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I'm considering using Carepatron. It is HIPAA-compliant and fairly inexpensive. They do offer a Business Associate Agreement (BAA), and I believe you will send an invite to the email address so the client can do the visit on their phone.

I have attended virtual appointments with my client in the past. How I do it is have the facility or doctor send me the link and attend with the client at her home.
Another client calls me and puts me on speaker when the doctor comes into the room to see her.

Kathaleen, GREAT question! I hope you get lots of response!

I haven't personally done it, but I have spoken with several patients that have had their advocate on the phone during an appointment — letting the provider know that of course upon the provider's arrival.

I'm super curious to see if others have insights as well!

Karen, this is GREAT! Would you consider also making it a blog post with us? in your «gna dashboard» is the blog creator. You can simply copy/paste it there, do any edits you need.

At the BOTTOM you are welcome to write a brief bio and to include information on your free resource site.

This is very helpful. Thank you for sharing!

Hi everyone, I’m Sheri Gaynor, and I’m so grateful to have found this group. Joining this community has truly helped confirm that starting my advocacy practice is the right next step for me, and I’m excited to learn from all of you along the way.

I’ve been a nurse since 1991, and my career has taken many different paths over the years based on the needs of my family and the experiences life brought my way. My background includes hospital nursing, home health, school nursing, case management, and working on the health plan side of healthcare. While my experience is diverse, caring for moms, babies, and children has always held a special place in my heart.

As my parents have gotten older, I’ve also developed a growing interest in Medicare, aging care, and helping families better understand and navigate the complexities of the healthcare system.

Life has also shaped me personally in profound ways. In 2022, I lost my 22-year-old son to a fentanyl overdose, and that experience changed me deeply. It has strengthened my compassion, broadened my perspective, and reinforced my desire to support families during some of the most overwhelming and vulnerable moments of their lives.

I’m looking forward to connecting, learning, and growing alongside all of you. Thank you for welcoming me into this space.

Excited to join this group who speak the same language I do…Advocacy! 😀

I am a career nurse case manager with the last 20 years in hospital case management leadership. Retiring in December!

I owned an independent advocate business from 2019-2025. In 2026, I founded The American Senior Citizen, LLC to focus on written and video content expanding the reach for patients, families and caregivers who are seeking real-world solutions quickly.

I look forward to connecting, collaborating and celebrating the wins with all of you 👏

Hi Everyone!

I’m Lisa Jo McLendon, a registered nurse with over 30 years of experience, primarily in CVICU and Geriatric Behavioral Health. About five years ago, I transitioned into healthcare advocacy, and I couldn't be happier! It is becoming the most meaningful chapter of my career.

I’m a lifelong learner at heart. Along the way, I obtained my Life & Health Insurance License and Long‑Term Care Certification so I can better support seniors and families planning for the cost of aging. Long‑term care planning has become a true passion of mine, and I’m actively expanding my expertise to best help clients meet the cost of their long‑term care.

I’m grateful to be part of this community of advocates who are committed to raising the standard of care.

I’m always happy to connect, collaborate, or support in any way I can.

Warmly,
Lisa Jo

Renae, thanks so much for sharing this informative pst. I hope others will ask questions or share what's working for them!

Hi Natasha,
The only Independent Advocate that I know that is billing Medicare is Terry McLellan — Sunnavhca. She is located in TX. I'm sure she will be happy to have a conversation with you. Here's her email: terry@sunnavhca.com
Let her know I referred you.
Tammy

Hi, Damiana! Thanks for asking!

here's a great resource that has a TON of links in it. One of them is «business in a box», which is from Nicole Broadhurst's program. I understand that package is free; she has other resources that are part of a paid service.

gnanow.org/community/survivor-support/room-1-ss/27-from-survivor-to-supporter-explore-turning-your-lived-experiences-into.html

Hi Mari, To the best of my knowledge, a person in any state with assets exceeding the Medi-Cal threshold will not qualify for any type of public healthcare assistance. The LGBTQ community is well organized in the Bay Area, and may provide financial assistance on a private basis. I would check with their local organizations; keep in mind that any grants might also be dependent upon financial need. — Every LTC policy has an elimination period, and requires proof of payment by the insured as part of the policy’s authorization process. A limit of $650/day sounds as though the LTC policy doesn’t carry an annual inflation endorsement; this should be confirmed by reading the entire policy (and not the policy Summary of Benefits.) I would also verify the policy allows assets other than the insured’s to cover the elimination period. The elimination period of 90 days, at $650/day, equals $58,500, which can be covered by your client’s assets if he is required to pay. LTC policies all contain language regarding caregiving coverage by formal and informal caregivers. Understanding policy guidelines in this regard is crucial. — I didn’t see any mention of the cause of your client’s medical decline. If another party was involved (i.e. an accident, premature discharge, improper diagnosis) the opportunity may exist to explore the LTC policy elimination period coverage by the other responsible party. Good luck.

Hello,
First allow me to preface that I am not giving legal advice — that is for attorneys only. But I have a healthy background in the legal system and my belief is that you can be deposed...period. You do not have doctor/patient protection, clergy/congregant protection or attorney/client protection.

Here's what I would do, if it were me and I truly believed the client and I are a good fit: Find a good attorney to represent you (not your prospective client) and ask them to advise you if a «Non-Disclosure Agreement» (NDA) could be executed between you and the prospective client such that you would have the ability to refuse to answer any questions posed in a deposition based on the NDA. You would still have to appear if you get a subpoena (and they «should» provide a stipend for your trouble if you have to travel over a certain number of miles...at least that's the case in my State).

So, bottom-line is — ask an attorney and go from there.

Best wishes. Let me know how this turns out for your.

Val Barschaw
Author/Speaker/Advocate… and former Superior Court Clerk

In my years of hospice care, I can tell you that this is an important conversation to have with your parents before a crisis occurs.

Be proactive AND insistent in getting a plan in place. Call a family meeting or have an elder law attorney help.

This is SUCH an important conversation. Thank you so much for bringing it here.

This really resonated with me. As someone stepping into independent advocacy, I’ve seen how overwhelming the system can be for families. This work matters, and it’s needed more than ever. Thank you for speaking on it so clearly. I shared this on my LinkedIn post. I hope you don't mind. People should read this to understand what is happening, so change can take place. Again, great article!

Leona — what a GREAT and important topic!!! Thank you so much for sharing it.

If you'd like, you may also share it as a blog post. If you need help doing so, just email me at help@gnanow.org and I'll show you how.

This is so important to do sometimes. There are a lot of reasons why we forget to clear out the clutter periodically. I think that sometimes we fall subject to the fallacy that something we've invested a lot of time and energy in but isn't adding value to our lives will start doing so if we just keep at it a little bit longer, and a little bit longer. I also think that, in the U.S. at least, we tend to carry a deeply ingrained belief that quitting is inherently bad — and clearing out that clutter can at times feel like quitting. Letting go of something you’ve invested time, energy, or resources into can feel wasteful—as if the only acceptable option is to push through no matter what. We see this reinforced in messaging and marketing at times too, reinforcing the idea (Nike’s “Just Do It” being a classic example).

And yes—there are absolutely times when pushing ourselves matters, when stepping away wouldn’t serve us. But there are also times when not quitting, or not clearing out the clutter, is what causes harm.

That constant pressure to keep going can lead us to normalize chaos and clutter—both mental and physical—leaving little room for ourselves. I feel like this is especially true in roles like patient advocacy, where so many of us are deeply passionate and driven to support others, often at the expense of our own well-being.

What often gets overlooked is how much more we’re capable of when we allow ourselves space—mentally and physically. That the space isn’t something that always needs to be filled. In fact, protecting it can strengthen our ability to function, to process difficult emotions, and to feel more grounded and present in both our personal and professional lives.

Good advice for clients, patients and advocates alike!

David, this is exactly the systemic issue Cheryl is pointing to — and there's an underutilized resource worth knowing about.

The Older Americans Act established the National Long-Term Care Ombudsman Program, staffed by both paid and volunteer advocates. Critically, they work for residents, not facilities. They can address individual resident concerns and pursue systemic facility issues. Complaints feed into state and national trend databases that can drive regulatory action.

As a former Texas ombudsman, I can tell you SNFs were prioritized in caseloads over assisted living, even though both are covered under the OAA. The program is lean, but strategic.

As a first step I recommend looking for the ombudsman contact information typically posted at the facility entrance. Introducing yourself creates a ready partnership for exactly the issues you're describing.

Understaffing explains resource constraints. It doesn't excuse poor care.

Renea Stasaski, BCPA
Sonoran Wayfinders
Advocate's AI Atlas

Thank you for asking such an important, complex question!

Oh gosh, this is such a major problem! And if I knew how to fix it, I would be a wealthy woman! I experience this both as a clinician and as an advocate. A few strategies that are absolutely not fixes:

1. bundle needs as much as possible so there are fewer calls on the call light. I know it's not always possible! If possible, build ADL routines so they're more anticipated/scheduled and more efficient.

2. let the staff know they're appreciated, with words and maybe snacks. Let managers know who is excellent.

3. escalate as needed if/when there are safety concerns

4. aim for non-profit care centers whenever possible

Well, that's a few thoughts to start the conversation.

Cheryl Kauffman, PT, BCPA
Seattle Patient Advocates

Thank all of you, so much, for your input. It means the world to me how thoughtful you have all been in trying to contribute positively to this situation.

You all are echoing something I knew from the start: it's all about how she's framed. It was my goal from the start to figure out what angle I can take...how to change how the healthcare system is seeing her. Perspective rules everything, doesn't it? And as an advocate, and a nurse, my goal is always collaboration first...I don't want to go into this meeting opposing things. That won't get my client what she needs.

You all have given me several excellent pieces of information and things to be thinking about. Though I have so much experience, I will constantly be learning and leaning into this amazing community.

Depending on how this meeting goes tomorrow, I may call on those of you who have offered to assist. As a type A personality with a fiery passion for this, I absolutely need to make sure I've done everything I could. My conscious won't allow anything less.

AnnMarie — please do share via the private facebook. All thoughtful comments/advice is welcome.

Again, thank you.

Hi Blaire,

I spoke in depth with the girl's aunt when they were searching for an advocate. I am so sad you are still running into denials. So many wrong steps have been taken when this family is willing to do anything for her. What is wrong with people!?!?

I spoke with some contacts who were willing to help as best they could. I am happy to pass them on to you.

I am not nearly as capable as you with this case, but I am here to lend a familiar ear. I am also available if the family needs anything I can help with for caregiver support.

Thank you for sharing this case and for using PA360º as a thoughtful sounding board. Your approach reflects both humility and resourcefulness. Creating space for peers to weigh in not only opens the door to new perspective, but can be grounding and clarifying in complex situations like this. Even advocates benefit from the insight of other advocates. I appreciate your openness and commitment to getting this right, Blaire.

Hi, Rachel!
Do you mean you are trying to become an advocate who accepts Medicare?

if so, there are a number of agencies around the country that accept Medicare. It is my understanding that an RN must work under a licensed supervising clinician, and the setup is long, indepth and complex. I know of one RN advocate who is deep into the process and actually building a training program she intends to offer once she has reached sort of 'a good endpoint' with the process.

I hope other nurses might respond here to provide more information, although if this question is about accepting Medicare as reimbursement, it's likely in the wrong conversation space, and I can move it for you.

If you would like the list of agencies that we at GNA are aware of and have had at least some contact with/knowledge of, feel free to ask. I'll gladly share it here.