As Jeannie said, you are getting a service and are expected to pay for it.
AL is usually private pay and you have to sign a contract and either you or someone will sign off as financially responsible for payment. In some states, there are Medicaid waiver programs that will pay for AL for those that qualify for Medicaid but you have to do the paperwork & followthrough to have it happen. Medicare & Medicaid are quite different in what they cover and how you qualify.

When there is a delinquency, the facility will issue the resident and whomever is responsible a "30 Day Notice" and usually within the notice - which is almost always cc'd to the State Dept of Aging or Human Services or whatever it is in your state and the local aging ombudsman that is in the Area Agency on Aging - it will state what happens after day 30. The dreaded "30" can be somewhat routine for NH when the anticipated payment is "Medicaid pending" as the initial review period is for 90 days in most states. I had to deal with this with my mom as her NH Medicaid application took almost 6 months (Texas). Letter gets sent certified too. The caseworker just sends out a fax to the NH to basically re-set the clock for another 90. But you have to follow-up to make sure that it was done and noted in their file. What I have actually seen happen for a resident at the NH who was like 5 mos behind, was they were made an emergency ward of the state and then transferred via ambulance to a NH that was several counties away. Being a ward of the state meant that the state would pay. The old place wouldn't keep them until the account was cleared, so that's why the move was needed. This incident was all about a transfer penalty issue, which the family just flat chose to ignore. This can be quite a PIA to get through and they might find themselves permanently removed for any say-so in their parents care as the state is now in charge and all because of the delinquent account. Not pretty. Just horrific and so sad and terrifying for the elderly person too. The facility will turn over an account to collections and the amount could be rebelled at the much higher private pay rate and not the lower Medicaid rate. You really don't want to be in this situation, which is very antagonistic and panic driven. Meet with the billing office and work something out. Yes, MSM does love the common man in need story but this is a deadbeat story which doesn't get positive coverage and the family member who refuses to pay the bill either comes across as a self-serving ninny or too dim witted to be POA or guardian. The facility will likely have a press release or other crisis management letter at the ready for this type of thing too. The IL my mom was at is part of a larger CCRC/AL/NH group and they have a PR firm.
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Every business, for-profit or not, must get paid for the goods and services they provide. No resident of an ALF has a right to stay there indefinitely without paying. The question is more about how long a notice they have to give and the details of moving out, but there is no question of staying without some payment plan in place.

Is Father eligible for Medicaid? Does the ALF he is in accept Medicaid? Are they even eligible for Medicaid payments? Where ever father goes next he has to have some means of paying for it. If he can no longer pay out of his own funds, he needs to arrange something else, such as Medicaid.

How much assistance does Father need with activities of daily living? Is he ready for a skilled nursing facility?
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The short answer is yes. The longer, more correct, answer is not for a while. No business can afford bad publicity. They won't simply dump him at the front door because that would bring the media asking all sorts of embarrassing questions. If the facility manager hasn't thought of this, you might remind him or her.
It is now time for you to check out other care facilities to see if they accept medicare only residents. There are some that do. There is also a possibility that his current facility will do so (to escape the embarrassment above) if they are prompted by the right people (see State Office on Aging; Medicare Representative; local Congress representative or senator; Elder-Law specialist attorney; media outlet).
Don't give up. There are solutions. If necessary, take a two or three day break by going somewhere you consider fun to "re-charge your batteries" before making another attempt to sort all of this out.
Blessings on your efforts.
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what do you charge for a month at you home do you need a down payment?
Jaunita
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