🔹SERVICE MODEL🔹

Adaptable Abodes provides concierge private pay support services for families and individuals who want to live safely, comfortably, and independently at home.

Eligible projects may also be supported by VA Grants, Tribal Grants, or Medicaid Waivers.

I do not accept Medicare. Adaptable Abodes Design Services go well beyond the scope of what Medicare covers.

By operating primarily as private pay, I am able to offer high-touch, personalized services - without rushing, cutting corners, or limiting the scope of what clients truly need.

Plan before crisis hits. A proactive OT-led home assessment is one of the smartest investments you can make - protecting your safety, your budget, and your peace of mind.

If you’re doing estate planning, I strongly recommend incorporating a comprehensive Adaptable Abodes Home Assessment to help anticipate future home needs, clarify likely modification costs, and inform smarter long-term decisions.

🔹SERVICE RATES 🔹


Home Assessment Packages


$700 - Standard Home Assessment

Best for straightforward aging-in-place planning and 1-2 priority areas (bathroom, entry, stairs, or bedroom setup).

Included

  • Up to 2 hours on-site (interview, functional observation, photos, key measurements, goal planning)

  • Written Action Plan (typically 20-30 pages, with annotated images, photos, and links, depending on scope) with prioritized recommendations

  • Product suggestions and practical next steps

  • Professional Referrals Checklist (recommended types of professionals to engage)

  • 1-2 starter referrals (additional referrals and personal hand-offs are part of Project Coordination)

  • Education and resources (included in the report): OT and contractor roles, how to choose and interview contractors, scam prevention tips, and potential funding pathways

  • Follow-up Q&A: up to 20 minutes total by email or phone within 14 days of report delivery

  • Travel included for up to 1 hour round trip


Scope note: This assessment is focused on up to 2 priority areas. It includes general safety observations for paths of travel, but it is not a full room-by-room whole-home review. Larger homes, multi-level homes, or expanded scope may require the Complex tier or added time.

Not included

  • Contractor bidding, scheduling, or project management

  • Permits, code compliance, or architectural drawings

  • Hands-on installation, repair, or construction work

$1,000 - Complex / Contractor-Ready Assessment

Best for progressive conditions, larger scope, multi-level homes, caregiver workflow planning, or when you need documentation to guide a remodel team.

Included

  • Up to 3 hours on-site (more measurements, workflow mapping, caregiver considerations as needed)

  • Detailed custom report (typically 30-50 pages, with annotated images, photos, and links, depending on scope) with contractor-ready guidance

  • Product resources and accessibility parameters (clearances, placement logic, sequencing)

  • Visual design support as needed (simple sketches, annotated photos, layout concepts, and AI-assisted concept visuals for imagining options - not to scale and not architectural drawings or permit sets)

  • Planning-level cost ranges (estimates - not bids) to support decision-making

  • Professional Referrals Checklist (recommended types of professionals to engage)

  • 2-3 starter referrals (additional referrals and personal hand-offs are part of Project Coordination)

  • Education and resources (included in the report): OT and contractor roles, how to choose and interview contractors, scam prevention tips, and potential funding pathways

  • Follow-up Q&A: up to 20 minutes total by email or phone within 21 days of report delivery

  • Travel included for up to 1 hour round trip


Scope note: Designed for larger scope, multi-level homes, progressive conditions, or projects needing contractor-ready guidance. If scope expands beyond the package, additional time is available at $100/hour with client approval.

Not included

  • Contractor bidding, scheduling, or project management

  • Permits, code compliance, or architectural drawings

  • Hands-on installation, repair, or construction work


Good to know

  • Follow-up is capped at 20 minutes total and must be used within the timeframe listed above.

  • Travel beyond 1 hour round trip is billed at $50/hour (door-to-door).

  • Cost ranges are planning estimates, not bids. Final pricing depends on site conditions, scope, and contractor pricing.

Project COORDINATION

  • Project Coordination & Product Resourcing - $100/hr

Design REVIEW & planning

  • Architectural Floor Plan & Design Review - $150/hr

Virtual Services

  • Zoom Consultation - $100 (1 hr)

    • Recorded & transcribed session

    • Written follow-up with resources & recommendations

    • Option to send photos, videos & measurements in advance

Clinical / Legal

  • OT Legal Support & Letters of Medical Necessity - $150/hr

Travel

  • Travel/Driving (beyond 1 hr round trip) - $50/hr or flat fee by distance

Sliding scale for Veterans.

Next Steps

What I Provide

I offer services that help families plan ahead, adapt their homes, and feel confident about next steps.

I guide clients through the healthcare system, explain options, provide vetted referrals, and offer strategies to advocate for needed services and support.

I collaborate with home access contractors, builders, designers, and medical equipment providers, and maintain a trusted network of senior-focused professionals - including elder law attorneys, placement advisors, real estate agents, and home care agencies - so every part of your plan is covered.

Note: I do not provide ongoing in-home therapy treatments. That care is best delivered by a Medicare Part B occupational therapist through a home health agency.

Credentials

In addition to being a licensed Occupational Therapist (OT/L), I hold advanced certifications:

  • CAPS - Certified Aging-in-Place Specialist (from National Home builders Association)

  • ECHM – Executive Certificate in Home Modifications (from USC School of Gerontology)

  • I am licensed and insured in OR/WA.

Medicare Clarification

  • Medicare Part A covers people who are homebound and receiving skilled care. OT cannot be the sole discipline. Medicare visits are typically brief, less flexible, and assigned rather than chosen.

  • Medicare Part B functions like outpatient therapy at home.

  • If you specifically need a Medicare Part B in-home OT, check Medicare’s Care Compare and call local Home Health agencies individually to see if they offer Part B Mobile Home OT.

    FYI

Home Care (private pay) usually means non-medical support such as caregivers, aides, or companion services.

Home Health (Medicare) provides skilled medical services like nursing or therapy in the home - and requires a doctor’s order to qualify.

What Medicare Does and Does Not Cover:


Medicare may cover a few durable medical items, such as a walker or basic wheelchair, typically every five years and only when prescribed by a doctor.

Medicare Does Not Cover:

  • Home remodels (e.g., widening doorways, ramps, roll-in showers)

  • Grab bars or safety rails

  • Shower chairs, bath benches, or handheld shower heads

  • Stair lifts, ceiling lifts, or hospital beds used for comfort

  • Smart home upgrades or fall-prevention modifications

  • Long-term caregiver support (e.g., bathing, dressing, meal prep)

  • Assisted living or long-term housing costs

To explore official Medicare guidelines, visit:

https://www.medicare.gov

Otherwise, here are some alternative funding sources (grants, loans, long term care insurance benefits, financing options, Veteran benefits).

FUNDING SOURCES

🔹 Grants 🔹

  • VA Specially Adapted Housing (SAH) Grant – For eligible veterans with service-connected disabilities.

  • VA HISA Grant – For medically necessary modifications.

  • HUD Home Modification Grants – Offered through local housing authorities.

  • Community Development Block Grants (CDBG) – Local government-administered support for accessibility upgrades.

  • Rebuilding Together / Habitat for Humanity – Free or low-cost repairs for income-qualified seniors.

  • Area Agencies on Aging (AAA) – May offer minor home repair funds.

  • Utility Company Assistance Programs – May include accessibility improvements under energy efficiency support.

🔹 Government & Public Programs🔹

  • Medicaid Waivers (HCBS) – In select states, may cover home modifications.

  • State Assistive Technology Programs – Offer funding, equipment loans, and referrals.

  • USDA Section 504 Loans & Grants – For low-income, rural homeowners (age 62+ for grants).

🔹 Loans & Lines of Credit🔹

  • Home Equity Line of Credit (HELOC) – Flexible option using home equity.

  • Home Equity Conversion Mortgage (HECM) – Reverse mortgage for adults 62+.

  • Personal Loans / Credit Unions – Useful for smaller or short-term projects.

🔹 Private Insurance / Legal / Employer Benefits🔹

  • Long-Term Care Insurance – May reimburse accessibility upgrades

  • Worker’s Comp / Legal Settlements – May cover injury-related modifications

  • Employer or Union Retiree Benefits – May include stipends or support for aging-in-place needs.

🔹 PAY here 🔹

(Venmo, Paypal, Zell, Stripe, Square)

kelly-nesbitt.squarespace.com/payment

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Disclaimer: Consultant is not a general contractor or architect. Recommendations are based on clinical and accessibility expertise. Final decisions and code compliance are the responsibility of licensed professionals.