🔹SERVICE MODEL🔹

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

Eligible projects may 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.

Investing in an OT-led home assessment before you’re in crisis isn’t a luxury - it’s smart planning.

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

BOOK A CALL


🔹SERVICE RATES 🔹 (09/2025)

Clinical / Legal

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

Design / Planning

  • Architectural Floor Plan & Design Review - $125/hr

  • Project Management & Product Resourcing - $75/hr (basic)

    • Large projects: $100–125/hr

HOME VISIT Services

  • Home Visit Package - $300

    • 2-hour in-home visit (within 1 hr radius)

    • 2 hours detailed custom report (contractor-ready specs, recommendations, product resources)

    • Follow-up questions included

Virtual Services

  • Zoom Consultation - $75 (1 hr)

    • Recorded & transcribed session

    • Written follow-up with resources & recommendations

    • Option to send photos, videos & measurements in advance

Travel

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

Tiered Options

  • Basic - Home Visit + Recommendations - $300 flat

  • Standard - Visit + Full Report + Resource List + Cost Projections - $750 flat

  • Premium - Ongoing Project Management & Coordination - retainer from $1,000 (10 hrs)

Sliding scale for Veterans, Solo Agers, and clients below the poverty line available by request.


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 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.

Adaptable Abodes Design Services go well beyond the scope of what Medicare covers.


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


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.