Centers for Medicare & Medicaid Services has recognized the importance of working with memory care communities and at home care organizations in providing the help families need to face the journey ahead with peace and confidence.
The Guiding an Improved Dementia Experience (GUIDE) Model was launched in 2024 to aid both individuals with dementia and their caregivers.
In this episode we’re talking to Christian Kuswita, President and Owner of ComForCare Home Care, about The GUIDE Model and how it has the potential to greatly assist families in affording care for loved ones and receiving the resources they need to achieve better quality of life all around.
Hello, everybody, and welcome into Senior Living Live. My name is Melissa. Thanks so much for being with us here today. Christian Kuswita, president and owner of Comfort Care Home Care, is our guest today to help break down a new offering from Medicare that could help you or a loved one diagnosed with dementia. Christian, thank you so much for being with us.
It's great to be here, Melissa. Thank you.
Great. Well, before we dive in, let's talk a little bit about you and your background.
Yeah. So, my wife and I opened Comfort Care about four years ago. Before that, I worked with multiple national companies such as Whirlpool Corporation, Newell, Rubbermaid, and, you know, the passion of doing it by myself, you know, our parents were entrepreneurs. It's always been there. And so I think in 2019, the stars were alinged, and we said, my wife and I have decided that we wanna do something that is, you know, on our own, but also doing good. So my dad passed away twelve years ago, Melissa, from not from a stroke. He suffered the stroke, but the isolation was, I think, thenail in the coffin, I would say. And so because of that, I think home care was was very close to emotionally very close to what we wanna do just because, you know, of the experience that we had with my parents.
Yeah. That makes sense. And I'm sorry to hear that about your father, but, now you're providing a service that will prevent that for families in the future. So we thank you for that and for what you do with your company, which we'll talk about throughout this presentation here today. As we discuss our main topic, you know, the centers for Medicare and Medicaid services, they did announce an improved dementia experience to aid people with dementia and, of course, their caregivers. They call it the GUIDE model, which is it's kind of fitting that we're having this discussion here today. This actually came up in one of our recent webinars, so I'm glad we're having this discussion. Can you explain, what this is, the GUIDE model, and why and who it was created for?
Yeah. So the GUIDE model GUIDE stands for guiding an improved dementia experience. Right? And this is, I would say, a groundbreaking for Medicare because for the longest time, when somebody come to us and said, hey. You know, what are the sort of payment for in home care? Medicare has not been, you know, one that we would say would pay for in home care. It's usually private pay. You know, VA can have some benefit, you know, Medicaid, long term care insurance, but this is brand new. So I think the way that why Medicare is doing this is that, you know, and we've seen it firsthand in our work is when we're caring for somebody with dementia, we're actually caring for two person. Right? The patient itself, just because of the changes in their, you know, cognitive ability, but then their caregivers. And, usually, it's gonna be their family members, spouses, children, who not only take physical toll, but emotionally, they're drained also. And we've seen so many, you know, depression happen, emotionally drained. You know, people, you know, a lot of these unpaid caregivers really struggle. And so I think the benefit is that Medicare realized that they need to also improve that care, not only for the person who has dementia, but also to their unpaid caregivers. And that's why I think this guide is so important. But I think the other thing is the first time in, I think, in our history that Medicare is really doing something, you know, and then also participating with in home care companies such as ours.
Yeah. And this is, really recent as of 2024 that they announced this initiative. So, wanna sort of just try to get out in the forefront and explain what it is because I don't think a lot of people know it even exists.
Yeah.
So that's why we're having this conversation here today. So, if you could, could you tell us a little bit more about the support initiatives for this? What do Medicare and Medicaid members have immediate access to today?
Yeah. So there's a lot of benefits out of the GUIDE model. Right? Things like, you know, that now have access with medication management. They have access to care coordination. They have access to resources, right, around the area. They have a twenty four hour, you know, a hotline number that they can call to access a lot of those benefit and resources. But I think the one that a lot of people are very interested about is the respite voucher or the respite care that Medicare now will provide. Right? So every year, Medicare will now provide up to twenty five hundred dollars of respite care. So that's about eighty hours of care. When you think about it, right, it's not gonna replace the day to day care because, you know, somebody who has moderate to severe dementia, they will need more than eighty hours a year. But, again, this is respite. Right? Meaning that it will provide a little bit of help for that unpaid caregiver so that they can be themselves. They can recharge themselves. They can do things that, you know, they like and they enjoy. I always tell people, especially the caregiver, is that when your glass is empty, there's no way you can share that glass with your loved one. Right? And then and you have to do whatever you can to recharge and get that glass full again. So now you can have you know, you can care for your loved ones. So that part will help significantly for some of the family members.
Right. And you know, you mentioned the twenty five hundred. So let us discuss the cost. How does this model reduce expenditures for daily care of someone living with dementia?
Yeah. So the eighty hours can be used in four hour increments. Right? That means that, you know, somebody if you look at four increment, that's eighty divided by four is twenty times. Actually, forty times. So they can actually schedule forty shifts of four hours. Right? And, you know, our company can help. So ComfortCare is a national franchise company with over two hundred and fifty locations in US and Canada. Of course, the US will be the one that can provide the offering. And so each of us, each of the offices can provide the help. We can start consulting with the family members of the people with dementia. We can then understand the qualification, which, you know, we need to discuss today too. And then we can refer them to Medicare. Right? So there are a few qualifications, though, with this program. Okay? So this is very important. Number one is the person or the patient needs to be with traditional Medicare part B. So they cannot be under a Medicare Advantage. Right? They can have a part B and supplement, but they can't have part B Advantage. Second qualification is that they need to be, they cannot be under hospice care. Okay? Now, you know, for hospice professionals out there, right, when a hospice company is diagnosing or assessing somebody, not all of them may qualify for hospice. Right? And that would be the great opportunity because then they can't get the benefit, then GUIDE can help. Right? And so if they are dementia, they're not qualified for hospice, then GUIDE can help with that. And then the third and last one is that they cannot live in a nursing home, meaning skilled nursing, rehab facilities. Okay? And then lastly, the voucher for the respite voucher will also be only qualified for people that have the moderate to severe dementia diagnosis. So if they are early stage, they can take advantage of the all of the other benefits, the medication management, you know, the care management, the safety check assessment, things like that, but they just can't qualify for the respite voucher.
Got it. So what would be the first step for someone who would need to utilize these services? We have dementia webinars quite often, and we have people who are in the caregiver role and are looking for any help that they can get. So where would you send someone like that today?
Yeah. So if you go to comfortcare.com, our website, and just look at the locations, put your ZIP code in there, and see if there are locations around the area. Like, our company, we are in the Atlanta area. We serve the Cobb and Cherokee, counties, but we also serve the Alpharetta, Milton, and Johns Creek area. So if you live in that area, contact us. Our phone number is 470-231-0023. If there is no comfort care in your area, I would suggest learn more and look at you know, just Google GUIDE model Medicare. You'll have a lot of information in there. And there's also, I think locator capability to see who are in your area that are, you know, participating in GUIDE. Right? And then call that particular, you know, company or agencies to inquire more.
Got it. Now how does your business incorporate the GUIDE model in your day to day practices?
Yeah. So, you know, it's been very interesting because, you know, in the previous time that we actually talked to people when they are, they don't have a lot of income to afford home care, there's really nothing that we can do other than trying to refer them if they have Medicaid to somebody that can do Medicaid or the VA, things like that. Now the game changed a little bit. Right? Because if somebody, because GUIDE doesn't have an income level. Anybody can actually participate in the guide model as long as they have the dementia diagnosis. And so now we are every time that we talk to clients with a new or current, we always ask about that question. Right? If they have dementia, then let us refer them to Medicare and see if they can qualify. Because if they qualify and if they qualify for the voucher, then Medicare will come back to us. And then what we need to do is we need to admit them into our company. We need to then send a nurse to do the assessment. We have to get the documentation signed by the family, and then we can start service. Right? And they don't really need to use us in any way other than when they need to. Right? And so we don't, we you know, our minimum is only four hours, which is correlate directly with what the guide model minimum is at four hours and only when they need it. So the program resets every year, Melissa, and so I don't think it rolls over if you have any unused hours, but it will roll, it will reset every July of the year. So if they don't use it, they can use it next year again. And the way that they use it, it's really up to the family members. Again, this is a respite. So, like, for example, we tell people be flexible, and we can be flexible the way they wanna use it. If they wanna use it every four hours, every two to three weeks, just to give them that respite time so they can go out, you know, lunch with their family members, their friends, we can do that. If they live in memory care, let's say that they live in a memory care and, let's say they have a UTI, you know, mom has a UTI, go to the hospital, they come back. And usually, when somebody comes back from the hospital, they get really weak and falls could be their number one, you know, risk, right, at night especially. We can use the GUIDE model, the respite vouchers as putting, like, a safety sitter maybe overnight, maybe two to three nights if need to, right, until the mom gets stronger and then now be able to, you know, be okay by herself. So, again, we can be very flexible. We only have, we need only twenty four to forty eight hours of notice once everything is set up. And so we always tell the family, once you're, once you're qualified and you're in the system, just use it when you need to, when you want to, and we'll be there for them.
Got it. So this is something that could be used whether you are just at home taking care of your loved one by yourself. They could reach out to you, and get help. If they're utilizing in home care, such as your services, or if they're, currently living in senior living and they need a little bit of additional help. Correct?
That is correct. Yep. That's correct.
Yeah. Yeah.
For all the bank But I yeah.
And I but I tell the family and also, you know, we work with a lot of communities that these are family directed care. Right? And so the family will need to say, yep. I need this, you know, to care for my mom. And so that is the and I think that's the beauty of it. You know? You can use it in all the settings that you need if you need it. Right? And, again, the only thing the only, place that you can't use it if they are under hospice, you know, or if they are living in a nursing home like a skilled nursing home we have, they can't use that in there. But other than that, apartment, homes, assisted living communities, memory care community, independent living community, fifty five plus, you know, we can go there and help them in those areas.
Yeah. Great. This is fantastic information. And, again, fairly new information for everybody out there who may not even know that it exists, which is why we're discussing it here today. Christian, as we wrap up, can you tell us how someone in either your area or nationwide can reach out to you and your company once again if they want additional information or they wanna use you to sort of handhold, to get this benefit?
Yeah. So, comfortcare.com is the website, and then look at the locator, and then you can use the ZIP code to see if there's any, agency nearby. You know, our agency is located in, and we serve the carpenter in Alpharetta, Johns Creek, and Milton. But you are more than welcome to call me in case just if you want, if you don't live in that area but you want information, please call us. So my number, our number, is 470-231-0023. So, you know, please call us if you need help or if you just wanna consult with us. You know, hopefully, we can help. You know, we wanna help in any way.
Yeah. Well, you've been fantastic and a great resource. I know this is just a small snippet of what is very lengthy information. And, again, as you mentioned, you could find that by googling, guide, G U I D E, slash medicare, and then it will pull up the first two web pages. It will be the government website that will tell you all the benefits of this. And, and, of course, Christian, you're there to help, our viewers, potentially get that benefit. So we're trying to sort of, bring everything together and tie it together in one big ribbon, and I think we've done a pretty good job with that today. Thank you so much for being with us.
Absolutely. Thank you so much for the opportunity.
Thank you. Now if you enjoyed this video, or you learned a lot from Christian here today. Please head on over to our website, www.seniorlivinglive.com. There we have videos all about senior living just like this one. And the best part, they are all free. Thanks so much for being with us here on Senior Living Live. Have a great day, everybody.