We visited my MIL on Long Island, NY, who turned 95 last weekend at a reputable or at least recognizable LTC chain. She is in memory care, (highest level, locked elevator, etc).

MiL’s administrator was there working on Saturday and we asked to speak with her to review MIL’s general status. This particular Mgr was a Social Worker. My MIL has dementia & needs assistance with everything but still walks using her walker, has a voracious appetite and her recent lab work is better than my own. She is 5’ 110 lbs & most of the time is up and out of her room with supervision walking. (Restless - gets meds for that but we all know it can be a fine line between medication tolerance and disaster for our elderly.

I asked the Social Worker if this center had a % of Medicaid waiver beds for the purpose of not having to move a person who had exhausted their $ resources to SNF. (Playing dumb) I asked her what happened when a private pay could no longer fork out the almost $10K monthly fee (as they get from my MIL who has been there about 4 - 5 years so far).

I came enlightened from what I have learned on this forum, lol, & eager to hear her response.

The SW said once a resident runs out of funds to pay the center, the resident would need to be transferred to a SNF.

I asked, prefaced with, don’t you have a percent of rooms you set aside for situations where perhaps a resident who has self payed for a certain time is able to remain there while the center took what Medicaid paid.

The social worker said no, and that New York State has no such law addressing this important issue of Medicaid waivers.

So, I asked again, did this mean my 95 y/o MIL would be discharged from this specific chain assisted living (which has indeed been around and thriving for years)- when her money runs out?

Yes....that was the answer.

Can anyone from NY confirm this is true? There are a few New Yorkers here. I can research after work as well but maybe someone knows?

Can you imagine moving a 95 y/o from luxury to a SNF? After spending so much for her care for 5+ years?

To me, cruel and Inhumane.

This is what happens to our seniors these days in New York. And New York will limit the size of sugar drinks you can buy, but then reneged with Amazon to do business in Queens which would have created thousands of jobs in that community (perfect fit for residents of not only Queens but NYC btw), etc etc.

What’s wrong with this picture?

Rant over.

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I did see a huge banner there stating they had “zero deficiencies in their 2018 survey”, so that means some state agency is overseeing them. Now I am wondering who that regulatory body is, due to someone’s answer about avoiding state surveys in order to make themselves ineligible to receive Medicaid funding (which makes perfect sense to me, thank you!).

Yes I see the point asking why the center should accept a discounted rate other than what Medicaid pays. But when you are a reputable chain and you’ve already accepted almost $10 grand a month from a Senior for 5 years, you would hope they would set aside a small number of beds allotted for that purpose. They would get the cheapo Medicaid reimbursement rate as well as my MIL’s SS & NYS pension for payment so the center would take a minor hit financially - I understand that. The family figures MIL has funds for another few years at this rate, so she’d be bounced at 97 years old to a Medicaid SNF bed.

I am happy to see that the memory care unit where my MIL had a full contingent of staff present for a weekend.
I purposefully noted the routines of the staff and how they interacted with this group - all seniors in memory care- with this forum in mind and what I’ve learned here. I was pleased with what I saw there are far as care and attentiveness toward the residents.

I get blown away just realizing the monthly fee for this AL. But what really gets my goat is that of all the money a state like New York spends on BS programs, it appears no one in the state legislature cares to research how we can look after our seniors better.

Thanks for for the heads up re: Maryland being the same. I live in Maryland too.

Its up to her son who is POA to search for a different AL & he is 73 & moved from NY to SC two years ago as one of the million people leaving New York annually due to the higher taxes. So MIL will stay where she is.

I just feel flabbergasted by the whole thing - her monthly rent, and now knowing - for sure - that she’d be asked to move once her private pay runs out, and the center isn’t willing to accept just SS & a pension fund. She can’t live forever but boy physically she is in great shape. She had an aortic valve replacement about 6 yrs ago and I am sure that surgery worked so well MIL may live to be 100. Mentally she doesn’t remember her children, has difficulty opening a present and a card.

This is the way Medicaid works in MD also.  Can you blame the owner of a facility for not wanting to work for free or at least a very discounted rate?  I agree looking for a smaller facility like a 4 bedroom house ALF may be more amenable to a discounted rate.  We saw one here in MD for $3k/month.

To add to what Worried just said...
ALs are not required to accept Medicaid waivers. I think what the SW was telling you was that this facility does not accept Medicaid waivers.

You might need to start looking for one that WILL accept Medicaid after a certain period of private pay.

Many of the nicest facilities do not want any Medicaid patients. All they need to is avoid getting certified by NY State. Honestly, the Medicaid reimbursement is so low they really don’t want people who have that as the payer.

if it were me...I would be looking now for a new place. Some of the nice places will accept a new placement that is first self pay, and then keep them once Medicaid starts.

if you wait till the money has run out, the choice of places might not include any of the places you like. ie : nicer ones.

NY does have Medicaid waivers for assisted living but there are only 4200 Medicaid waivers/beds. If the senior is in a assisted living facility that is not certified by the state as an “assisted living program” then the facility cannot take Medicaid waivers and that is why those who run out of Funds to self-pay are moved. Many ALs in NY are not certified as assisted living programs.

Looks like she would be covered, right.

I am surprised that this SW does not know how the facility she works for operates. Either that or they don't want residents to know they maybe able to stay. I would call your local Medicaid office and run it by them. Ask if they have printed info on the subject, if so have them mail it. If not, ask where you can find the info on-line. Take the info to the SW and show her.

Now, make sure that this facility can except Medicaid. They may not. They have to be contracted with Medicaid. We had an AL that lost their accreditation so the residents using Medicaid had to find other places to live.

I found this for you Shane, hope it helps:

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