Has anyone's parent with dementia/Alzheimer's been denied Medicaid approval for assisted living?

Hi igloo....thanks for your reponse. Mom really doesn't require skilled nursing at this point and that is really what worries me the most. And I think as long as she doesn't require it, I get worried she will not be Medicaid approved because of this. But, there is no doubt that she cannot live alone as she suffers from early onset dementia. When she lives alone, she literally loses it. She gets paranoia/anxiety, walks up and down the street looking for car rides, cannot maintain her meds, forgets to eat/drink causing all kinds of issues, etc. So, this is where I wish I had a crystal ball to see what the future holds. I actually am trying my best to get my mom into a shared room because my sister placed my mom in a 1 bedroom and it is very expensive and I'm very upset that my sis did this. I speak to the AL facility all the time pushing to try to downsize her to make her money last, but no opportunities are opening up yet. I've even asked to see if she could get a roommate in her room as a shared but they said they worry my mom would be too possessive over everything in the room.....just my luck! Anyway, I'm trying so hard to make it work and I'm so scared and worried they will throw her out if not approved when her funds run out. I will look into NH's, but I doubt she would be able to go there without skilled nursing. That's why she's in AL instead at the moment. I appreciate all your help and advice. Thank you!! I'm so glad it worked out for your mom! NJ is a strict state when it comes to Medicaid, so I'm not feeling too good about it working out....I know it sounds negative, but it is so hard to think it's going to work out.

Trinity - it sounds like you have pretty good insight on all this. 4th place is almost top of the list! Yes she would need to require "skilled nursing care". Some places are very by the book and other not so much. Do you have any idea of what the AL occupancy rate is and what the rate is for a NH (or 2) that you like. For MIL, her old NH in LA was very let's say flexible in their criteria. Now because of its location not on most folks list so keeping their occupancy was an issue but for us it was perfect. It was pretty great (she hated it but would hate the Ritz Carlton). My mom's first NH had lots of beds as they had undergone a renovation so all of a sudden had extra beds, so they really needed residents. If your in a larger city, stuff like this can work in your favor.

If the $ 600 can work for you, that would be wonderful if she is not the roommate type. My mom liked having a roommate as she had 3 sisters and as they age they really do revert to childhood pattern. I'd ask if the room is till forever or what happens if she moves to a shared room or needs to move to one. Often the studio rooms or rooms at the end of the hall by a stairwell (so somewhat smaller so "fit" 1 bed) will have a preference for residents who still have a in the community spouse, so when they visit - which is usually often - they have some privacy. they did this at my mom's 2nd NH which was a sign of a good NH imho.

Thanks igloo! My mom is 4th on a waiting list at the AL home she is currently in for an approved Medicaid room. She also has the option to occupy a studio if Medicaid approved, but we would be responsible for paying an additional $600 out of pocket for that room per month. The shared would be covered 100%. This AL facility I believe has 10-15 Medicaid approved beds. I'll also look into nursing homes as well, but for a nursing home, wouldn't you still require some sort of skilled nursing to reside there? Mom only needs medication management, meal reminders and reminders to drink fluids, and to be kept an eye on, etc.

Trinity - One kinda big issue to keep in mind for the whole AL/Medicaid situation, is that Medicaid funding for AL is "diversionary/waiver based" funding & it usually is a specific type of waiver & the vendor can choose to participate. Medicaid is/was designed for paying for skilled nursing services aka Nursing Home & NH either fully participate in Medicaid or not at all. As elder population # have increased, SOME states have decided to use part of the $ that is discretionary for waiver programs. Some states just flat do not do AL diversion or waiver programs. Medicaid is a joint federal & state funded program but administered uniquely by each state.

For the waiver programs, the funds are limited. Then add onto that whatever participation quota the facility has for Medicaid. What often happens with the 2 year situation is that even though you are on the list, your name never comes up to the top as the beds are staying occupied by those there ahead of you. For my state - Louisiana - the AL waiver program has a list of thousands. When we were looking for placement for my MIL, basically were told that she never would get off page 2 of the waiting list; that the few beds the AL had for waivers were going to always come from those there for years private pay; nobody off the street was ever coming in on a waiver.

If your mom could possibly qualify medically for NH, that will be the easiest way to have her cared for and paid by Medicaid. You may need to look into this (going to NH) also because many states are pulling back from AL waivers and going to funding PACE programs instead with the diversionary funds.

I moved my mom from IL to NH & totally bypassed the whole AL stage. It can be done with a bit of dogged work on your & mom's part.

NJ does, but from what I understand it is not easy to get approval. I know that funds need to be exhausted, but they also need to get approval through a medical exam by a nurse from the state. I'm curious to know how many out there have been denied whether it be nursing home or assisted living. In our state they do pay for assisted living so long as they pass both the financial and medical requirements. Is anyone on her from New Jersey??

Trinity, Medicaid does help pay for cost for a nursing home if the patient qualifies and most do if they don't have the financial resources..... but I never heard of any State where Medicaid pays for Assistant Living.

In my state assisted living facilities are able to accept Medicaid patients as long as they pay out of pocket for the first 2 years and then they can apply for Medicaid when funds are exhausted. I'm just curious to know how many people have been denied. We are in NJ.

I did not think Medicaid paid for assisted living anywhere. Some memory care facilities accept Medicaid but only after a period of two years on self pay. Againstthe law? Yes, probably, but how are we to finance care for elders when there are not resources?