Key Services – Residential Care

Some Residential Considerations

RESIDENTIAL CARE FACILITIES

For persons whose care needs cannot be met in a private home, there are several kinds of residential care facilities. Talk to your physician about which facility is appropriate for your situation.

Assisted Living Facilities is “…a facility consisting of a building complex offering dwelling units to individuals and services to allow residents to maintain an independent assisted living lifestyle. The environment of an assisted living facility shall include one in which meals are provided, staff are available on a 24-hour basis and services are based on the individuals needs of each resident. Each resident, family member, and significant others shall work together with the facility staff to assess what is needed to support the resident so that the resident can achieve his or her greatest capacity for living independently. The facility shall be designed to maximize the independence and self-esteem of limited mobility persons who feel that they are no longer able to live on their own.” Chapter 90, section 321-15.1

Such facilities may provide some or all of the following services: 1) Three meals a day served in common dining room; 2) Housekeeping services; 3) Transportation; 4) Assistance with activities of daily living – eating, bathing, dressing, toileting, etc.; 5) Access to health and medical services; 6) 24-hour security and staff availability; 7) Emergency call systems for each resident’s unit; 8) Health promotion and exercise programs; 9) Medication management; 10) Personal laundry service and/or; 11) Social and recreational activities.

Using a checklist may help you select the right facility for you: assistive living facility checklist.

Adult Residential Care Home is “…any facility providing 24-hour living accommodations, for a fee, to adults unrelated to the family, who require at least minimal assistance in the activities of daily living, but who do not need the services of an intermeidate care facility. It does not include facilities operted by the federal government. There shall be two types of adult residential care homes: 1) Type I home for 5 or less residents; and 2) Type II home for six or more residents.” Title 11, Chapter 100

Extended Care Adult Residential Care Home “means a category of an adult residenital care home qualifed to serve nursing facility level residents. There shall be two types of extended care ARCHs: 1) Type I home shall consist of five or less residents with no more than two nursing facility level residents; and 2) Type II home shall consist of six or more residents with no more than 10% of the home’s licensing capacity as nursing facility level residents.” Title 11, Chapter 101.

Intermediate Care Facility is “…a facility which provides appropriate care to persons referred by a physician. Such persons are those who: 1) need 24-hour a day assistance with the normal activities of daily living; 2) need care provided by licensed nursing personnel and paramedical personnel on a regular, long-term basis, and; 3) do not need skilled nursing or paramedical care 24-hours a day.” Title 11, Chapter 94

Skilled Nursing Facility is “…a health facility which provides skilled nursing and related services to patients whose primary need is for 24-hours of skilled nursing care on an extended basis and regular rehabilitation services.” Title 11, Chapter 94

RESIDENTIAL CARE

Nursing Facility Care is for individuals who are chronically ill or who are recovering from an acute illness requiring extended care but not hospitalization. Services provided include room and board, a range of medical services as needed, skilled nursing and personal care services. Using a checklist may help you select the right facility for you: nursing facility checklist.

Custodial Care is for people who require room and board plus assistance with personal care. This type of care is offered in Personal Care Homes and Domiciliary Care Homes. Personal Care Homes which are facilities for independent adults who require minimum supervision. They might be supported through Supplemental Security Income (SSI). Using a checklist may help you select the right facility for you: board and care checklist or maybe supported housing checklist.

OUR NEUROTRAUMA WEBSITE ALSO PROVIDES A LISTING OF RESIDENTIAL OPTIONS:

Some additional questions you may want to consider:

  • Ask your physician what level of care is most appropriate to the needs of the individual with the disability.
  • What can you and/or family members afford (private payment, long-term insurance, etc.).
  • Is the facility located close to family members and/or friends?
  • Is the facility licensed? How frequently monitored and by whom?
  • What choices, services and activities are offered to patients? How regimented versus individualized are the lifestyles of the patients? Is community access for the patient an issue?
  • What is the condition of the facility? Clean? Quiet? Are current state-of-the-art equipment being used? Are they well supplied?
  • What are the other patients like? Any observations of bedsores, dehydration or being underweight? Neglect, abuse or exploitation? Any challenging behaviors? Any thefts?
  • Is privacy being respected? Is there sufficient closet space and drawer space available and secured from theft?
  • Are staff trained, certified, licensed? Are the staff trustworthy and truly caring of their patients. Do staff spend the time to listen to the concerns of their patients and act on them appropriately?

MEDICARE-CERTIFIED HOME HEALTH AGENCIES

These agencies are certified to provide services to Medicare beneficiaries and required to provide part-time, intermittent skilled nursing services with at least one other therapeutic service (occupational, physical and speech therapy), or medical social services. Medicare-certified home health agencies are licensed by the State of Hawaii to provide skilled care in the home. These organizations also provide services to Medicaid recipients or those with other types of insurance. When visiting or asking questions about such agencies, the home health care (certified) checklist may help you in your selection.

Home Health Agency is “…a public or proprietary agency, a private non-profit organization, or a subdivision of such agency or organization which is primarily engaged in providing direct or indirect skilled nursing services and other therapeutic services under a physician’s direction to homebound patients on a part-time or intermittent basis (in a placed used as the individual’s home).” Title 11, Chapter 97.

PRIVATE DUTY HOME CARE AGENCIES

Private duty home care services range from personal care assistants to specialized nursing technologies on a short term or long term basis. Private duty services are requested by the individual and the individual assumes responsibility for payment of the services. Medicare does not reimburse these services. When visiting or asking questions about such agencies, the home care services checklist may help you in your selection.

Home Health Agency is “…a public or proprietary agency, a private non-profit organization, or a subdivision of such agency or organization which is primarily engaged in providing direct or indirect skilled nursing services and other therapeutic services under a physician’s direction to homebound patients on a part-time or intermittent basis (in a placed used as the individual’s home).” Title 11, Chapter 97.

SHARED HOUSING

Shared housing is a group living arrangement for two or more people. Ideally, this housing arrangement would serve both the individual with neurotrauma injuries who may need significant support services as well as shelter, and basically independent persons who wish to live with others for financial, social or interdependency reasons. Title 15, Chapter184.

HOMELESS SHELTERS

Homeless shelters may offer those without shelter and food a short-term or longer term stay depending on the management policies and availability of funding. Many charitable organizations start up a homeless shelter and soup kitchen to serve those who are less fortunate. For a statewide listing, click on shelters .

IN-HOME SUPPORTS

Home support services are available to help with various household tasks such as cleaning, shopping, minor home maintenance and running errands. Use a checklist to help you select the right provider for you: home care services checklist.

Personal care services involve the use of attendants trained to assist disabled persons with key activities of daily living such as eating, dressing and personal hygiene. Personal care services are not available in Hawaii’s State Medicaid program.

For a listing providers in your community, check our neurotrauma website:

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