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Ombudsman/
Long Term Care

What is Ombudsman?

Ombudsman is a Swedish word that means “citizen representative”.

In South Carolina, an Ombudsman provides advocacy and assistance to the residents in long-term care facilities.

Your help will be needed.

Your opinion and feedback will be requested in various ways and times. Caregiver participation helps us achieve our goals and create a program that will best serve caregivers and their families in the Catawba Region and throughout the State of South Carolina.

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How does the Long-Term Care Ombudsman Program work for me?

Residents of long term care facilities can experience problems or miscommunications related to their quality of care. Many of these individuals are elderly or frail. They may feel alone, and not seek help or not be aware that there is assistance available to them.

 

But there is help. The Ombudsman Program offers a way for residents and their families, as well as others, to voice their concerns and have their complaints addressed.

Concerns addressed by the Ombudsman may include issues of nutrition, care planning, resident's rights, privacy and confidentiality, visitation rights, or issues related to discharge and transfers.

Ombudsman services are free. 

The LTC Ombudsman Program is governed by the Older American’s Act and by South Carolina law. The SC Department on Aging administers the statewide LTC Ombudsman Program through regional offices located throughout the state. These programs are affiliated with Area Agencies on Aging (AAA) and funded with federal and state dollars.

Help starts with a call.

Contact Catawba Area Agency on Aging by calling
803-329-9670 or toll-free 1-800-662-8330.

What is the difference between an assisted living facility, a skilled nursing facility, and a continuing care retirement community?

Assisted Living Facilities (ALF)

 

Assisted Living Facilities (ALF) is appropriate for those individuals who cannot live on their own but do not require the skilled care of a Nursing Home. 

 

Assisted Living Facilities can vary in size, appearance, and the types of services they offer. For example, an assisted living facility could be a residential home with just a few people or a high-rise, apartment-style building with more than 200 residents. Living arrangements could consist of a single room or a full apartment.

Most assisted living facilities provide:

  • housing

  • meals

  • personal care

  • support services

  • social activities

  • some supervision

  • health care services in some

Usual services include:

  • prepared meals in a common dining area

  • housekeeping

  • bathing

  • toileting

  • dressing

  • grooming

The extent of services/additional charges varies by facility. The goal of Assisted Living is aimed at helping residents be as independent as possible while providing assistance when necessary. Assisted Living facilities are not required to have a nurse on staff, although some do.

Continuing Care Retirement Communities (CCRC)

 

CCRC’s are communities that provide a continuum of care, at one location, consisting of different levels of care including: Independent Living, Assisted Living and Skilled Level of Care. 

Nursing Home Facilities (SNF)

 

Nursing Homes or Skilled Nursing Facilities (SNF) offer skilled Care for Residents. Residents of a nursing home need more attentive care, which include the skills of a Registered Nurse (RN). The resident's physician must determine that skilled care is needed, and the resident must qualify for Medicaid before Medicaid will cover the cost of the nursing home.

What are my payment options for long term care?

Medicare Assistance
Medicare assistance only applies after a three-day hospital stay. Medicare will pay for the first 20 days in a nursing facility 100% and days 21-100 Medicare will pay all but the daily co-pay that the patient is responsible for. This co-pay usually changes every year. Daily co-pay as of 2019 is $135.50 daily. Medicare does NOT pay for anything after the 100 days in the nursing facility. Medicare does not pay for assisted living.

 

Private Insurance
Private insurance is often referred to as long-term care insurance. It is similar to life insurance in that you purchase it before you need the nursing facility and pay for it on a monthly basis. Then, if needed, it pays for the Nursing Facility costs.

  

Medicaid
Medicaid will pay for a skilled nursing facility if the resident meets the physical and financial requirements.

 

Private Pay
Private Pay simply means that you pay for all expenses out of your own pocket.

  

Optional State Supplement (OSS)
OSS will pay for an assisted living facility if the resident meets the financial requirements.

Do you qualify for Optional State Supplement (OSS)?

Optional State Supplement (OSS) is for the aged, blind or disable individuals who have countable resources less than $2,000.00, a monthly income less than $1,456 (single individual 2019 amount) and reside in domiciliary care facilities, also referred to as Assisted Living.

 

To apply for OSS call or visit your local Department of Social Services or apply online at:

 

The recipient must reside in an Assisted Living Facility that
ACCEPTS OSS for payment.

Your help will be needed.

Your opinion and feedback will be requested in various ways and times. Participation helps us achieve our goals and create a program that will best serve seniors and their families in the Catawba Region and throughout the State of South Carolina.