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My Dad is 88 and cannot go back to assisted living from rehab. He is physically pretty healthy although the stroke 7 years ago was definitely the start of decline. He is diagnosed with vascular dementia and alzheimers. He has enough money to private pay for about two years, but then it will be medicaid.

I thought I had made my mind up and even paid a deposit at one facility, but now I have doubts. The one I put the deposit on is well respected, closer to my home and takes Medicaid, if and when the time comes.

I made the mistake of visiting a brand new facility that is 25 miles from my home and does not currently have a medicaid contract. Of course, it was beautiful and well laid out, with a choice of nice rooms on the courtyard. (It is just opening this coming week, however it is part of a large campus of independent and assisted living buildings, which has been there many years and has a good rep as well.) I loved it, but I only met the Administrator, Sales Person and Chef.

I've probably just answered my own question, but it's nice to get informed advice from the ones who have gone before me on this path. Thank you.

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Location-Location-Location. You will be sorry, I can almost guarantee it, if you choose a home 25 miles from where you live. Don't know where you live, but in the Chicago area (traffic), 25 miles could take an hour or more.

The ideal (for me anyway) is a place where I can pop by. Mom was rehabbing for about 3 months a while back. Most of the time she was there, I was going every day so she wouldn't forget me (because I expected to...and did...bring her back home). I would pop in any old time and got a really good idea of the care she (and others) received. That's golden.
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Don't know where you live, but in certain climates, closeness would be of utmost importance, as no one wants to go slip-sliding all over the place to go somewhere far if there's a closer place. (thinking now of how I even, while looking for an apt, felt I needed to be a bit closer than some for this climactic reason, as well as some others).
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I agree with Pam regarding Medicaid and with the others as to being close. My mother went to assisted living, less than a mile from my home. It is a nonprofit and will accept Medicaid when the time comes. Plus, you never know what could happen. When my mother went in, we thought that she had the funds to last longer than it will. You always have to consider the rate they pay today, will change as they get worse. They will require more supervision, and more personal care, which sadly, will cost more money. Mom had a recent fall, and she is in rehab 2 miles from my home. Luckily, the social worker gave me a list of places to pick from, which were all close to home. I talked to people at mom's assisted living facility, and also read all the reviews online when making my choice. We will be at our 2 week point this week, I don't know if she will get to go back to assisted living..(we had already paid for August, and will hold the room if it appears that she will return) With her being close, I'm able to stop in almost daily. Some days I stay 3 hours, and some days just a half an hour. Her concept of time is very distorted now, but I know she knows I'm there. I'll be going tomorrow to have lunch with her. My time is limited, so being close was the most important factor along with being clean, and a friendly, caring staff. At her assisted living place, I still do her laundry, and clean her room (my daughter's get so mad at me because it is included, but I just can't let it go yet). I'm only doing her laundry while she is in rehab. The fact is, you never know. Medical bills can become very large, very fast. The sad reality is, we never know how much time is left Mom could pass away tonight, or live another 10 years (she is 81). Good Luck with your decision. If you think the closer place is a safe, caring place..that is the one that I would pick.
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Go with option A, it is always better to go in private pay and then convert to Medicaid. When you go in Medicaid only, a lot of doors close.
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My personal experience has been to go with the one that fits the best right now. I moved dad into a close ALF that would take medicare when the time came and sounded and looked good. Who could tell? the med techs ran the place, scolding my father if I had him out beyond the pill time (not teasing, scold) the nursing director turned into nurse Rachett threatening my father with "lock up" when he complained that he couldn't get out of bed. I finally took him to the hospital for pain and then relocated him to a new facility where they were small (so far) and had reason to want their reputation to be golden. its a 25 minute drive instead of a 15, but they are less expensive and they really do care and they are easy to get a hold of. it also works out best because my father doesn't just call me at the drop of a hat and say "I need you to slip over here right now". he knows its a longer drive and he has become more accustomed to buzzing his buzzer. this is in fact, his third move in a year. the second one being a more expensive place because "you get what you pay for" and, guess what, we didn't.

so im convinced that for me personally, I want dad to have the best now I don't know how long "the rest of his life" will be. having said that, did you ask the new place what their intention is for Medicaid as they go forward? maybe its just that Medicaid licensing takes longer?
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Close to your home is important. There is no substitute (in my mind) for frequent visits, even if they are short. Being able to "drop in" is very valuable.

Taking Medicaid is critical, if Dad's funds will only cover a limited time of private pay.

The level and quality of care is far more important than a lovely setting. That both places have a good rep is very encouraging, but the newer place has yet to establish its reputation in the arena you are most interested in.

Moving your father when his money runs out will be traumatic. The new place may be accepting Medicaid by then. But what if they are not? Many places only accept it after a period of self-pay, and Dad won't have funds for that at that time. He may wind up much farther from you or in a place with a lesser reputation.

I'd go for the one in the hand (closer to you) instead of the two in the bush!
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