This guide provides information about issues affecting our seniors.  Information can change so please understand that the articles and links provided may not be current.

Medicaid for the blind, aged, and disabled in Indiana

Home Repairs

Your home is often the biggest investment you will make. It is important to keep your home safe and in good repair. Often, small problems can lead to bigger ones if you do not fix the problems early. It may save you money and time to fix small repairs as they come up.

If you cannot afford to make the repairs, you can check in your area to see if any agencies offer free or low-cost home repairs. You could contact:

  • Churches.
  • Schools that have a vocational education program.
  • Veterans’ Administration.
  • Community Action Programs.
  • District Area Aging Agencies.
  • Boy Scouts.
  • Local charitable organizations.

If your repair is small, you may be able to get it done through one of these agencies. You will probably have to hire a professional home repair contractor for larger repairs.

Shopping for Repairs

Before hiring a contractor, you should check his or her references. If a contractor cannot give you any names of satisfied customers from previous jobs, do not hire the contractor to repair your home. You can also contact the Better Business Bureau and the Attorney General’s Office, Consumer Division to see if any complaints have been made against the contractor.

Ask for estimates on the work that needs to be done. You can get estimates from more than one contractor, along with starting and completion dates, and find out what permits will be needed. Get the estimates in writing, so you can compare the contractor’s prices.

Ask if the contractor will get the necessary permits for the work to be done. If not, you will have to get the permits before the work can start. You can check with the county to see what permits are needed and also to make sure your contractor is licensed to work in your county.

Financing Repairs

Be careful about financing your repairs through the contractor. You may be able to get a better loan through your bank or your mortgage company. Do not sign anything that gives the contractor a lien on your property. (However, if you do not pay the contractor, the contractor can place a Mechanic’s Lien on your home and could actually take possession of your house if you do not pay the contractor. Read more about this later).

Once the Work Begins

Once you have contracted for work, do not pay everything up front. You should keep half of the payment for when the job is done properly. If the contractor tells you he needs to have more money for the materials, tell him you will pay for the materials directly to the building supply company, and subtract that amount from the final payment to the contractor.

After the Work is Done

You may have to have the work checked by the county inspector before it can be considered final. Once the work has passed inspection and you are happy with the work, make the final payment. Always get a signed receipt for any payments you make for home repairs, and keep your receipts.

If the contractor has a guarantee or warranty on his work, and you discover any problems, contact the contractor as soon as you discover the problem.

Home Improvement Law

If you are getting repairs made to your home and the repairs will cost more than $150, the Home Improvement Law applies. Under this law, the contract for home repair must include several things:

  • A description of the home improvements.
  • The approximate starting and completion dates.
  • The cost of the repairs.

The homeowner and the company or person doing the repairs must sign the contract.

If the contractor does not follow these rules and does not do the repairs correctly, the homeowner can sue the contractor for damages and attorney fees. The Attorney General can also make the contractor pay a fine.

Mechanic’s Lien

If you have work done on your home and you do not pay for the work, the contractor can file a Mechanic’s Lien against your property. This means that if you try to sell the property, you will first need to pay off the lien. The contractor could even file a lawsuit asking the court to make you sell your home to pay the lien. You should receive notice from the contractor if the contractor files a Mechanic’s Lien or a lawsuit.

Do not ignore a Mechanic’s Lien or a lawsuit filed by a contractor. You could lose your home. If possible, you should pay the money owed. You can contact local agencies such as the ones listed above or your local Trustee to ask for help paying the money.

If you disagree with the amount the contractor says you owe or the way the work was done, you should contact an attorney right away.

If You Have a Problem...

If you have a problem with home repairs that have been done to your home, you can contact the Attorney General’s office at (800) 382-5516 and your local Better Business Bureau to make a complaint. You can also contact a private attorney or your local legal services office. A private attorney might handle your case without charging you a fee because the contractor might have to pay your attorney’s fees.

If you have a problem with home repairs, ESPAÑOL 1-877-323-6260 you should make these calls soon after you notice a problem because there are time limits for filing lawsuits.

Last revised: 7-03
LSC Code: 1620199

Solving Nursing Home Problems-Sources Outside the Facility that Can Help

If you cannot solve the problems by working with nursing home staff, you can make a complaint directly to the State Department of Health. You can also make a complaint through a third party like an Ombudsman. See below for more information about these sources of help.

In almost all cases, complaints should go first to someone in charge at the nursing home (the administrator, head nurse, etc.). In fact, most outside agencies will take the complaint more seriously if you can show you have already tried to fix the problem through the nursing home.

There are some complaints, however, which should go directly to an outside source. A person with knowledge of physical abuse, neglect, or exploitation of a resident must report it to an Adult Protective Services Unit or to a local law enforcement agency. See below for more information about Adult Protective Services.

Here are outside agencies that may be able to help:

Indiana State Department of Health

The State Department of Health is responsible for making sure that state and federal requirements are followed. Complaints about resident care, diet, conditions in the nursing home, and residents’ rights can be made to the State Department of Health. The complaint should be as specific as possible, telling what happened, to whom it happened, who did it, when it happened, and where it happened.

The complaint should also say whether the complainant and resident are willing to have their names used and other special considerations, and how you can be reached for further information. The depth of the investigation will depend greatly on the seriousness of the problem and the degree of detail given about the problem.

Complaints should be directed to:

Indiana State Department of Health
Division of Long Term Care
2 North Meridian Street, 4B
Indianapolis, IN 46204

(317) 233-7442 (Long Term Care Receptionist)

(317) 233-1325 (ISDH Main Switchboard)

Within 7-10 days after you report the complaint, you will receive a letter from the State Department of Health verifying that they have received the complaint and will investigate it. The State Department of Health will investigate more serious claims more quickly. After the investigation is completed, you will be informed in writing of the results.

In addition to investigating complaints, the State Department of Health will also conduct an annual survey in each facility. Extended surveys will be conducted if the standard survey indicates substandard care. See Surveys in the Nursing Home for more information.

You can also file the complaint online using the forms you find here.

Nursing Home Ombudsman Program

Ombudsman is a Swedish word that means : ”citizen representative.” A nursing home ombudsman is a representative for residents. Ombudsmen can:

  • Investigate and try to solve complaints about nursing home care that affect the health, welfare or quality of life of a nursing home resident.
  • Protect the rights of residents.
  • Help residents assert their rights.
  • Work to insure quality care and treatment of residents.
  • Answer questions and provide information about nursing home care and related services.
  • Educate residents, families, staff, and community about nursing home residents rights.

Anyone can contact the ombudsman program for assistance. However, the resident will be consulted and the resident will direct the actions of the ombudsman.

Adult Protective Services

Under Indiana law, it is a crime to physically abuse, neglect, or exploit an endangered adult or a dependent, or to threaten the endangered adult with abuse, neglect, or exploitation. It is also a crime for someone to fail to report known or suspected abuse, neglect, or exploitation.

An endangered adult is a person at least eighteen years old who cannot manage property or take care of his or her own needs because of some incapacity resulting from infirmity, senility, old age, insanity, mental illness, mental retardation, habitual drunkenness, or drug abuse, and who is harmed or threatened with harm from neglect or battery, or exploitation of personal services or property. Dependent includes an adult who is mentally or physically disabled.

Here is a link to the Indiana Adult Protective Services.

You can reach Adult Protective Services at 1-800-992-6978.

Protection and Advocacy

Residents who are developmentally disabled or family or friends of these residents can receive help from Protection and Advocacy services at:

Indiana Protection and Advocacy Services
4701 N. Keystone Ave., Suite 222
Indianapolis, Indiana 46205

Telephone and contact numbers are:

For services in Indianapolis and South, contact Dann Ward at 1-800-622-4845, ext. 460,
or e-mail him at dward@ipas.IN.gov.

For services in Northern Indiana, contact Debbie Dulla at 1-800-622-4845, ext. 444, or e-mail her at ddulla@ipas.IN.gov.

For general information about IPAS, contact Karen Pedevilla, Education and Training Director, at 1-800-622-4845, ext. 452, or e-mail her at kpedevilla@ipas.IN.gov.

For information regarding the website, contact Anthony Liggins at 1-800-622-4845, ext. 450, or e-mail him at aliggins@ipas.IN.gov.

TTY at 1-800-838-1131

Protection and Advocacy services are available statewide.

Medicaid Fraud Control Unit

The Medicaid Fraud Control Unit in the Indiana Attorney General’s office investigates complaints in Medicaid certified facilities. The complaint does not have to involve a Medicaid resident. You can reach this Unit by clicking here.

The Medicaid Fraud Control Unit will investigate any type of complaint against a provider, including substitution of drugs, billing for services not performed, abuse, neglect, overbilling, and theft of funds.

Veterans Administration

If you have been placed in the nursing home through the Veterans Administration or are receiving Veterans benefits, you can contact the Social Work Services at the nearest VA hospital. The social work service department of the Veterans Hospital in Indianapolis can be reached at 1781 West 10th Street, 317-988-4619 . Or, you can click here to get to the VA Social Work web page.

Postal Inspectors

A complaint can be made to the enforcement arm of the United States Post Office if a nursing home interferes with your mail. The telephone number is 1-877-876-2455.

Legal Services Programs

Indiana has various legal services programs that provide free legal advice and representation to persons with low incomes. If the client is eligible, there is no lawyer’s fee. However, the client may have to pay court filing fees and other costs for the case. Many programs have special projects for persons over the age of sixty. These projects do not have the same income and resource eligibility requirements as do the regular legal services programs. To search for legal services programs in your areas Find Legal Help.

Private Attorneys

Many lawyers will take cases on a “contingency fee” basis. For instance, if you have been injured because of something the staff of the nursing home did or did not do, a private lawyer may take the case and get attorney fees out of the money you win, if you win the case. In addition, some local bar associations may have panels of private attorneys who will perform routine legal services free of charge if the client has a low income. The county bar association can provide information on the availability of these services.

The Indiana Health Care Association

The Indiana Health Care Association is an organization of for-profit nursing homes. The Association will investigate complaints it receives about resident care and rights in facilities that belong to the Association. Complaints should be directed to: Indiana Health Care Association, One North Capitol, Suite 100, Indianapolis, IN 46204, or you may call 800-466-IHCA.

Last revised: 04-2014
LSC Code: 1591904

Pension Locater Services

A pension is a retirement fund, usually provided by your employer. If you or your spouse may have had a pension, it could be worth your time to look for it. A pension can provide you extra money in your retirement years. There are several places to look. If you don’t have paperwork on it, you can:

  • try to contact former co-workers who may be getting a pension to find out information about the pension plan;
  • if the former employer had a union, you can contact the union (even if you were not a part of the union) to ask about the pension plan;
  • contact the pension plan administrator;
  • do a computer search under the company name to get current information about the company, and then contact the company.

If you still cannot find the pension plan, you can try searching through the Pension Benefit Guaranty Corp. (PBGC). This is a federal corporation created to protect the retirement incomes of workers by maintaining pension plans. You can find information about using this search to find a pension here. You can search by the person’s name, company name, or state.

If you cannot find the pension using this search, you can contact the PBGC by mail or email to ask them to help you look for the pension. You can write to them at:

PBGC
1200 K. Street NW
Washington DC 20005

or by email at: missing@pbgc.gov

You should have the employee’s full name, social security number, and date of birth, your current address and phone number and the company name and location. It would be helpful if you also had the dates of employment, the name of the pension plan, and the employer’s federal id number. (You can get the employer’s federal id number from your social security benefit statement, which tells you how much social security benefits you are entitled to receive).

LSC Code 1290900
Last Revised 11-02

Using Nursing Home Staff to Solve Problems in the Nursing Home

Nursing home staff can help solve some of the problems within a nursing home.

Nursing home residents and their advocates, as a general rule, should always try to solve any problems with the facility by talking to the person who has the power to fix the problem. You have the right to voice complaints, including complaints about treatment that was received or was not received, without fear of retaliation. The facility must promptly attempt to solve the problems.

Here are some people within the nursing home staff that might be able to help you. There may also be other people in your nursing home that can help. Some of the people listed (for example, the bookkeeper) may be available only during normal business hours or by appointment, if an evening consultation is needed.

Administration

The nursing home administrator is the one who is responsible for the overall operation of the home. The administrator has the most responsibility. However, you should usually first go to the person who is in charge of the particular area where you are having a problem. It is important to talk to a person who does have authority to correct the problem.

Nursing

There is generally a “charge nurse” responsible for the nurses on the shift.

There is also a director of nursing who is responsible for nursing staff and nursing policies and procedures.

Housekeeping

Most homes have a person in charge of housekeeping. The nursing supervisors may also have authority over housekeeping personnel.

Food Service

All homes have a food service supervisor who is responsible for buying, preparing, and serving food. If nursing staff serves the food, the nursing supervisors are responsible to see that it is served properly (at proper temperature, for example). There should also be a dietician or consultant dietician available.

Bookkeeping

Generally, the bookkeeper and administrator are most directly responsible for residents’ finances.

Social Services

The nursing home’s social services staff may be of assistance in solving problems that do not fall into the above areas. For example, the social services designee is responsible for helping the resident cope with problems. A social services designee has successfully completed a training course. A social worker with a college social work degree may also be available.

Last revised: 04-2014
LSC Code: 1591904

Long Term Care-Alternatives to a Nursing Home

There are many home and community based services available to help people stay at home. Your area Agency on Aging can help you decide what you need and review the services that are available in your area. You might be able to stay at home or in an assisted living facility instead of going to a nursing home.

The government pays for some of the programs, and some are private (which means you would have to pay). People who are eligible for Medicaid may be able to get services under the Medicaid “waivered services program.” Medical services and some non-medical services such as home modification are available under this program.

“At home” services that are available in some areas include:

  • home health care
  • home delivered meals
  • telephone assurance
  • adult day care
  • personal/attendant care
  • respite care
  • case management services
  • transportation

You should ask for qualifications and references from any service provider before you have them into your home.

If you determine that you will need more care than you can get in your home, you can consider moving to a facility where 24-hour care is available. There are two basic types:

  • residential care facility (sometimes called assisted living facility). This provides room, food, laundry, and some help with daily living activities. Residents are physically able to manage their own needs with occasional help. The facility provides general supervision of health care, medication, and diets as defined in the written policies of the facility.
  • comprehensive nursing care facility (commonly referred to as a nursing home or a nursing facility). This provides nursing care, administration of medications, special diets, treatment, and perhaps rehabilitative and restorative therapy under a doctor’s order.

A facility can be licensed to provide both residential and comprehensive levels of care. So it is possible to go to an assisted living facility, and then move to another part of the facility if you need more care later.

In Indiana, not all assisted living facilities are required to be licensed by the Indiana State Department of Health. If you are thinking about entering a nursing home, you will need to discuss your care needs with your physician.

Last revised: 11-03
LSC Code: 1591900

Nursing Home Resident Rights

When you move into a nursing home, you do not lose any of your rights. You are still protected by the Constitution and the Bill of Rights. You continue to have the right to:

  • Speak freely.
  • Enter into contracts.
  • Manage your own personal and financial affairs.
  • Associate with and visit whomever you choose.
  • Communicate with persons outside the home.
  • Be free from physical, mental and sexual abuse.
  • Make your own decisions about medical treatment.

If you have a guardian, the guardian exercises your rights. If you have an attorney in fact (representative) under a power of attorney or a health care representative, your representative can exercise your rights as allowed by your documents.

In addition, when you move into a nursing home you have special rights. These include:

THE RIGHT TO INFORMATION

Homes must tell you about your rights at admission and upon request. Homes must provide:

  • A copy of the latest survey results and any plan of correction in a public area.
  • Advance notice of changes in your room or roommate.
  • A written copy of your rights, the right to file a complaint and how to contact the ombudsman and the state survey agency.
  • Written information about services covered under the basic rate and extra charges.
  • Written and oral information concerning Medicaid.
  • Notification of nurse staffing waivers.
SELF DETERMINATION

Nursing facilities must respond to your needs and concerns, as expressed by you or your legal representative. You have the right to:

  • Choose your personal physician.
  • Receive full information, in advance, and participate in your care plan and treatment.
  • Receive reasonable accommodation for your individual needs and preferences.
  • Voice complaints without reprisal and receive a prompt response.
  • Organize and participate in resident groups.
PERSONAL AND PRIVACY RIGHTS

You have the right to:

  • Participate in social, religious, and community activities as you choose.
  • Have privacy during medical treatment, personal visits, written and telephone communications.
  • Have all of your records kept confidential.
TRANSFER AND DISCHARGE RIGHTS

You may only be transferred for one of the following reasons:

  • The transfer is necessary to meet your welfare and your needs cannot be met in the facility.
  • Your health has improved so that nursing care is no longer needed.
  • The health or safety of others is endangered.
  • You have failed, after reasonable notice, to pay for your care.
  • The facility closes.

Notice of Involuntary Relocation must be given on the form required by the State Health Department. You and your representatives have the following rights:

  • At least thirty days advance notice, or as soon as possible if immediate transfer is needed because of your immediate health needs.
  • Notice must include the reason for the transfer, the location to which you will be transferred, information concerning your right to appeal the transfer, and the name, address and phone number of the local and state ombudsman program.
  • Information concerning bed-hold and your right to return to the next available semi-private bed if coverage ends, you need the services provided and your care is paid for by Medicaid.
  • Preparation and orientation by facility staff to ensure safe and orderly transfer from the facility.
VISITATION RIGHTS

You have the right to receive visitors and to refuse visitors. The federal Reform Law provides for:

  • Immediate access by personal physician and representatives from state and federal agencies, including the ombudsman program.
  • Immediate access by relatives, if you consent.
  • Immediate access by others with “reasonable” restrictions.
  • Reasonable visits by groups, subject to your consent.
  • Access by ombudsman to records with your consent.
PROHIBITION AGAINST MEDICAID DISCRIMINATION

Discrimination in treatment of residents is prohibited and applicants for admission are protected from fraudulent activities. Facilities must:

  • Have identical policies regardless of source of payment.
  • Provide information on how to apply for Medicaid.
  • Not request, require or encourage residents to waive rights concerning Medicaid.
  • If your facility is a Medicaid provider, not transfer or discharge solely because payment source has changed from private pay to Medicaid.
  • Not require a guarantor of payment.
  • Not charge, solicit, accept or receive gifts, money, donations or other “considerations” as a precondition for admission or continued stay for persons eligible for Medicaid.
PROTECTION OF PERSONAL FUNDS

You have the right to manage your own money. If you request the facility to manage your funds, the facility must:

  • Keep funds over $50.00 in an interest bearing account.
  • Keep your funds and facility funds separate.
  • Keep and give you complete and accurate accountings, at least quarterly, and upon request.
  • Not charge for services or items covered by Medicaid.
  • Upon your death, turn funds over to the administrator of your estate.
  • Purchase a surety bond or provide other assurance of security.
RIGHTS AGAINST RESTRAINT AND ABUSE

You are protected from physical, mental and sexual abuse and the inappropriate use of physical and chemical restraints, including freedom from:

  • Physical or mental abuse, corporal punishment, or involuntary seclusion.
  • Restraints used for discipline or convenience of staff.
  • Restraints used without a physician’s written orders to treat medical symptoms.
  • Drugs used to control mood, mental status, or behavior without a written physician’s order in the plan of care for a specific medical symptom. An independent, external expert must annually review the appropriateness of the prescriptions.

The Resident Rights section of the federal Reform Law states that you have “the right to be free from physical or mental abuse, corporal punishment, involuntary seclusion, and any physical or chemical restraint imposed for purposes of discipline or convenience and not required to treat the resident’s medical symptoms.”

A physical restraint is defined as “any manual method or physical or mechanical device, material, or equipment attached or adjacent to the resident’s body that the individual cannot remove easily, which restricts freedom of movement or normal access to one’s body. A chemical restraint is a drug used for convenience or discipline and not required to treat medical symptoms.

Restraints may be imposed only to ensure the physical safety of the resident or other residents, and upon the written order of a physician that specifies the duration and circumstances under which the restraints are to be used.

The nursing home must try to minimize the use of restraints. The nursing home should try less restrictive alternatives before resorting to the use of restraints. Where appropriate, occupational and physical therapy should be consulted first. A restraint should function as an “enabler” which betters your quality of life. You and your family should receive a full explanation before a restraint is used.

The facility must monitor whether the restraint causes you any adverse mental, physical or psychosocial effects. If it does, the facility must attempt to eliminate those effects, either by removing the restraint, or by finding a more acceptable means to treat your condition

You are to be free from any unnecessary drugs. Antipsychotic drugs cannot be given to you except to treat a specific condition.The facility must also try, if possible to discontinue antipsychotic drugs through gradual dose reduction and behavioral treatment.

Ask your doctor if you have questions concerning restraints. You can also call your local ombudsman.

Last revised: 11-2003

LSC Code: 1591999

Nursing Home Surveys by the Indiana State Department of Health

The Indiana State Department of Health investigates complaints about nursing facilities. The State Department of Health will also conduct an annual survey in each facility. Extended surveys will be conducted if the standard survey indicates substandard care.

How does this survey work?

Surveyors will meet with residents in a group setting. The surveyor will ask residents questions and also give residents the opportunity to discuss concerns of their own. If you do not feel comfortable discussing your concerns with the surveyor in a group setting, ask a surveyor to come to your room.

The surveyors will not reveal the names of residents or family members who spoke to them.

After surveyors have completed their inspection they will conduct an exit conference to review their findings with facility staff. A resident, generally the President of the Resident Council, should also be invited to attend.

The local ombudsman may participate in the survey process. The surveyors will contact the ombudsman during the survey to inform the ombudsman of the survey and invite the ombudsman, with residents’ approval, to the resident group meeting held during the survey process. The ombudsman will also be invited to attend the exit conference. The ombudsman can share complaints with the survey team.

The survey team will leave a report with the facility staff. If the surveyors found the facility was not in compliance with federal or state requirements, the facility must develop, document, and complete a plan of correction.The plan of correction is found on the right column of the survey report. The deficiencies that the surveyors found are on the left column of the report.

The survey report becomes a public document and must be available in a public area in the facility after ten days or, if the plan of correction is not accepted by the Department of Health, when the plan of correction is accepted. The facility has the right to dispute findings of the surveyors.

If the facility is found to be seriously out of compliance in major areas or if the Department of Health believes residents are at a serious and immediate health risk, the Department of Health can request that the facility be decertified for participation in the Medicare and Medicaid programs. The Department of Health can also issue an “Emergency Order to Relocate” residents the Department believes are at a serious health risk. The Department issues the emergency order to alert residents and families that serious problems exist in the facility.

If your home is to be decertified or if you have questions about the survey or the survey process, contact the Department of Health or your local ombudsman.

You can reach the Indiana State Department of Health at :

Indiana State Department of Health

Division of Long Term Care
2 North Meridian Street, 4B
Indianapolis, IN 46204
(317) 233-7442 (Long Term Care Receptionist)
(317) 233-1325 (ISDH Main Switchboard)
If you click here you will be taken to the Indiana State Department of Heath’s web page.  Toward the bottom of that page are links for filing a complaint.

Last revised: 04-2014
LSC Code: 1591904