To comply with the Elder & Vulnerable Adult Referral Agency Act of April, 2011. Last updated: Nov 1, 2013
We are grateful if you would please confirm receipt of this document now by placing check marks in the two sections at the bottom of this form and then click on "Submit".
If you prefer, you can click on "Download as PDF" to read and print out the entire document. If you choose this less automatic method of confirming with us, you can then print out the form and sign and either 1) scan and send the completed document to firstname.lastname@example.org or 2) fax the signature page to our toll-free fax of 800-206-6910.
Any concerns you have may be reported to Officers at CHOICE Advisory Services, Inc.
Clint Slater, President, Director of Business Services 800-361-0138 or email@example.com
Les Ostermeier, VP, Director of Development 800-361-0138 or firstname.lastname@example.org
© Copyright 2015, CHOICE Advisory Services, Inc. All Rights Reserved.
You are requested to confirm receipt of this information so CHOICE may be of help to you. This document in no way obligates you at any time to continue to receive assistance from CHOICE Advisory. The referral services provided to you are at no cost to you, the consumer.
About CHOICE Advisory Services, Inc.
CHOICE [which from here on will be referred to as the agency] was established in 1993 as a senior housing & care referral agency. The agency is comprised of approximately 35 full-time employees working directly with senior housing providers, care providers, elderly adults and those who seek to help older adults with transitions to senior housing or care communities. We also help people remain in their homes by providing assistance finding in-home care. The agency's primary function is to identify and make information and resources available to consumers. The agency gathers pertinent personal information about the older adult through its intake process which helps to identify needs, interests and preferences of the older adult. Based on this input, the agency then provides housing and care options that will likely be of interest to the older adult(s) and/or responsible party. Further, the agency provides the support and resources to enable a move, or to encourage an older adult to become accepting of support or services.
In the course of our work with older adults, we are often in communication with adult children or other legally responsible persons or entities which represent the older adult. CHOICE Advisory views both the older adult and the legally responsible party as clients of CHOICE Advisory Services, Inc.
The agency manages detailed information about senior housing and care providers [which from here on will be referred to as Providers]. The primary benefit of accessing the assistance of the agency is to yield a more focused search during the selection process. To help the Client avoid the need to research options and make dozens or even hundreds of phone calls to providers, the agency gives our client a targeted list of providers offering services in alignment with those being sought. A defined list of questions (called the intake process) helps CHOICE better define geographic preferences, style of living, personality and aesthetic preferences, pricing parameters and anticipated services for the short-term and long-term. CHOICE staff is available by phone seven days a week from 8:30AM to 8:30PM.
CHOICE Advisory's primary geographical focus is on the greater Puget Sound, the greater Spokane, Tri-Cities and Vancouver areas of Washington State and the Portland Metro Area in Oregon. CHOICE does offer limited services within Kootenai County in the state of Idaho (Coeur d’Alene area). CHOICE works with partner agencies to serve southern Oregon, the state California. The agency also maintains relationships with referral agencies throughout the United States should you or someone you know need help in other areas other than the West Coast.
CHOICE does not require or request the client to sign waivers of potential liability for losses of personal property or injury, or to sign waivers of any rights of the client established in state or federal law. It is, however, critical to note that the agency, through its processes and through this disclosure, have made a concerted effort to ensure the client is aware that the agency and its employees in no way make guarantees of services extended by providers.
CHOICE has increased our strength by partnering with other, well-established senior referral agencies.
In the Spring of 2015, The Senior Resource Network (established in 2006) and A Caring Heart, Senior Housing Referral Service, LLC (established in 2006), began supporting CHOICE Advisory and extending their knowledge of specific geographic areas in Washington and Oregon. CHOICE Advisory is the parent company of these two agencies. In Southern Oregon CHOICE has partnered with Noble Senior Living Referrals to meet the unique requests of residents living in Lane County, Oregon.
The client is in charge of the selection process
Employees of the agency do not select a specific provider on behalf of the client. The client must make the selection of the provider of his or her own accord. Likewise, the client must negotiate applicable move-in and monthly rent and care fees directly with the provider. To seek admission to a community or to establish in-home services, the client must follow the application process of the chosen Provider. The agency makes options known to the client, but does not make the ultimate decision selecting any one particular option. If a client is seeking the recommendation to a specific housing or care provider, it is suggested that the client contract separately with a paid professional such as a guardianship agency, trust department or private case/care manager which may hold the legal capacity to fulfill such a responsibility.
We are a referral agency. CHOICE is not a placement agency. Our staff do not place older adults into living situations. Quite differently, CHOICE offers information and supportive information for the older adult and/or their responsibility party to make their own decision regarding housing and care.
Client's ongoing communication with the provider
Within the scope of senior housing and care referral services, CHOICE does not serve as arbitrator or communicator between client and provider. During both the search process and after move-in, CHOICE does not have the responsibility of ensuring communication or agreement between the client and provider. CHOICE's responsibility is focused on information to the consumer for the consumer's review and consideration. It is the responsibility of the client to communicate requests or concerns directly to the provider.
Medical professional's approval may be required prior to admission
State law may require the older adult's physician to become involved in defining medication management and the appropriate level of care prior to admission to a senior care community, or before arranging for in-home care services. Additionally, a professional nursing assessment and the completion of a care plan may be required (depending upon the laws for the state in which the senior living community or home is located). The agency does not offer medical advice. CHOICE Advisory is a non-medical information service. The provider reviews the pre-admission paperwork and/or assessment. The Provider makes the decision regarding acceptance or non-acceptance of admission. At no point is CHOICE staff able to ensure services or quality of services provided by a Provider. CHOICE staff are not trained in the numerous city, state, federal and fire safety laws that regulate senior housing and care providers. CHOICE staff has no exact knowledge of what services a care a provider may or may not offer as the management/owners of the senior living facility are the only individuals who can communicate or provide such information. Because the services providers offer are based on the current staffing levels as well as current resident needs, the admission and retention criteria of residents evolves and changes. The client and senior housing provider are fully responsible for reciprocal communications about admission and continued stay in a senior housing or care community. CHOICE Advisors are not medical professionals, they have no control over what services are offered by a senior housing & care provider and CHOICE staff does not assist in the communication of care plans or delivery of services.
The quality and competency of the care and services provided within a community or home are the jurisdiction and purview of the applicable state licensing agency. Vigilant and on-going involvement of the family and/or a responsible party is strongly recommended in support of any vulnerable and/or older adult. With staffing and management changes as well as changes in residents, an older adult needs the continued support and advocacy of a legally-responsible party.
The service is provided free-of-charge
So that referral services provided by the agency may be extended free-of-charge to its clients, The agency signs contracts with providers. The agency receives a referral fee (a calculation is based typically on a percentage of the fees paid by the older adult from the 2nd, 3rd, and 4th months of residency/services) from the provider selected by the client. The agency maintains a policy of charging the provider only when the provider is receiving direct compensation for housing and/or care from private funds or from long-term care insurance-based funds. The Agency accepts no fees from the provider if any part of the monthly cost of housing is paid to the Provider by Medicaid/COPES or Medicare. In instances where a resident passes away or moves out prior to the completion of contract with CHOICE, a prorated fee is charged to the provider.
The agency endeavors to contract with all providers in the same manner so that options are presented in a way which best serves the client. The agency makes the details of specific payments from the provider to the agency accessible to the client upon written request. (See the last page of this document for the various ways you can contact the CHOICE main office.) The agency prides itself in its practice of full disclosure.
Although the agency does not negotiate on behalf of the client, the agency does obtain specific information regarding any promotions or offers being made by the provider to the general public and makes such information available to the client. Consumers are encouraged to speak directly with the provider regarding any specifics they may have regarding bases or care rates.
In almost all cases, senior housing and care providers increase their rates annually. Many follow a practice of implementing increases based on inflation, others use other methods. It is standard practice for providers to base their care rates on the amount of care required as outlined in an assessment and in a plan of care. It is important for the consumer to obtain the parameters of rate increases and to obtain information on care rate increases in writing from the provider. CHOICE does not maintain information about pricing or rate increases other than general information that is available to the community at large.
Providers value the services CHOICE offer to older adults and their responsible parties. Because it is time intensive and costly for providers to market services to older adults, working with an experienced referral agent is a cost-effective means for providers to welcome new residents and clients to their business. In working with the agency, the provider knows that the client has been well-informed regarding their options, and that clients have the support of a helpful third party with whom to discuss their concerns or questions. The agency performs duties as a dual agent. The agency provides information regarding provider options and is compensated by the provider (a client relationship to CHOICE), yet the consumer (older adult or their responsible party) is also considered by the agency as a client. The Client at no time pays any fee to the agency for referral support.
The Agency charges no fee to the client or older adult for referral services
CHOICE prohibits any employee of the agency to assess any fees to the client or older adult for referral services. To ensure that the agency is compensated for our efforts, clients are asked to allow the agency to make initial introductions to all providers. Clients are particularly cautioned from entering their name and contact information in senior housing and care web sites. Most of these web sites are national companies who seek to sell your name to many senior living providers. All family members should be informed that help has been sought from CHOICE so that your name and contact information are appropriately protected from businesses who distribute such information randomly throughout the community.
Unique aspect of assessments in the State of Washington
As of April 2015, Washington State is the only known state which requires the completion of a specific type of pre-admission assessment by a qualified assessor prior to move-in to an adult care home. Assessments for move-ins to assisted living do not require a person with a specific professional designation, however assessments for move-ins to an adult care home do. The contents of the pre-admission assessment is dictated by the state of Washington. Some adult care homes are operated by a Registered Nurse, Advanced Nurse Practitioner, Masters in Social Work or another health care professional. Such owners may offer to complete the pre-admission assessment at a charge or at no cost. Other adult care homes work with specific or preferred assessors.
To be of continued support the people we serve, CHOICE Advisory employs a Registered Nurse (currently serving the Eastside, Seattle, Shoreline, Snohomish, Whatcom, Skagit and Island Counties) to complete the pre-admission assessment. This service is not considered part of our complimentary referral services. There is a fee applicable to the pre-admission assessment.
Accessing the services of CHOICE's Nurse Assessor/Advocate is not a requirement of working with CHOICE. It is at the discretion of the older adult or responsible party who completes the pre-admission assessment.
The information contained in the assessment allows for the creation of a plan of care that is followed by the adult care home. The assessment offers initial information about the older adult and is one of many aspects an adult care home owner considers when defining monthly rent and care fees.
At no time does CHOICE require the use of the Agency's Nurse Assessor/Advocate. This service is intended to offer options to the consumer to complete the pre-admission requirements in way of their own choosing.
CHOICE maintains a list of approximately 50 Assessment Professionals. Please call our office at 800-361-0138 to receive a copy of this document.
If you own a long-term care insurance policy
CHOICE and its representatives do not hold licensing or training to interpret long-term care insurance contracts. We do, however, offer a complimentary service of reading long-term care policies to give the client insight as to the types of providers that may or may not be approved by the insurance company and to help the client better understand how the language appearing in the policy may or may not relate to the actual industry of senior housing and care being offered at this time. CHOICE and its representatives cannot be held responsible for any loss, harm or injury which may occur as a result of information (or lack of information) given to the client about the long-term care insurance policy. CHOICE offers to be of support to the Client in the process of accessing long-term care coverage when applicable; however, the Agency and representatives make no statement about what claims may or may not be paid by the insurance company. The contract held with the insurance company is a legally binding agreement between the owner of the policy and the insurance company. The insurance company is the only entity which can approve or deny a claim.
The insurance company is to fulfill their contractual obligation based on the specific language appearing in the policy. It is of value, however, to make inquiry as to whether the insurance company has internal policies or exceptions which would make it possible for the policy holder to receive coverage for a provider-type not specifically mentioned in the policy.
The steps and guidelines set forth for the policy-holder by the insurance company must be followed and the policy-holder must initiate any questions to obtain the information desired or needed. Insurance companies will not make suggestions on how a policy-holder may qualify to file a claim and receive insurance coverage.
If a client feels they have been treated unfairly as it relates to applying for and receiving payment of benefits for long-term care from a long-term care insurance provider, they may contact the Insurance Commissioner's office in the state where services are received.
Conflicts of interest
The agency does from time to time enlist the help of a private case manager or nurse (at the agency's expense) to help older adults in conflict or in denial about their need to make a move or to accept care services. These complimentary services typically range from one to two hours in duration.
At times, the agency may suggest the older adult or responsible party work with other providers (such as therapists, counselors, social workers, mental health professionals or arbitrators) to resolve conflict or to gain clarity on their own preferences before working with a CHOICE Advisor. In such instances, the older adult or client are responsible for the costs of such services. At no time does CHOICE derive a referral fee from such providers.
CHOICE may pay additional fees or commissions to other agencies or businesses in return for information, services or goods.
Due to laws within some states where CHOICE provides services, the agency must inform clients that family members, friends and business associates of staff working at CHOICE Advisory Services, Inc. may hold ownership in or work at senior housing and care communities or may hold ownership in or work within healthcare settings.
Moirah Cretu, Certified Senior Advisor owns and operates an adult family home. Jennifer Duma, RN has a mother, Monica Duma, owns and operates two adult family homes in Bothell.
Infractions of senior housing and care providers
If you are considering a senior housing or care provider which offers care services, the provider is licensed by a specific state agency. Because senior care providers are regulated, they are subject to inspections and follow-ups to complaints or self-reported issues. In the state of Washington, information regarding infractions can be found on the Department of Social and Health Services web site. In Oregon, licensing varies based on whether the provider is licensed as an assisted living provider, residential care facility or adult care home.
Infractions should not necessarily be viewed as a negative thing. As an example, a provider who is found to be out of compliance in matter may be cited by the state for an infraction. The owner and/or management of the facility then must correct the deficiency, or the facility is at risk for being placed on "stop placement". "Stop placement" is a status indicating that a provider may not legally admit a new resident to the facility. The provider is also at risk of losing their license if they continue to be out of compliance.
From the perspective of CHOICE Advisory Services, it is a great benefit to consumers that senior care providers are regulated. We have spent decades at CHOICE reading infractions, yet we know that the infractions are a historical document. They may not be a true representation of the operation of the facility in the present time. Although we feel that state regulatory agencies are helpful to inspire quality care, we believe that on-going communication and diligence of the older adult and responsible party and/or family members and friends is of greatest importance.
Reading a regulatory document about a citation is from a snapshot in time. It does not necessarily speak to the quality of care available from the provider at this time; though it may be possible to see trends from viewing such documents.
If a provider is in "stop placement" status they are required to inform you at the time you tour.
Clients are given access to the full spectrum of options and care
Because of the Agency's long-standing service to the community and to the senior housing and care industry, nearly all senior housing providers that a client would wish to consider are contracted with the Agency. Approximately 15% of the licensed or existing providers do not meet the minimum expectations of the agency, and are therefore never given as options to clients. A very small percentage of the total provider network of assisted living and adult family homes serving older adults has opted not to contract with the agency. Such providers tend to have lengthy waiting lists, or have been in existence for decades and rarely have availability. The agency may opt to make known such providers to clients without receiving a referral fee. The agency does not generally contract with providers who specialize in care to young adults with developmental disabilities or young adults with mental health concerns. CHOICE Advisory focuses on serving older adults in our community.
For private duty (non-medical), in-home care services, the agency may offer one of two options. The agency will either offer a listing of agencies serving the client's geographic area of preference or the agency will provide one or more specific home care agency options to the client. In some circumstances the agency may receive a referral fee from non-medical in-home care providers. This will not impact the fees paid by the client. Rate structures of the in-home care providers are the same whether you access the agency's assistance or whether you contact the provider on your own.
The agency makes referrals to both skilled nursing as well as Medicare-certified in-home care, yet neither the agency nor its employees receive compensation from such referrals.
The agency may make additional referrals to clients for legal assistance, financial guidance, health care or therapies, real estate, moving services or other community-based services. Neither the agency nor employees of the agency receive financial compensation for such referrals. Referrals to products or services require the due diligence of the consumer. The agency does not warrant or guarantee the quality or performance of any ancillary product or service. Further, the agency is held harmless for any loss, injury or harm which may occur as the result of accessing ancillary products or services. The agency and its employees make known ancillary products and services for your consideration and personal benefit. It is the responsibility of the client/consumer to make their own personal choices regarding the purchase of such goods or services.
Frequency of the agency's visits to providers
As it relates to retirement living, assisted living and adult care homes, the agency makes scheduled and unscheduled visits to providers. Communities receive referrals from the agency only once an in-person, full review process has been completed of the senior housing provider. Dates on which agency employees have visited specific providers are available by request to the agency. The senior housing and care industry serves an ever-changing clientele with ever-changing needs. The services and care extended by providers is based not only upon regulatory requirements, but also upon the provider's willingness to extend such services to each individual resident. Residents and their responsible parties also hold the power to accept or decline services. Additionally, the senior housing and care industry is complex as it relates to interrelationships between older adults, their families, staff and regulatory agencies. It is critical to note that frequency of visits from the agency should not be given value by the client to anticipate future performance of a provider. A visit by the agency is only a snapshot in time. The client must continue on-going review and communication with the provider and/or regulatory or advocacy organizations at their own discretion and in a manner that fosters quality communication and quality care.
CHOICE employees are mandatory reporters
State law requires all employees of the agency report suspected instances of abuse, neglect, abandonment or financial fraud to the appropriate authorities. Clients must be aware that the request of a client to not disclose such matters to authorities is against the law and strictly prohibited by the agency.
CHOICE involves the older adult(s) as a standard business practice
To the maximum extent possible, the agency involves the older adult in the process of searching for housing or care options. If the client is not the older adult, but rather their responsible party, and they feel that the older adult may suffer unnecessary stress due to involvement in the search or feel the older adult may not be able to comprehend the situation, the client is encouraged to communicate their concerns with the agency immediately. The agency endeavors to treat each older adult with the respect and dignity they deserve while remaining committed to the rights of older adults to be involved in these important decisions.
If you choose to end your relationship with CHOICE
If at any time a client wishes to end a relationship with the agency and stop receiving help from the agency, the client may do one of the following (please include the name of the senior, the name of the responsible party and a contact phone number):
- Send an email to: email@example.com
- Call CHOICE (toll-free) at: 800-361-0138, 7 days a week between 8:30am and 8:30pm
- Send a fax (toll-free) to: 800-206-6910
You may end your relationship without cause, and certainly (as there is no charge for our referral service), you may do so without penalty or recourse.
Be wary of sharing your contact information with internet-based providers –(in fact, it is wise not to give your name and contact information out on the internet)
Attention: Many clients or their family members go to internet sites and enter their name and phone number in order to receive information regarding a particular community or service; multiple family members may call numerous senior housing and care communities to request brochures and information. Internet-based companies may sell or give away the names, phone numbers, and email addresses to myriad of senior-related businesses, which will then begin mailing, calling and emailing the requestor to initiate a sales process. Also, because of the complexities of services and pricing, it is possible that many of the providers who begin calling the requestors will not meet the specific expectations or needs of the client. Clients are better served by taking a systematic approach to this process, which includes involvement of a CHOICE Housing & Care Advisor completing an intake process in order to make appropriate introductions.
Please inform all family members and friends that have secured the support of CHOICE Advisory and that they should refrain from giving their name out on the internet and that they should not call senior living providers to request brochures.
To file a complaint against CHOICE:
The owners of CHOICE are highly involved in the operation of the agency. If you receive service differently than what is explained in this document, or if you wish to share any aspect of the service you received, you are encouraged to call the owners of the agency: Les Ostermeier or Clint Slater. Les or Clint can be reached at 800-361-0138. They are interested in hearing your concerns as well as your ideas for broadening and improving our services.
If you feel CHOICE Advisory has not complied with state laws protecting older or vulnerable adults, you may contact the Attorney General's office in the state where you received services.
As of April 2015, the only state with specific regulations regarding senior housing & care referral is Washington State.
Link to the "Elder and Vulnerable Adult Referral Agency Act":
Attorney General's Office in the state of Washington:
- Phone: 360-753-6200 Monday - Friday, 10 am to 3 pm
- 800-551-4636 For In-State callers only
- 800-833-6384 For the hearing impaired callers
- 206-464-6684 For Out-of-State callers
- Mail: Office of the Attorney General, 1125 Washington Street SE
PO Box 40100, Olympia, WA 98504-0100
- Complaint form: https://fortress.wa.gov/atg/formhandler/ago/ComplaintForm.aspx
Attorney General's Office in the state of Oregon:
Attorney General's Office in the state of Idaho:
Attorney General's Office in the state of California:
Consider the following benefits of accessing the agency's help:
CHOICE has been in business since 1993, which means you benefit from our knowledge and systems for helping older adults and their families
- While you are receiving help from one specific person at CHOICE, you are receiving the support of 34 other CHOICE staff members who are seeking and providing helpful information
- No other agency offers connection with such an extensive listing of providers as CHOICE
- All representatives of CHOICE are employees of the S-Corporation so that all procedures, taxation, insurance and liability concerns are accounted for appropriately and accurately
- A CHOICE Housing & Care Advisor is available 7 days-a-week, 365 day-a-year, from 8:30am to 8:30pm
- Housing & Care Advisors have come to CHOICE with professional experience within service-oriented industries and are then trained to be effective listeners to help people find what they are seeking
- CHOICE Housing & Care Advisors prefer meeting clients in person and offering personalized escorted tours of options, yet make themselves available in whatever manner best serves the Client, such as by phone or email
- CHOICE Housing & Care Advisors have the support of assistants to serve their clients in a timely manner
- Information gathered by CHOICE is managed based on professional guidelines
- The CHOICE staff is friendly and committed to providing quality communications and information
- CHOICE follows a protocol for serving clients, inclusive of follow-up and quality assurance contacts with both the client and the provider
- There is NEVER a fee charged to the client by CHOICE for referral service
- CHOICE Advisory Services, Inc, is a business committed to integrity and service
- We are not a small organization. Small agencies promote a small number of providers. We are not a large agency. Large agencies are not contracted extensively with providers, nor do they know the providers. CHOICE is just the perfect size to offer you the support you need and deserve.
Authorization granted to CHOICE and permission to release information
Pursuant to the requirements of the Health Insurance Portability and Accountability Act (HIPAA), the purpose of this disclosure, at this time, is for both non-medical and for medical purposes. Further, there is the potential for the protected health information to be re-disclosed by the recipient and thus, no longer is protected under this Privacy Rule. I understand that this consent may be revoked in writing at any time with the exception and to the extent that disclosure of information may have already occurred prior to the receipt of revocation.
I give the staff and representatives of CHOICE Advisory Services, Inc. permission to access information regarding the older adult(s) named below. I also give permission to the providers working with CHOICE (physicians, clinicians, ARNPs, licensed assessors, senior housing and care providers and/or paraprofessionals as well as regulatory or vulnerable adult advocacy organizations) to access this information as it relates to the client's interest in arranging for in-home care or relocating to a senior housing or care community.
I confirm receipt of the Disclosure Statement & Information Release Form of CHOICE Advisory Services, Inc. contained in this document. Also, I verify that I am either the older adult seeking assistance or I am a family member or related to the older adult OR, I hold legal documents such as Power of Attorney or Guardianship to help the older adult(s).