nurse assistance is available 24 hours a day.

How is hospice care paid for?

Hospice costs may be covered by Medicare, Medicaid or private insurance. Community support may also help with expenses that are not covered by another funding source.

What services does Crossroads House provide?

Crossroads House is a comfort care home that can provide an alternative to a hospital or nursing home for people nearing the end of life. Care focuses on physical, emotional, spiritual and social needs.

The source states that residents must be medically determined to be within the last three months of life and must be under the care of a certified home health care agency or hospice for medical case management.

Experienced end-of-life caregivers and trained volunteers provide around-the-clock support. Lodging and support may also be available to family members.

How much does Crossroads House cost?

The source states that Crossroads House services are provided free of charge and are supported by volunteers and the community.

Independent Senior Housing

What types of services or amenities may be offered?

Depending on the housing provider, amenities may include housekeeping, cooking, medical transportation, 24-hour security, beauty salon services, library access, grocery and prescription delivery, social activities and entertainment.

Does independent senior housing provide help with bathing, dressing or medication reminders?

The source states that these housing providers do not directly provide those services, although residents may arrange private-pay aide services.

Are there independent senior housing options in Genesee County?

The source identifies the Greens of LeRoy, Victorian Manor and Havenwood. Havenwood is also described as having a service coordinator on site.

Why does hospital discharge planning begin before a patient is ready to leave?

Discharge planning begins early so patients and families have time to arrange a safe place and appropriate services before the patient leaves the hospital.

Some people return home without assistance, while others need temporary family support, home care or more extensive services. A discharge planner or case manager can help identify and arrange appropriate care before discharge.

What services are available for people who need inpatient rehabilitation after an illness or injury?

Depending on a patient's needs, inpatient rehabilitation may include medical, nursing, social work, dietary and rehabilitative services. Staff may also help arrange equipment and other services needed when the patient returns home.

Are rehabilitation facilities available in Genesee County?

The source identifies the following facilities or systems as offering rehabilitation services:

• Batavia Nursing Home;
• LeRoy Village Green Residential Health Care Facility;
• Premier Nursing Home;
• New York State Veterans' Home at Batavia; and
• Veterans' Administration of Western New York Healthcare System.

What is respite care?

Respite care is short-term care that gives a family caregiver a temporary break from caregiving responsibilities. An older adult or person with a disability receives care while the caregiver takes time away from those duties.

Where is respite care provided?

The source lists the following options.

In-Home Respite Care

• HomeCare and Hospice
• Genesee County Office for the Aging
• VA Western New York Healthcare System
• Willcare
• Tender Loving Care

Community-Based Respite Care

• Genesee County Office for the Aging

Residential Respite Care

• Eldercare
• VA Western New York Healthcare System
• Local nursing homes

HomeCare and Hospice may provide respite through hospice services. The amount and length of care vary based on individual needs, provider availability and funding.

Because arranging respite care may require applications and other paperwork, families are encouraged to begin planning before care is urgently needed.

What services do skilled nursing care facilities provide?

Skilled nursing facilities may provide medical, nursing, social work, dietary and rehabilitation services, along with social and recreational activities.

The source identifies:

• Batavia Nursing Home;
• LeRoy Village Green Residential Health Care Facility;
• Premier Nursing Home;
• New York State Veterans' Home at Batavia; and
• VA Western New York Healthcare System.

What does skilled nursing home care cost?

The source estimates a cost of approximately $12,000 per month.

Who pays for skilled nursing home care?

Payment depends on a person's insurance coverage, financial situation, veteran status and medical condition. Residents and families should discuss coverage and payment options directly with the provider.

Will Medicare pay for up to 100 days in a skilled nursing facility?

The source states that Medicare coverage may be available for qualifying skilled nursing facility care and describes requirements involving a prior hospital stay, continued eligibility, coinsurance and pre-certification.

If I move into a nursing home, do I have to sell my house or spend all of my savings?

The source explains that Medicaid eligibility depends on income and resource requirements and references protections for a spouse under federal spousal impoverishment rules.

For information about current income and resource requirements, contact the Genesee County Office for the Aging or Genesee County Department of Social Services. The Office for the Aging also has a Legal Services program that can help older adults understand their individual financial circumstances.

Patient Review Instrument (PRI)

What is a PRI?

A Patient Review Instrument (PRI) is an assessment used to better understand a person's medical and care needs. Nursing homes and some adult homes or assisted living facilities may use PRI information when determining whether they can meet a person's needs.

A PRI may be completed when someone is preparing to leave a hospital, skilled nursing facility or rehabilitation center. Agencies may also be able to arrange a PRI for someone living at home.

Is a doctor required before moving into a nursing home?

The source states that a doctor must complete medical forms documenting the person's current conditions and medical history. Depending on the nursing home, residents may be able to continue seeing their existing physician or use a physician associated with the facility.

What should I look for when choosing a care facility?

The New York State Department of Health surveys and monitors nursing homes and certain other facilities. The source states that facilities receive survey reports and that results are also available through the Department of Health.

Where can I learn what different housing and care terms mean?

The source directs residents to a "Housing Definitions" section for definitions of different housing and care levels.

What services are available to veterans?

Available services depend on the individual's circumstances and veteran status. The source recommends contacting:

• Veterans' Administration of Western New York Healthcare System;
• New York State Veterans' Home at Batavia; and
• Genesee County Veterans' Services Agency.

What services are available through the Veterans' Administration of Western New York Healthcare System?

The source lists nursing home care, dementia care, homemaker and home health aide services, adult day care, hospital-based primary care, community nursing home care, respite care and hospice services.

It also states that shuttle transportation is available between the Batavia VA and Buffalo VA for eligible veterans.

What is Veterans' Administration respite care?

The source describes short-term care for veterans that gives family caregivers planned relief from caregiving duties and states that up to one month may be available per fiscal year.

What are the admission criteria for the New York State Veterans' Home at Batavia?

The source states that an applicant must need skilled nursing care and that the Veterans' Home is certified for Medicare and Medicaid. It also lists the following criteria:

• entered active duty from New York State or was a New York State resident for one year before admission;
• was discharged under honorable conditions and served at least 30 days on active duty, with preference given to wartime veterans;
• if applying with a spouse, was married for 10 years before application; or
• is a widow, widower or parent of an eligible veteran.

Does the New York State Veterans' Home at Batavia offer rehabilitation services?

Yes. The source states that residents are assessed at admission and that medical, social work, dietary and rehabilitation staff evaluate needs and help arrange equipment and services necessary for a return to the community when appropriate.

Do veterans have to enroll to receive Veterans' Administration health care?

The source states that most veterans must enroll but describes certain exceptions, including:

• care solely for a VA-rated service-connected condition;
• a VA service-connected disability rating of 50% or more; and
• certain recently discharged veterans with disabilities determined by the military to have been incurred or aggravated in the line of duty.

What is a Veterans' Administration service-connected rating?

A service-connected rating is an official determination by the Veterans' Administration that an illness or condition is related to active military service. The source states that these ratings are established by Veterans' Administration Regional Offices.

How is it determined whether care is provided in a VA facility or private nursing home?

The source explains that placement and payment depend on eligibility for VA nursing home care and individual medical or social circumstances. It describes possible care in a VA facility, a contracted private facility or a community nursing home.

The source also states that temporary community nursing home care may sometimes be arranged following an episode of VA care while longer-term arrangements are developed.

What help is available if someone does not qualify for long-term care at VA expense?

Veterans' Administration social workers may help families identify funding sources, determine whether Medicare or Medicaid may apply, locate other services and apply for other veterans' benefit programs.

What is TRICARE?

TRICARE is the Department of Defense health care program for eligible active-duty and retired members of the uniformed services, their families and survivors.

NY Connects Genesee Care Options can help residents understand their needs and identify providers and services that may be appropriate.