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Mom has recently spent a short time in a beautiful assisted living facility. It was really great...and luxury living. She thinks this is a place she wants to be in permanently. At $350 per day, she cannot afford to live the rest of her life there. They do not accept Medicaid

All,this makes me wonder. Can someone tell me the actual logistics of this process?

When the money runs out, do they simply put her on the street? Do they move her to a Medicaid only facility? What exactly happens when she has spent all the savings and investments?

We looked at several places for a temp stay. Some of this place are really awful! But, among those places accepting Medicaid that are not totally dreadful (none were actually OK) ....they all require self pay for some period of time first. What happens when all the money was spent at a different place? What becomes of the senior then?

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Wow, I wish facilities around here charged $3500 a month.. here it is about 7000
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Very, just look at other countries including Canada where there are wait lists. Katie you may want to hire a geriatric specialist even if it costs $400/ hour. The right person can help you navigate. My MILs specialist helped file paperwork about 6 months prior to anticipated eviction. They applied for Medicaid and the specialist gave recommendations about which NHs were better than others. The family had to do field trips and learned how to do the paperwork to place her on wait lists. While she still had a few months of self pay, that brought her higher on the list. Is this worth considring?
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isn't death more acceptible than to lay there and die
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Plan ahead to die from exposure. America has a huge problem with homelessness. People mistakenly think that homeless people must be mentally ill. Few are.
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$350/day is way too expensive. Most facilities will charge around $3500/month. It is sad to say but care requires funding, so only large corporations could afford to have someone with no pay, and eventually they can run out of money if they see no profits. Best to do is to plan ahead, as many here have suggested.
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I know exactly what KatieKate means by "put her out in the streets." It's an important question that deserves an answer from the owners of all retirement homes, nursing homes, and politicians also. Let's put it another way. I knew a man who ran out of money in the retirement home he was in. He didn't wait for it to put him out in the streets. Instead, he shot himself to death one day, right outside the building (while he was still a resident.) Does everyone here understand THAT?...................................................................................................................................................................................... I think zythrr summed it all up very nicely: "When the person can't pay,the facility will start discharge proceedings being sure to follow state laws. Once the person is discharged, they're on their own, and will not hear from the facility again, unless money is owed."
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When the person can't pay,the facility will start discharge proceedings being sure to follow state laws. Once the person is discharged, they're on their own, and will not hear from the facility again, unless money is owed.
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Unfortunately, each state has its own version of Medicaid and various levels of living that are funded. Texas did not participate in the expanded version of Medicaid from the federal government since it has participation requirements, and the residents of Texas that need Medicaid have felt the pinch. Fewer beds, often less "nice" facilities. As Rocknrobin notes, some states will cover supported living. Katiekat, the answer to your original question is the same as a hotel or apartment - if you have money to pay, Mom can stay. If you don't have the funds to stay there between private pay and Medicaid and long term care insurance, your mother will be asked to leave when her money runs out - she won't be put on street but she will be relocated to a facility with a Medicaid bed. Very disruptive to dementia, but the facilities are for-profit. Money needs to come in to pay for services. That's one of the reasons that it's so important to tour facilities that you might need before you actually need them. Just like a doctor does not have to accept your insurance but will accept private pay, the luxurious assisted living facility doesn't have to accept Medicaid. And if she is already a resident and runs out of money at a non-Medicaid facility, the facility has the right to evict her. And it's probably not a 30-day type of thing - read the intake paperwork as to the time frame. Hotels don't let you stay past your money on credit card/debit card/cash; apartments don't let you stay rent free (in theory, but most start eviction 1-3 days from rent due). If you think Mom will need services soon, look hard now. But look at places that she can afford for 2-5 years of payment and Medicaid. Look on the Assisted Living without Medicaid as resort living - good for 1-2 weeks but few people live there full time due to cost. We are having to look at that for my in-laws. They seem to think both will be able to live at VA free (shaking my head) and keep spending their social security on guns and his Dodge Challenger.....
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Illinois has "Supportive Living." If an AL is also a supportive living, they can take Medicaid. They can move in "Medicaid pending" and they don't have to start out private pay. These facilities are beautiful and up to date. All the same services of a private AL. Housekeeping, laundry, medicine management, 3 meals daily plus snacks and staff 24/7
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As I understand it, Medicaid never pays for assisted living. They only kick in for nursing home care after all of a persons funds have been exhausted. Medicaid is a poverty based program, designed for use by those who have no remaining options or money. If they paid for assisted living there would be droves of seniors moved into luxurious assisted living places at taxpayer expense, something our country doesn't do. Your mother will need to require nursing home care and have exhausted her money to qualify for Medicaid. My mother spent four years in a nursing home and we were self pay along, her Social Security, with long term care insurance at first, but it wasn't long before we came to Medicaid for her. The costs are just too large for many people to keep up for that long. We did find a nursing home that accepted Medicaid that was good. I wouldn't say any of them are what any of us want for our parents. It's what you do when there's nothing else left to do.
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I have to add that if a person is paying $350 a day for an AL place and they are not making any money, then they are living WAY beyond their means. This is more than people usually pay for NHs.
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katiekate, there is only one answer that is the same for people no matter what their age. They have to live within their means. If money runs out a person has to accept what is available to them. It is a reality of life.
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The vast majority of assisted living places do not accept Medicaid. And, when the elder becomes more ill, the assisted living place will not be suitable anyway, a higher level of care will be needed.

When the elder runs out of money (actually before this happens) the elder will apply for Medicaid. Once accepted to Medicaid they can then move to a Medicaid facility. Alternatively they can move to a Medicaid facility when the money runs out as "medicaid pending"...when accepted Medicaid will backpay the facility.

Not sure what you mean by "put her on the streets". Facilities need to be paid for their services. You can't stay there for free. If the money runs out they have to leave....so its best to plan ahead for the move to a Medicaid facility before that happens. For example, get her on a waiting list for the Medicaid facility of your choice long before she will need to move there...they usually have a very long waiting list. That way, when the money runs out she will have a better chance of getting into one of the facilities you deem good enough...rather than having to move to the poor ones.

Angel
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