HEALTH CARE

Many older and disabled individuals want to stay in their homes or apartments, but need help and skilled nursing care to safely remain at home. A Medicaid Managed Long Term Care Plan (MLTC) can provide these services to you in your home if you qualify. CELJ helps its clients understand the benefits of an MLTC, and will work with your plan to help you receive the care you need to stay in the community.

Having Medicare does not always mean that it will pay for all claims or hospital stays. Unfortunately, many Medicare recipients do find themselves facing large health care bills. This often happens after receiving inpatient rehabilitation in a skilled nursing facility, or after an ambulance transport. You have the right to appeal claim denials. Our attorneys can review your medical bills, and can represent you throughout the appeals process where appropriate. If you believe that a claim has been wrongly denied, you can contact our office to see if you qualify for assistance.

Medicaid can help cover the high costs of nursing home care, but if you make more than the monthly income limit, you will have to contribute towards the cost of your care. Spousal budgeting for Medicaid is very complex and varies based on individual circumstances. We help our clients make informed decisions about how to budget their income and resources to make sure the spouse living in the community has enough money to maintain their home, while also ensuring that the spouse living in a nursing home has everything they need as well. If you disagree with any determination made by the Department of Social Services regarding your Medicaid coverage or budgeting, contact our office to see if you qualify for assistance.

Anyone who has questions or concerns pertaining to the care/treatment in a nursing home or assisted living facility can contact the Ombudsman program. For nursing homes and assisted living facilities in Cattaraugus, Chautauqua, Erie, and Niagara Counties, please contact People Inc. at 716-817-9222. For inquiries outside our covered counties, please contact the State LTCOP program at 1-855-582-6769.

No. Ombudsmen work to promote and protect the rights of nursing home and assisted living residents. Ombudsman work with residents, their family, facilities, and other interested parties to address concerns of residents. In situations where the Ombudsman is unable to resolve a resident complaint, the LTCOP will link the resident to the appropriate resource for further assistance.

Ombudsmen respond to any concern, complaint, or problem a resident may have. Common problems include: quality of care, visitation rights, diet/food, and resident rights. Confidentiality is the cornerstone of the LTCOP and all resident concerns, complaints, or problems remain confidential unless the resident consents to disclosure.