My income is above income limitations for Assisted Living facilities in my area. Any suggestions? -

My income is above income limitations for Assisted Living facilities in my area. Any suggestions?

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I live in a Mobile Home Park for seniors. I am 86, but one of my younger neighbors does work for other neighbors as a part-time income source. He does all my regular cleaning every 10 days, does minor repairs, and also is a friend who checks on me to see if everything is o.k. I have lawn care service, and also winter snow clearing services, so I do not have any unfilled maintenance needs. I have checked the County Office for the Aging which maintains a list of AL facilities. I have checked that list and all the listed facilities have income limitations as they are federally subsidized and have to follow their regulations. I am not eligible because my income is too high. Under my HMO Medicare Advantage plan I have a free Home Visiting Nurse service which has an on-call service available 24/7 and visits me regularly every 2 months or so for overall check-ups. There are 2 Home Visiting Nurse Associations available to me in my local area and I plan on interviewing them when I need their services. Their fees are based on your needs and time requirements. I would not be interested in using a "room and board" or group home. I continue to do online research into various alternative solutions for my future needs as they arise. Some of the residents in the MHP I live in are well into their 90's and I don't think I will actually need medical assistance beyond what I currently have, for a couple more years. Thanks very much to all the helpful answers and suggestions I have received. They are very much appreciated. Kevin C.
Helpful Answer (1)

I'm not at all familiar or wasn't even aware that federal regulations preclude paying full "market rental in an assisted living facility." Could you elaborate? My understanding from posters here is that they often bear the full cost of AL for their loved ones.

Long before you feel you might need private duty care, do a lot of research on the companies and call some to get an idea of what you'll face. And know that there's no oversight for them as they aren't reimbursed by Medicare. That lack of oversight gives them a lot of latitude to set their own terms.

Be prepared for misrepresentations between the advance people and the admins. In my experience, most of them aren't on the same page, unless you find a company that's still owned individually and not franchised, as most of them.

And that's another drawback; some folks here and on another forum I visit have used the same national franchise, with good results, but I found our local franchise to be owned by people with a much different approach, and not a very professional one.

So start your research early.

What you might consider trying to find a private duty nurse as that's not typically provided by private duty care unless the company has a home care affiliate, and nursing might be the most important aspect you need.

I've found that the light housekeeping is really not much and am going with a real house cleaning company that does a thorough cleaning.
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Do they have "board and care" homes in your area? They usually are the least expensive option for care. ($2,500./mo. (in California) and up depending on needs and/or dementia.)
It's a private home that has residents who need assistance in one way or another, (bathing, dressing, eating, meds, transportation, etc.) There are only a few (6-8) residents because there are only 2 to a bedroom and usually only up to 4 bedrooms. Possibly you could get a private room for added cost.

Having home health caregivers is good also but they don't do things like yard work, heavy house cleaning, etc. You would have to hire others to do work not covered by home health. Caregivers go for around $21./hr. here in San Diego county (California). Overtime (for the same employee) starts after the 9th hour worked but would be regular time if a new employee came on duty.

Hope this helps. Good luck.
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I am middle-income or upper middle income. I am covered by a Medicare Advantage program. I am not eligible for any waivers. There are no full-pay or personal pay assisted living facilities near me. Although I am well able to pay full market rental in an assisted living facility, federal regulations do not allow that. I have not consulted an eldercare attorney yet. I will not need access to an assisted living facility for another year or so. My only option seems to be to stay put (I live in a mobile home in a Seniors' Mobile Home Park) and to enter into an agreement with a private Home Visiting Nurse service to provide home health care and other services as I become in need of them. Thanks for your answer to my question. Maybe this will clarify my current situation a little.
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I'm not sure I understand. Are you talking about your income being to high to get assistance through a Medicaid waiver program?

Have you talked to an eldercare attorney about creating a pooled income trust? Find out if that is a way that you can get your income below the limit.
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