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I realize this is a question for the ALF directors but I don't want to tip them off that Mom may run out of money paying their fees. I don't want her to be turned down on this basis. Of course, I am sure this happens regularly but I would like to know how they handle it.


Mom is 87 years old and currently living in an apartment with my stepfather. They have in-home care during the week. Their family members live out of state.


They are looking at ALFs in California. ALF costs are very high their area but Stepdad won't leave the mild climate because of his severe COPD and the proximity to his doctors. Their combined income will cover most of the costs but they will be dipping into their savings from Day 1. The math tells me that they will be down to their Soc. Security and pension alone in four years or less, depending on the yearly raises in ALF costs.


Assuming that Mom and Stepdad outlive their savings, what is the procedure for the ALF to evict them? I'm thinking Mom and SD would have to "spend down" to qualify for a Medicaid bed. I know the spend-down process is complicated and I don't know if, considering their pension and SS, they would ever qualify. But if they do, would the ALF be required to find them a Medicaid bed in order to evict them?

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Your mom & stepdad are in California and Medi-cal does not pay for the entire cost of assisted living. One their money is gone, they may not be able to afford AL even with the waiver, if their income is too low. Medi-cal uses a waiver program that helps with SOME of the costs of assisted living but not room & board. There has been a waitlist for the waiver for years now, I know they expanded the program in order to get people off the waitlist but I don’t know if there is again a waitlist.

the caveat with the waitlist is, in order to use it, you have to be willing to live in certain counties. For the eviction, the AL has to give them 30 days notice, in writing and there does have to be a “safe discharge”. Just be aware, if family members don’t step up and find a nursing home with a Medi-cal bed, then your mom/step dad will go to the first Medi-cal bed the social worker can find. No one will have any say in where they go. Been there, done that with my FIL. No one wanted to get involved until the day he was transferred to the nursing home and my SIL wanted the hospital to put the transfer on hold so we could all look at the facility and other facilities and make sure it was good enough for him first. That didn’t happen and he was sent to the facility the social worker chose. Not all facilities are the same, so if you care where they end up, you might not want to let the AL SW find a bed without your involvement.
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DePopa Jul 2019
Thank you! The eviction process was exactly the information I was looking for.

Being across the country and without funds to travel to CA and shop the nursing homes, I fear the worst. But, hey, better to "roll with it" and deal with this if it happens, as recommended. So many other things may come to pass instead.

Thanks to all for your input.
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Unfortunately, Mom and Stepdad are looking at pricey AL communities that do not accept Medicaid. (Mom would be willing to move to Arkansas where they could live for much less but Stepdad won't leave southern CA and Mom won't leave Stepdad.) As DollyMe mentions, we (Mom, Stepdad and the family) are just going to "roll with it." Once their money rolls out, we'll cross that bridge. I am a worrier who likes to plan for all possibilities well in advance, which is why I ask questions sooner rather than later.
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ALs are privately owned. Not all meet Medicaid criteria and cannot except it when the resident runs out of money. Those that do, may require private pay for at least two years before they will except Medicaid. And then that depends on if they have met the amount of residents they allow on Medicaid.

You really need to find out what Medicaid allows in ur state. Then check out the ALs in your area asking if Medicaid is excepted.
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I am confused, there are homes that are step up. One can come in at ID, then step up to AL, then MC, some even have Hospice care. They go in on self pay, when they get close to the Medicaid requirement, apply and stay where they are. yes, there are some homes that do not take Medicaid, choose one that does.They can earn $2025 per month and be in the Medicaid program. Basically it all boils down to math. Who knows, one of them may not live 4 years, roll with it and see how it shakes down.
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You need to find out if Assisted Living Facilities are paid for by their states Medicaid program. Many states do not cover ALs, only Nursing Homes.

You need for mom and dad to consult a certified eldercare attorney in their state. This is a legitimate use of their money and the upfront cost is well-justified by the angst and trouble you will avoid by getting solid, factual guidance.
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