We are in Minnesota. We are bringing her here from Kansas. We found a place that seems nice. We had a long conversation about the ability for her to age in place. We understand there are situations where that might not be possible and she moves to a nursing home. So, can anyone say if they have had trouble moving to Medicaid in a Memory Care place after private pay runs out? Has anyone had experience with moving someone to a NH after their private pay runs out and their current place doesn't have a Medicaid bed available? Or, is there some sort of assurance that we can get from the MC place that they will keep her until a bed is available without expecting us to makeup the difference, which wouldn't be possible? Our biggest fear is that we have this great place that will deplete us of all her money and then when she really needs help/care, they say goodbye. What prevents them from doing that and kicking her out?
Not sure if this is formulated within state or federal laws, but I feel fairly safe with the document in hand. May not apply in Minnesota.
A facility such as this is not regulated by the laws that nursing homes are regulated by. It is a business. When your money goes, you go. And there may be SOME that allow you to stay, but anymore, it's rare as hen's teeth.
The ones to ask are in administration at your facility. If you do not have this in black and white, a signed contract, then you have nothing.
We will have to reapply-new facility Medicaid eligible placement-self paying for now with family assistance as we were desperate to get out of the bad place she was in-injuires, being unclean. We did not have time to wait to re do Medicaid as was covid start we grabbed the spot. You should get it in writing that facility will guarantee you a spot after X time or the money runs out, who will do the application-them or you time line etc. I have not done this-no guarantee it will work.
During my facility search I asked to be on wait list. None have called in the last 10 months-probably never will. Really great place says 2 year wait list. Medicaid rules say a facility can approve more medicaid beds but getting facility to actually do that?????
Most of what I have learned from my research as that the facility will want some assurance of your ability to self pay for a period of time 1-2 years worth. They wlll always give first choice Medicaid to current facility residents. I was told this a few times when we were told a bed was going to be available-but then a day or so later-poof the spot was "taken". Which sis did not have a huge amount in the bank to pay for high needs care. Sis needs full on nursing care was combative in the past-limited places will take on difficult cases. She is not combative now but having other behavior issues.
So yes, they would insist my 95 year old MIL apply for Medicaid and leave AL for a Medicaid NH after self paying $8-11K monthly for 3 years. My MIL passed last May @ 96, but for a while there we thought she would live forever. We were sweating bullets about the fact that after one more year her funds would be depleted.
As far as increasing the # of Medicaid beds, that requires certification from whoever regulates AL’s and the AL wouldn’t bother with it. My MIL’s AL had no Medicaid beds.
Assisted Living centers are businesses after all. Plus the overhead the AL’s must pay for employee staffing and benefits is probably high. The residents fund that as well as those “activities” for the seniors, meals, linen changes, housekeeping, etc.
Is this right? Not in my opinion but it is what it is.
1. Will your State Medicaid pay for MC.
2. Does the MC except Medicaid and if so what is the criteria. Not all
except Medicaid and are not required to.
3. There may not be any guarentees.
With number 1, if your State Medicaid does not pay for MC the rest is mute. Be aware that you are bringing her from another state, Medicaid does not go over state lines. She may need to be in Minn. for a while to claim residency.
With number 2, MCs are private pay. Here in NJ you need to pay privately for at least two years before Medicaid can be considered.
With number 3, if MC excepts Medicaid it may only have a % of residents they allow on medicaid. Because of this, no guarantees can be made. If they have hit their quota when she runs out of money, then she will need to go into a NH on Medicaid. They do not make money on Medicaid. Medicaid does not pay what the private pay is. My Mom paid 9600 a month privately in a NH for 2 months then medicaid took over. When she passed, her SS had paid 1700 towards her care a month for 3 months. The Medicaid lean was for 6k in that 3 month period. Unless Medicaid doesn't recoup the whole amount, my Moms care was only 3700 a month in a room of 4. Lots less than the 9600 she paid privately.
The assisted living facility that my mom is in keeps raising their pricing structure and moms money is dwindling down quickly. So, we are in the same boat as you. I am still looking for the right place to be her next step.
Good luck.
This is the time to call and ask them directly if they accept Medicaid clients when the money runs out. Some places will avoid answering the question directly because they do not want to lose a chance to get your money now, but ask again until you get a YES or NO.
Good luck.
Why from Kansas to Minnesota? That is a long way if there are problems that you need to respond to.
You need to find out if the facility accepts Medicaid or not. If NOT, then you need to start looking for a different place before it becomes an emergency situation (i.e., she has no money left).
The only kind of real assurance that current facility will keep her after funds are gone is to have it in writing. A verbal conversation will be a moot point several months or years down the road. It will probably be a moot point if the facility sells out to someone else.
Also, for anyone who was in the military, or their spouse, check into the VA Aid & Attendance program. Assets need to be less that $129k. Monthly checks are around $1200. So far, our claim has taken 8 months, but when they approve, we will receive pay from the first date of application.
Take care of yourself. Your assistance will still be needed when he does go to a facility. But, much less.
these homes are tricky.
I think you have a lot of work to do. If you get discouraged or it feels overwhelming, just remember this saying, "How do you eat an elephant? One bite at a time". In other words, do a little bite into each phase. or as in cleaning a dirty room, pick a corner and start.
I think there is a host of good advice here. Consider purchasing a notebook, start chapters, like Medicaid, assisted living, or memory care, whichever it is. Maybe a chapter on Attorneys and other legal stuff like POA. That helps me. I have a file for my husband, who is home with me, included is two files for the two times someone has complained to APS about me. etc.
Hope this helps.
You can Google to get more info. Definitely worth exploring.
ci
I can't tell you the number of places that have not had available Medicaid beds when a long time resident runs out of private funds. When NJ maintained government run LTC facilities, we often took these residents but government facilities were not beautifully designed and decorated as the private facilities so both families and residents had to accept big changes. Remember, the promise is not to keep the resident IF a Medicaid bed is available. The statement you want is that they will CONVERT a resident bed to a medicaid bed when/if private pay runs out. Please feel free to message me if you want to further discuss.
That’s a huge reason that many AL/MC do not even have Medicaid beds. They are not Medicaid certified and cannot bill until they have a Medicaid provider number.
That’s not likely to happen. I wouldn’t bet on this.