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Old 12-07-2015, 10:48 AM
 
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ok, thanks. Maybe it wasn't discussed in detail (I can't recall - it was such a rushed thing) because either my mom has a good amount in the bank and also gets a good amount in various retirement sources that will never end (until she dies). But I will find out what the future holds
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Old 12-07-2015, 11:21 AM
 
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Quote:
Originally Posted by ukrkoz View Post
Yes. Medicare does for qualified recipients. Medicare pays somewhere around $2000 plus. Medicaid should pick up whatever is left as supplement insurance.
You can listen to whoever you want to, but I work in sniffs - skilled nursing facilities - all the time and have several patients that run assisted living. I actually asked them and have the know.
What you should be careful with is getting into private pay situations. Some of those folks are predators and you may end up paying a lot, a lot more, if you get into private pay. 4-5 K for same thing OOP. What you need to do is to ask the recipient to call Medicare and find out first hand. Don't absolutely trust a word from any forum and specifically - a word from AL place owner.


Wrong, MEDICARE does not pay for an AL.


MEDICAID will in some cases pay for an AL, and will pay for a NH.
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Old 12-07-2015, 11:27 AM
 
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Quote:
Originally Posted by clarksvillemom View Post
ok, thanks. Maybe it wasn't discussed in detail (I can't recall - it was such a rushed thing) because either my mom has a good amount in the bank and also gets a good amount in various retirement sources that will never end (until she dies). But I will find out what the future holds


Are you aware of the 5 year look back? You can't just get your mother on Medicaid for example by her signing over her bank accounts and home to you or another adult child. They want to know where the money went.


She will have to use up what she has, you might want to consult an elder care attorney.


Unfortunately in this country if you work hard, save your money but aren't wealthy you get screwed, you're really better off p*****g your money away and you get Medicaid.
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Old 12-07-2015, 11:48 AM
 
Location: Wisconsin
16,888 posts, read 17,203,069 times
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Quote:
Originally Posted by ocnjgirl View Post
No, they aren't required to keep her. And if they don't have certified Medicaid beds available, they won't even have a choice about it. Wasn't this discussed when she was accepted? They certainly knew how much money she had, they do a full accounting when they decide whether to take someone. We wee declined by many places (including the one I worked in for 8 years) due to her only having enough to private pay for a couple years, but the place she is in now agreed upfront to let her stay once she is on Medicaid, with the caveat she will have to share a room then.
.
I would talk to the administrator as soon as you are able to find out what the plan is. Let her know how long your mom has until she runs out of money.


Medicaid doesn't care where she is...they do not pay the full rent, the amount they pay each month is the same regardless of whether it costs $2000 a month or $10,000 a month. The facility is simply agreeing to accept the low Medicaid monthly fee, that is why it is so hard to get a nicer place to accept Medicaid patients, they will get much less rent for that apartment than they would otherwise. That is also why they will make my mom share a room...between the two of them, the facility may still only get 1/2 of the rent they are getting now from my mom alone paying privately.


If the facility agrees to let her stay there, you do not need permission from Medicaid, they aren't involved with deciding where the resident lives.

My best friend recently found that out with her mom. She was full private pay, at a very nice facility, for about four years and her children thought that she could stay there forever under Medicaid once her money ran out. Unfortunately, there was some type of complication. I believe it was that there were a lot more Medicaid beds used in the facility at the present time than when she moved in four years earlier, they really argued with the place but they would not let Mom stay. It was almost impossible to find a facility that would take her mom starting from day one on Medicaid. She ended up a much, much lower quality place but it was the only one that would accept her.
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Old 12-07-2015, 12:57 PM
 
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Hate when I make a loud statement and then have to go in and accept fault for misinformation.
But, live lifetime - learn lifetime.
I just talked to the same owner I refered to before.
He is actually running adult family home and as such, stay there with 24/7 care is covered by state of WA Medicaid program. Medicare covers regular expenses under plan A and plan B coverage.
Those that do not have Medicaid or another supplement that will cover adult family home, go on self pay arrangement.
He does not know who pays for assisted living, but it appears that principle is same - Medicaid does based on state regulations. So in some states it does not, in some, like AZ, it does.

Apologies for misleading info.

https://www.caring.com/questions/doe...ssisted-living
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Old 12-07-2015, 01:03 PM
 
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Medicare DOES NOT pay for assisted living as a custodial basis.

But DOES pay for short term assistance to recover from illness or surgery, but I believe you must be going from the hospital to the assisted living site, and you must have been in the hospital for at least 3 days, "Admitted" not "observed"

Many hospitals will now not make your status as "Admitted" and make your status as "observation".
They get paid more/day and don't fall under the new 30 day Medicare re-admission rules.
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Old 12-07-2015, 01:24 PM
 
20,305 posts, read 16,477,627 times
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Quote:
Originally Posted by germaine2626 View Post
My best friend recently found that out with her mom. She was full private pay, at a very nice facility, for about four years and her children thought that she could stay there forever under Medicaid once her money ran out. Unfortunately, there was some type of complication. I believe it was that there were a lot more Medicaid beds used in the facility at the present time than when she moved in four years earlier, they really argued with the place but they would not let Mom stay. It was almost impossible to find a facility that would take her mom starting from day one on Medicaid. She ended up a much, much lower quality place but it was the only one that would accept her.
That's exactly why I hired the geri-care manager, and why we made sure before she chose a place that she was guaranteed to be able to stay. The system is I admit very difficult to navigate for folks that don't have experience with it.
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Old 12-07-2015, 01:26 PM
 
20,305 posts, read 16,477,627 times
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Originally Posted by boater1 View Post
Medicare DOES NOT pay for assisted living as a custodial basis.

But DOES pay for short term assistance to recover from illness or surgery, but I believe you must be going from the hospital to the assisted living site, and you must have been in the hospital for at least 3 days, "Admitted" not "observed"

Many hospitals will now not make your status as "Admitted" and make your status as "observation".
They get paid more/day and don't fall under the new 30 day Medicare re-admission rules.
Assisted living facilities are not authorized for short-term rehab, it has to be a skilled nursing facility. The licensing requirements and staffing requirements are totally different for each, but ALFs are not considered skilled care. You can get "home" therapy at the ALF you live in under Medicare Part B, but that is different.
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Old 12-07-2015, 03:41 PM
 
4,948 posts, read 16,482,783 times
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Quote:
Originally Posted by germaine2626 View Post
My best friend recently found that out with her mom. She was full private pay, at a very nice facility, for about four years and her children thought that she could stay there forever under Medicaid once her money ran out. Unfortunately, there was some type of complication. I believe it was that there were a lot more Medicaid beds used in the facility at the present time than when she moved in four years earlier, they really argued with the place but they would not let Mom stay. It was almost impossible to find a facility that would take her mom starting from day one on Medicaid. She ended up a much, much lower quality place but it was the only one that would accept her.
Also a new company may take over and change requirement etc. They also may say the care needed is above what they can provide. A promise is only as good as the paper it is written on.

Right you are most places want private pay first since Medicaid pays very little.
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Old 12-07-2015, 04:24 PM
 
Location: SW Florida
9,665 posts, read 6,962,505 times
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Quote:
Originally Posted by ocnjgirl View Post
Medicare does not, Medicare is strictly health insurance. Medicaid does, but you have to do some legwork to find a facility. They are only required to have a certain small percentage of Medicaid beds and they are often hard to come by in desirable places. Normally it is very hard to get accepted into a good one if you are straight Medicaid from the start. They want people who can spend down and then convert to Medicaid.


My Mom is such a person. She had about $100,000 between her house and retirement savings, but I had a very hard time getting her accepted because she wasn't that old and was more than likely going to be Medicaid within a year or 2. I hired a Geriatric Care Manager who found us 5 nice places that agreed to accept my mom and let her stay once she is out of money. We chose one and that's where she is now. She is almost out of money and I am getting ready to fill out her Caid application,


The only thing is, she is going to have to now share her already very small room with a roommate once she converts to Medicaid.
My mother is in exactly that same situation, although she had pretty much run through her annuity when she got into an assisted living facility, although she has been able to pay for about half the monthly fee with her SS income. She's also 89 years old, and although her mind is good she is not so steady on her feet and definitely a fall risk- kind of epitomizes the "frail elderly" concept. Fortunately she had help finding the ALF she is in, it's a very nice place and they accepted her knowing she would end up on Medicaid within a year or so, and promised not to toss her out when she did. Even though she qualifies for Medicaid, she is still on the waiting list with no way to know when they might approve it.

I don't know that she will have a roommate, but they may move her to a smaller room. She's fine with that.
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