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HMO Guide for Seniors - Office of the Patient Advocate - State of ...

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55<br />

Questions & Answers<br />

If I need nursing care, do I<br />

have to go to a nursing home?<br />

No. You may be able to get<br />

<strong>the</strong> care you need at home.<br />

See page 52.<br />

My mo<strong>the</strong>r is in a nursing<br />

home. How can I make<br />

sure she gets good care?<br />

Try to have family or friends<br />

visit every day. If <strong>the</strong>re’s a<br />

problem, call your mo<strong>the</strong>r’s<br />

doctor and health plan. And<br />

call Cali<strong>for</strong>nia <strong>Advocate</strong>s<br />

<strong>for</strong> Nursing Home Re<strong>for</strong>m.<br />

They will refer you to local<br />

agencies that investigate<br />

long-term care facilities<br />

<strong>for</strong> seniors.<br />

My nursing home gave me<br />

a Notice <strong>of</strong> Non-coverage.<br />

I’m too sick to go home.<br />

What can I do?<br />

You can appeal this decision.<br />

Call HSAG right away.<br />

things you can do<br />

Choosing a Nursing Home<br />

Ask your <strong>HMO</strong> what nursing homes are in its<br />

network. Visit several nursing homes. Consider <strong>the</strong><br />

location, cleanliness, noise level, food, and safety<br />

<strong>of</strong> each place. For help choosing, call Cali<strong>for</strong>nia<br />

<strong>Advocate</strong>s <strong>for</strong> Nursing Home Re<strong>for</strong>m or visit<br />

www.calnhs.org.<br />

Long-Term Care<br />

If you need long-term care and your money is<br />

running out, find out if you qualify <strong>for</strong> Medi-Cal.<br />

Call Cali<strong>for</strong>nia <strong>Advocate</strong>s <strong>for</strong> Nursing Home<br />

Re<strong>for</strong>m.<br />

For help making decisions about long-term care<br />

and long-term-care insurance, call HICAP.<br />

For help choosing long-term care, visit<br />

www.calnhs.org.<br />

where to find help<br />

Cali<strong>for</strong>nia <strong>Advocate</strong>s <strong>for</strong> Nursing Home Re<strong>for</strong>m<br />

In<strong>for</strong>mation and advocacy <strong>for</strong> consumers<br />

1-800-474-1116 www.canhr.org<br />

Cali<strong>for</strong>nia Nursing Home Search<br />

A guide to nursing homes<br />

www.calnhs.org<br />

HICAP (Health Insurance Counseling & Advocacy)<br />

Free in<strong>for</strong>mation and counseling on Medicare<br />

1-800-434-0222 www.aging.ca.gov/hicap<br />

HSAG (Health Services Advisory Group)<br />

Help with nursing home discharge appeals<br />

1-800-841-1602 www.hsag.com

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