Follow
Share

My question is the facility said he had to pay 2 years private pay before they would consider Medicaid. That’s fine he’s at the 2 year mark his needs are increasing. We are pretty sure he will get the Medicaid. We are using an attorney. Should we tell the facility before he’s approved he’s going on Medicaid or wait until he’s approved? If there’s an overlap and the family needs to pay a month or two it’s fine. I’m just worried we will do something to jeopardize his assisted living arrangement. How do you find out exactly how many beds are Medicaid and if there are one's available anyway other than asking the facility? Anyone been through this? Thanks!

This question has been closed for answers. Ask a New Question.
You’re applying for a Medicaid waiver for Dad? Every state is different and every facility is different. Are you in contact with the financial department of his facility? They should be able to tell you how many beds they have for people on Medicaid. Are you using an attorney or not? There was a typo in your post and that wasn’t clear. Elder Law Attorneys who specialize in Medicaid can explain the process to you.
Helpful Answer (1)
Report

If you can afford to pay for one or two months of his AL then for sure you can afford to see a certified elder attorney experienced in transitioning from private pay to Medicaid. That way you will know that you are on the right track and have help with the application if you need it.
As Ahmijoy posted states have different laws. Some states Medicaid won’t pay for AL is my understanding. There is a financial as well as a medical qualification for NHs to accept Medicaid.
So your states rules have to be considered. Since your ALF made the provision of two years private pay prior to Medicaid that sounds like they accept Medicaid and that your state pays ALF but a visit with an experienced attorney would be where I would start.
Helpful Answer (1)
Report

Thank you. Yes. We are using an attorney for the Medicaid. The facility does accept Medicaid but they were vague about how many beds. The person who showed us around said she never heard of a problem with it. I don’t trust 100% I guess I am questioning if I should tell the facility about the Medicaid app or wait until it’s approved and spring it in them Or just defer to the attorney. I’m just scared and don’t trust the facility based in others who were asked to leave because of the care level needed. Dad is bordering on needing more and I’m scared they might ask him to leave when he’s in Medicaid under the guise if he needs more care. I’m nervous and rambling!
Helpful Answer (1)
Report

Carol - for AL having Medicaid beds & taking Medicaid $ is done via waivers and not dedicated (guaranteed) funding from the state/feds like skilled nursing care is aka care in a NH. Most states do NOT have any waiver programs for AL. That your state does is fortunate. But the issue often is that for waivers there is lots of uncertainty as waivers can change from year to year. So AL have to be conservative as to # of beds. My state (LA) has a waiting list of 2,700 for AL beds and it’s easier to get onto LTC NH Medicaid than a AL waiver as waiver $ is being directed to PACE type of community programs as it’s more cost effective for the limited funding available.

That being said, I’d suggest that dad be evaluated as to his needs and you do an assets & income sheet on dad as this EOM. A new needs assessment done beCause IF he’s kinda on the cusp of possibly being “at need” for skilled nursing care, then you may want have him go into a NH and apply for Medicaid LTC NH program. The big plus in this is that the reality is that if he lives long enough he will eventually need a NH and doing it now means he won’t have to move again. The AL may have a sister NH facility that could take him & make this all easier and he could have a couple of months to transition to NH and have his medical chart show to be needing skilled care if needed.  If he was to be able to private pay for a couple of mos at the NH before applying for Medicaid, it could be a plus.

The asset / income sheet tells you by when he’s eligible for Medicaid. I’d be frank with the AL as to when that’s to be.

Out of curiosity, what is the atty doing? Individual LTC NH Medicaid is pretty straightforward and specific; it’s 2k in assets & under the monthly income maximum. So they spend down till they hit the mark and the application is done at the NH with NH submitting the application in tandem with thier bill to the he Medicaid caseworker for their facility. Dpoa does have to find & get together all the supporting documentation needed, like life insurance policies, burial polices, old property sales & banking statements info if within 5 years. To me, it can be a DIY. Did dad have $$ moved into a special needs trust or property trusts done or a Miller trust done cause his income is too high?.... or were there gifting issues? in the past that could pose problems so an attorney is needed to shepherd his application?  
Helpful Answer (1)
Report

Being asked to leave because you are using Medicaid and being asked to leave because you need more care then what the facility can give are TWO DIFFERENT SUBJECTS. Please do not confuse one with the other.
Helpful Answer (0)
Report

Agreed. I do understand the distinction Imwgen you are bordering needing more care they could “conveniently” blame it on your needs I understand they wouldn’t overtly kick you out because of Medicaid. I only bring this up because it happened to another resident. Just want to make sure we are doing things right thanks for your help. Appreciated
Helpful Answer (0)
Report

I would tell the facility you are applying for Medicaid. That way they are aware and can make sure a room is available when he switches over. My Moms AL had 39 rooms. Not sure if I was told they allowed 14% of the rooms medicaid or 14 rooms Medicaid. So, if they have reached either way, your Dad will not be able to use Medicaid there. You say he needs more care, you need to make sure the AL can handle more care. He may need a nursing home.
Helpful Answer (0)
Report

This question has been closed for answers. Ask a New Question.
Ask a Question
Subscribe to
Our Newsletter