My parents are 89 and 94 and in assisted living. They have spent nearly all their money there over the last three years. How do I find out their rights? THANKS
Being evicted certainly is based upon income, the insurance they have and whether an assisted living facility accepts insurance coverage such as Medicare and/or Medicaid. If they are in a facility that drew up a spend down contract, you would have to re-negotiate under their current circumstances. In addition, some facilities reconsider certain health conditions, such as cognitive issues (i.e., Alzheimer's). My suggestion is to discuss the matter with the facility and if you are not sure of your parents' rights, I would suggest contacting a qualified and respected elder law attorney who can guide you through the process. Many attorneys offer free consultations. You legally are entitled to view your parents' files at the assisted living facility, as well as are entitled to a copy of any and all documents. You might have to pay for copies. I would purchase one of those inexpensive (about $100) portable scanners. Ask to see their file, scan every document, and download them into your personal computer for safekeeping. This way, you will have the documents for an attorney to view. This will provide all the necessary information an attorney will need to properly provide accurate advise. Hope this helps.
They cannot throw your parents out either until you find a place that is acceptable. I have seen residents that are physically inappropriate for assisted living. They need a nursing home. But, they drag their feet and they tell assisted living. They cannot find a place and this goes on for months. One thing that is concerning. Did your parent sign themselves in. Did you sign any paperwork. I am just wondering if they can come after you and put a lien on your home.
Bottom line is evictions are complicated and require a court ruling. The AL can look to evict if the resident needs care beyond what they offer, for example an AL may not feed residents, if someone has trouble swallowing and cannot feed themselves, they may need a greater care unit such as a NH. Yes, if someone is significantly arrears in payment and not making arrangements to pay, they can certainly be evicted....a difficult and costly court process. Intervene on their behalf, understand why, and you will be able to guide a solution. Try to negotiate with the facility. If your questions is can they,....yes they can, but it is costly and slow court process.
My in laws were evicted because they were unable to follow the rules like no smoking and they had a dog who was urinating all over the carpet. They ended up on Medicaid and lived with us for a year but they were a danger to each other so we finally found a good nursing home for them where they could share a room. It was very distressing to have gone through this process with a lot of RED TAPE due to the move from one county to another in CO.
YES YOU CAN BE EVICTED from AL. But it's not only for not paying your rent, it can also be for behavior issues. SOME assisted living accept Medicaid....NOT ALL. Best practice is to have a fine-tooth comb when you first starting looking at AL, do a very thorough reading of their Rental Agreement or whatever they call it.
I have a friend whose mom is on her THIRD assited living rental, the poor lady has mild dementia, and cannot control her behavior very well. So she has been literaly evicted from 2 AL's. My friend is at her wits end, after paying HUGE amout for rent, and all the moving expenses too, and her time to try and deal with the complaints preceding the eviction, she has had to move her mom 3x.
Assisted Living facilities--be very wary when entering one, and realize, it may in fact only be a temporary living situation, whether you like it or not.
In Washington State, when your money runs out Medicaid will take over and pay but there are conditions. First, the building management must accept Medicaid. Not all do and not all have to. I hope they asked before they moved in. They usually require up to a years notification. One AL building my dad lived in only allowed two rooms ( out of 65 rooms total) for Medicaid and if those where full...to bad. In his ADF he's in now it looks like the transition will be smooth if he lives that long and runs out of funds. VA is an option but be careful with that one. The money is not a lot and might interfere with Medicaid. Get a qualified adviser before asking for VA money. NOT an investment company...Get a qualified elder attorney. Making sure your parents are protected is an important issue as it does happen that someone may take advantage of them. Attend all meetings with them and don't let them sign anything until it has been thoroughly investigated. In 5 years of helping my dad I have seen a few things that made me stop and take a second look. However, having said all that, once your on the right path and have the right info, it is an easy path for Medicaid funding.
Bottom line - talk to the admin at the facility first and find out what the real situation is. If their income plus a small amount from you is affordable, or if they actually bought in to something long term, maybe they can stay there. I understood though that Medicaid pays for skilled nursing and maybe a comunity living waiver that covers supports to keep them in their own home, but not assisted living. Medicaid will WANT to be paid back, but if there are no assets that were exempt and nothing is left, they typically do not get paid back. It is called 'estate recovery" and will typically reduce what is left for any heirs, but allows the person to keep a house and a car as long as they live and "intend" to return to it, $2,000 in assets, and a burial policy.
My first question is"Are they spending their OWN money to live there now?" Is it thru savings, a sale of a home or insurance? I would check with the administrator to review their financial situation. Sometimes you you can downsize an apartment to lower costs i.e. a studio vs a standard size apt. Some nursing homes are step care facilities and have both assisted living and nursing home care. What level of care are your parents needing? Other options might be adult care homes. These residential group homes can be a less expensive option. Good luck.
I feel for you. It is a tough one when your parents out live their money. I believe it goes back to your original contract. Did you have to pay a lump sum for your parents to live there. I would ask if families or the community has money for situations like this. I live in Boston, MA my aunt lives in assisted living it cost her $6000 per month. It is all out of her pocket. Medicare does not contribute.
We're discussing two different things here: types of care and types of communities.
DEFINITIONS: "Assisted Living" is a type of care. It means that a person will get support with the 'activities of daily living' (bathing, dressing, eating, etc..). "Personal Care" is very similar. The licenses vary from state to state, but that basically describes AL and PC. Both may or may not offer 'memory care' or a 'dementia unit' and communities may vary in the level of care they'll take on. They do an assessment (it's surprisingly exact) which determines the 'level of care' a resident needs. In my state, a PC or AL cannot care for a resident who is on any form of life support (like a feeding tube - that would require skilled nursing care). But, they are able to take care of people all the way through end-of life (hospice) care.
Some AL facilities are part of a Continuing Care Retirement Community - you pay a very large entrance fee to "buy" an apartment ($80,000 to $500,000+), then your rent is fixed whether you stay in independent living or eventually need AL or SNF. They won't accept a resident who needs care upon move in or who has a diagnosis that will likely result in them having to quickly move into AL or SNF. They must have most of their residents living independently (less expensively) for their business plan to be viable. (Note: Often people don't realize that you don't own the apartment in a CCRC the way you traditionally own real estate. They have to re-sell it before you get your money back and in the meantime you pay a monthly maintenance fee)
Other AL facilities are rental communities. You are assessed when you move in and the amount you pay is determined by the care you need. There's typically a low entrance fee ($2,000 to $15,000, or in come cases $0). You need to have enough money to live out your days there even if the expense increases as you need higher levels of care.
I've 'run the numbers' for many different scenarios and the bottom line is, if you're youngish (early to mid 70s) it can make sense to buy into a CCRC. If you're older, it doesn't really make sense to tie up your assets that way.
If you have long term care insurance it's a whole other bunch of variables you need to consider.
MIL was in Assisted Living apt. Only applied to apt rent & emergency care. Than we found a place that supplied meals, housekeeping, bathing assist, & medication dispersal. Covered by a combo of Medicare/Medicaid.(CO) But if they are in a former AI than yes, if they get too sick to care for themselves or cannot pay rent, than they will have to find a new place. Differs from state to state so check with your state .
Hi there, keep in mind that every place is different depending on the location. I'm in Florida. My mother had lived with us for 19 months. We used respite care for 6 of those months, but she started going downhill quicker than we anticipated. We were very lucky to find a place less than 1 mile from our home. It is considered "Assisted Living", but also has a memory care unit. Mom has enough funds to pay for a little over a year, with the anticipation that her health stays the same (we have applied for VA Aid and Attendance), and my biggest concern is what would happen when she ran out of money. She is in a "Non-Profit", and they are listed as a "Assisted Living Medicaid Waiver Provider". I was told by the Administrator that they can't make anyone move for their inability to pay. I feel that she was honest with me, stating that it is easier to get someone in with a few months of private pay, and then apply for medicaid, vs. trying to get on a waiting list under "Medicaid Pending". She is in a private room, but she would probably get a roommate if Medicaid enters the picture. We are taking each day as it comes. She may outlive her money, she may not. It is a constant learning experience. I still take care of her medications, laundry, and clean her room...These services are all included in her rent, but I chose to continue doing these things. She has a cat that I take over there a couple of times a week. In fact, the dropped the cat off this morning, and will pick it up this afternoon. Her move in fee was 1,800.00. She needs help with her showers, and her monthly rent is 3295, plus incidentals. I don't think that they can toss people out. As others have said, talk with the administrator, and finance person. I would think they would be willing to work something out. I was up front with what mom got in SS, and her little pension of 107.00. They know about her cash on hand, her vacant lot, etc. Good luck, it is a very scary situation.
It's the Hot Potato Dance Redux: ElderCare Edition:
Facilities aggressively -covet- inpatients with fat retirement funds or other investment funds that actually pay the full costs billed. They might try to contract for only those patients, but, there are some rules that govern how they handle moving those who run out of funds. Contracts signed when people enter Assisted Living usually stipulate something about ability to pay; no funds means they must move out. Some facilities might stipulate in contract, refusal to accept Welfare/DSHS payment, because it's so poor a return, a facility or professional takes a huge loss, which they must write-off. The paperwork is monumental, which also costs the provider. Medicare also fails to cover a large chunk of the costs charged, but pays some bit more than Medicaid. Medicare also has lots of paperwork, which costs to handle. A facility or insurer gets paid government funds in addition to those from Medicare---something like about $800 per month additional money [that was over 10 years ago--it's probably more now]. This funding stream is rarely if ever discussed--it's a "deal" between Gov't and insurers [or facilities?]. Insurers got this pretty deal long ago, for any elder signed up for their Advantage / Supplemental Plans. I know less about how that money stream applies to facilities for elder care.
Loss of funding does not happen suddenly. A decent facility tracks where that money comes from, and how much is left at any given time. They usually have some months ahead to find other solutions. It can take every bit of that time to set something up, depending on availability of beds in other facilities, funding sources, etc.
When a person is already established under the care of a medical professional or a facility, and Funds run out, they cannot just be =suddenly= "evicted" or "fired as a patient". A facility is not allowed to dump-and-run, not to the sidewalk out front, nor to a homeless shelter. Laws prevent patient abandonment, for instance. Other solutions must be worked out.
One of those might include: a Facility will try to heavily coercing family members, even family friends, to take them home with them--I've heard facilities threaten to toss the elders into the street when the last dime of funding stops. I heard a facility Rep try to coerce a family friend to take the elder home with them; heard a Facility Rep try to strong-arm family by telling them the elder will be dropped off at a local homeless shelter. I believe all that is illegal. Facilities can get in deep legal trouble trying to ditch patients, can lose license, get very bad reputations, etc.
One facility may still try to take Medicare funds =after= someone has been moved to a new facility; Medicare and Medicaid funds immediately STOP being available to the 1st facility, once the elder has moved to 2nd facility.
All kinds of stuff has gone on, bordering on or flagrant Medicare fraud, by all levels of facilities, yet all systems seem to let it mostly slide---facilities have gotten very adept at hiding those transgressions by manipulating charting of events. Fraud on the part of facilities only gets found if staff are willing to testify--then those staff become pariahs in the workplace--whistle-blowing is NOT as protected as laws might make it seem.
Each facility usually has a Social Worker, OR, you can find one, by contacting your local branch of Area Agency on Aging, or call a local hospice to find one who can help you. A good Social Worker should be able to help find new facility your parents can afford using funds they have [like Medicare, maybe Veterans, maybe DSHS, etc.]. A good social Worker might also help them get hooked up with other sources of funding, though Veterans Services need contacted to deal with that System. Medicaid [Welfare] is usually very fast to respond. Veterans benefits, though, might possibly take months or years, depending on how effective the person handling application is at dealing with that system and it's paperwork. If one or both of your folks actually retired from military service, there are benefits to be tapped they may be unaware of---including some limited long-term care facilities in a few locations. Even a Veteran [not spouse] who didn't Retire from Service, can access Meds-by-Mail via the V.A., which can cost substantially less than Civilian Meds [Meds via Welfare Part D could be similar low cost]. Veteran's hospital and rehab services might be available nearby enough to use, too, which can cost the Ex-service member [Honorably Discharged] far less out-of-pocket--Veterans' Services do have a sliding-scale-per-income that helps cover remainder costs. CAVEAT for Veterans Services: It's extremely helpful for the person to have a good Advocate to make sure care rendered is appropriate, to prevent the person being used as a Lab Rat. The VA system manipulates people very adeptly for that--caveat emptor! One can get Extraordinarily Good care, or be treated very badly, =depending on circumstances=.
A Doc or facility might =not want= to deal with Welfare/DSHS, but unless there's some other fund to pay for services. A Medicare / Medicaid package is commonly used to pay elders' care, though Providers / facilities take substantial losses on that form of payment, and services are less-than-optimal. That's why it's so hard to find Providers who accept Medicare /Medicaid, and why some rules require facilities maintain at least a certain percentage of their patients in that category.
IF, as someone commented, one of your parents stayed in the Military long enough to retire from it, they BOTH then, Could get some Veterans assistance to pay part of their bill. IF one of them served for a time during a war or conflict time, then had an Honorable Discharge, only the Veteran can access Veterans Services, and there are some things that do not apply. Veterans benefits would come first, if they exist, then Welfare--Welfare is the last System in line to pay for facilitated eldercare--everything else pays first.
IF either of them has diminished in health, Assisted Living is NOT where they belong--they'd then need to move to a Nursing home/long-term care facility. NOTE: It's common for Assisted Living Facilities to aggressively court clients with strong funding available, and hang onto them far longer than it is appropriate. Assisted Living facilities also commonly sign up elders who need far greater level of care than is actually allowed in Assisted Living, just to get a person in with good funds available. When funds run out, or the elder's health gets so bad, only then do they relinquish those to Nursing Homes willing to accept Medicare/Medicaid patients. They're rarely brought up on charges for that, unfortunately; it's usually skillfully camouflaged to appear as though the Assisted Living place is doing the elder a favor, or that conditions are not so bad as they really are, etc.--the line is blurred.
There are transitional places with combination of levels of care, starting with little self-care apartments or units, then Assisted Living, then Nursing Home, then have agreements with nearby Acute hospitals. A person usually contracts/buys-in for a substantial fee, then pays hefty monthly charges to start living in one of the apartments, then as needed, move up to higher levels of caregiving--all covered under the same monthly charges. Those are costly to buy into, but provide a nice transition in familiar spaces for the contractees. SOME of those places have back-up funds to help a few years-established residents who might suddenly lose their income stream, stay with them. But most areas across the country have few available nursing homes or care homes; beds must open first, before an elder can be moved into them.
An originating Facility must find an open bedspace elsewhere, before they can move a patient out. They may be able to find one bed in one place, and another bed in a different place, splitting up the couple in order to re-house them elsewhere--elders can't really choose, at that point; it's commonly done. AFTER they're re-housed, AND new funding streams are established, it's still possible for POA's to rearrange where they are placed; maybe moving one to be in same facility as the other, if conditions allow.
Depending on your elders' current behaviors and needs, and family tolerance and ability with elder care, you may, OR Not, want to allow those elders to live with you, even temporarily until new facility is found. Once elders' reduced to only Medicare/Medicaid, are under personal citizen's roof [family or friend], that person is pretty much stuck, Unless the elder has a sudden emergency requiring hospitalization---then that hospital is responsible, and only then can the home-caregiver try to refuse to take the elder back with them. The hospital will try to strong-arm home-caregivers to take the elder back with them, but the caregiver has a right to refuse with good cause--such as a caregiver's/family member's health impairments that might impair proper caregiving, or create endangerment of other family in that home. Home caregivers have little other protection. Much needed laws have been passed to protect elders, and more might be needed. But No laws protect caregivers from elders who abuse, impoverish, endanger their caregivers or their families----we're kinda winging' it, having to resort to calling 911 to build up a file of reports, and caregiver's medical records, etc. to show cause why the elder must be taken in at a facility.
Hot Potato Elder Care: Caregivers get burned by it all the time. Hot Potato Elder Care: Facilities and Providers get financially screwed all the time. We need better designed systems and provisions. The Profiteering systems largely designed by Insurance Companies, are failing fast, at sad ethics and real health costs to human beings.
Entry fees vary from $2000 to $200,000 and there is no guarantee for SNF care if the facility does not have an SNF affiliation. We were very careful to chose an ALF that has a nearby skilled nursing and memory care wing. We also insisted on a facility with nurses on duty 24/7. They are not all the same.
I think the Assisted Living can indeed do that. If they have spent their resources perhaps it is time to check on a program for seniors called Elderly Waiver.
BTW, I was under the assumption (never assume anything) that assisted living meant you gave some sort of entry fee, paid rent for your apartment while they provided food, etc., for you. When you got ill and needed nursing home care, then you were assured nursing home care. Apparently, this is not true?
Yes, and Medicaid (in many states) doesn't cover AL care, only skilled nursing, so a person who exhausts their funds in an AL has to move to a SNF to receive Medicaid benefits. It depends upon where you live. Also, rocknrobin makes a good point, it's in your best interest to be completely open with the administration of the AL. Meet with them now and lay out your parents' finances and ask for their help with a plan. They may allow a period of non-payment while a move is coordinated. But, if they are full, they will have less leeway in doing that. You can't expect them to turn away a rent-paying resident.
PS - it really doesn't make sense to have Medicaid cover only SNF - the MOST expensive care option. We taxpayers are being robbed. So many SNF residents could be better (and less expensively) cared for in AL or PC, but they're relegated to SNF because they've run out of money. For someone with minimal to moderate care needs, an AL or PC can cost less than half what a SNF costs. You have to wonder what lobbying forces are keeping our legislators from changing the Medicaid laws with regard to nursing care.
I'd also contact your state representatives, etc. While these are private businesses, there should be some rules and regulations especially when dealing with PEOPLE who need a place to live. I never knew this about assisted living. My God, what are people coming to? Our elderly aren't being cared for properly. This was a problem over 14/15 years ago when I began studying elder care and it hasn't been addressed yet? There was a segment on 60 minutes last night about a study that's been going on at (I believe) an over 55 community which started in 1980 and is funded by the NIH every five years. The fastest growing age group now (and I remember back in the late 90s it was the 85 and up age group) is now the 90 plus age group! I don't know if those numbers are true, given the source, but it was certainly eye opening. We're next and it will be sooner than you can imagine.
Good job New Jersey!!!. Illinois was the first to have a Supportive Living Program. It's nice to the first at something besides # of governors in jail and the most broke state. Thanks for the info pamstegman.
I don't mean to contradict artist, but NOT all AL's are the same. They will work with you in the moving transition, but they need and want to be paid. It's not personal, it's business. If they have several empty apartments, they might work more with you. Medicaid doesn't even come close to their monthly rent. The harsh reality is their money will soon be gone. Speak sooner rather than later to the administrator of the AL your parents are living in. They can assist with the transition. Get going. You can do this.
sleeplessin201 - This will sound harsh because we're talking about vulnerable elderly people, but the fact is that living in an AL is a very expensive lifestyle and most ALs are not owned by charities. Their only source of income is the rent their tenants pay. They need the rent to provide the services. Although, unlike a regular landlord, ALs often work with families when their relative can no longer afford to live there, trying to find a good placement and even letting them live rent-free for a short period. But, the bottom line is that families themselves are the only source of 'free' care. As rocknrobin pointed out, there was almost certainly a discussion of finances when your parents moved in. However, none of us knows how long we'll live nor how expensive our care needs will become before we die, so living beyond your resources is a possibility if money was tight to begin with. If your parents funds are completely exhausted, they will be eligible for Medicaid which will pay for skilled nursing care.
I'm sure when your folks moved in there is was discussed. When their money runs out, they will have to move. Read their lease. Here in Illinois, we have a Supportive Living Program. If it is a supportive living community, when the residents resources are exhausted, they would make public aid application. The services and care are the same, just funded differently. Only a handful of states have this. You are probably looking at skilled care. Good luck to you.
I have not encountered that problem directly however i know in NYS there is NO assistance for assisted living. I would think the next step would be family taking them in or nursing home
Yes call adult protective service and have an investigation on this matter. Also go to assisted living and speak to a manger on this case. Hire lawyer while getting is resolve.
Contact the state Ombudsman. They are acvocates for residents in assisted living/nursing home/group homes. There will be one assigned to the one your parents live in.
Yes, if someone is significantly arrears in payment and not making arrangements to pay, they can certainly be evicted....a difficult and costly court process.
Intervene on their behalf, understand why, and you will be able to guide a solution. Try to negotiate with the facility.
If your questions is can they,....yes they can, but it is costly and slow court process.
They ended up on Medicaid and lived with us for a year but they were a danger to each other so we finally found a good nursing home for them where they could share a room. It was very distressing to have gone through this process with a lot of RED TAPE due to the move from one county to another in CO.
SOME assisted living accept Medicaid....NOT ALL. Best practice is to have a fine-tooth comb when you first starting looking at AL, do a very thorough reading of their Rental Agreement or whatever they call it.
I have a friend whose mom is on her THIRD assited living rental, the poor lady has mild dementia, and cannot control her behavior very well. So she has been literaly evicted from 2 AL's. My friend is at her wits end, after paying HUGE amout for rent, and all the moving expenses too, and her time to try and deal with the complaints preceding the eviction, she has had to move her mom 3x.
Assisted Living facilities--be very wary when entering one, and realize, it may in fact only be a temporary living situation, whether you like it or not.
Is it thru savings, a sale of a home or insurance? I would check with the administrator to review their financial situation. Sometimes you you can downsize an apartment to lower costs i.e. a studio vs a standard size apt. Some nursing homes are step care facilities and have both assisted living and nursing home care. What level of care are your parents needing? Other options might be adult care homes. These residential group homes can be a less expensive option. Good luck.
DEFINITIONS:
"Assisted Living" is a type of care. It means that a person will get support with the 'activities of daily living' (bathing, dressing, eating, etc..). "Personal Care" is very similar. The licenses vary from state to state, but that basically describes AL and PC. Both may or may not offer 'memory care' or a 'dementia unit' and communities may vary in the level of care they'll take on. They do an assessment (it's surprisingly exact) which determines the 'level of care' a resident needs. In my state, a PC or AL cannot care for a resident who is on any form of life support (like a feeding tube - that would require skilled nursing care). But, they are able to take care of people all the way through end-of life (hospice) care.
Some AL facilities are part of a Continuing Care Retirement Community - you pay a very large entrance fee to "buy" an apartment ($80,000 to $500,000+), then your rent is fixed whether you stay in independent living or eventually need AL or SNF. They won't accept a resident who needs care upon move in or who has a diagnosis that will likely result in them having to quickly move into AL or SNF. They must have most of their residents living independently (less expensively) for their business plan to be viable. (Note: Often people don't realize that you don't own the apartment in a CCRC the way you traditionally own real estate. They have to re-sell it before you get your money back and in the meantime you pay a monthly maintenance fee)
Other AL facilities are rental communities. You are assessed when you move in and the amount you pay is determined by the care you need. There's typically a low entrance fee ($2,000 to $15,000, or in come cases $0). You need to have enough money to live out your days there even if the expense increases as you need higher levels of care.
I've 'run the numbers' for many different scenarios and the bottom line is, if you're youngish (early to mid 70s) it can make sense to buy into a CCRC. If you're older, it doesn't really make sense to tie up your assets that way.
If you have long term care insurance it's a whole other bunch of variables you need to consider.
Facilities aggressively -covet- inpatients with fat retirement funds or other investment funds that actually pay the full costs billed. They might try to contract for only those patients, but, there are some rules that govern how they handle moving those who run out of funds. Contracts signed when people enter Assisted Living usually stipulate something about ability to pay; no funds means they must move out. Some facilities might stipulate in contract, refusal to accept Welfare/DSHS payment, because it's so poor a return, a facility or professional takes a huge loss, which they must write-off. The paperwork is monumental, which also costs the provider. Medicare also fails to cover a large chunk of the costs charged, but pays some bit more than Medicaid. Medicare also has lots of paperwork, which costs to handle. A facility or insurer gets paid government funds in addition to those from Medicare---something like about $800 per month additional money [that was over 10 years ago--it's probably more now]. This funding stream is rarely if ever discussed--it's a "deal" between Gov't and insurers [or facilities?].
Insurers got this pretty deal long ago, for any elder signed up for their Advantage / Supplemental Plans. I know less about how that money stream applies to facilities for elder care.
Loss of funding does not happen suddenly. A decent facility tracks where that money comes from, and how much is left at any given time. They usually have some months ahead to find other solutions. It can take every bit of that time to set something up, depending on availability of beds in other facilities, funding sources, etc.
When a person is already established under the care of a medical professional or a facility, and Funds run out, they cannot just be =suddenly= "evicted" or "fired as a patient". A facility is not allowed to dump-and-run, not to the sidewalk out front, nor to a homeless shelter. Laws prevent patient abandonment, for instance. Other solutions must be worked out.
One of those might include: a Facility will try to heavily coercing family members, even family friends, to take them home with them--I've heard facilities threaten to toss the elders into the street when the last dime of funding stops. I heard a facility Rep try to coerce a family friend to take the elder home with them; heard a Facility Rep try to strong-arm family by telling them the elder will be dropped off at a local homeless shelter. I believe all that is illegal. Facilities can get in deep legal trouble trying to ditch patients, can lose license, get very bad reputations, etc.
One facility may still try to take Medicare funds =after= someone has been moved to a new facility; Medicare and Medicaid funds immediately STOP being available to the 1st facility, once the elder has moved to 2nd facility.
All kinds of stuff has gone on, bordering on or flagrant Medicare fraud, by all levels of facilities, yet all systems seem to let it mostly slide---facilities have gotten very adept at hiding those transgressions by manipulating charting of events.
Fraud on the part of facilities only gets found if staff are willing to testify--then those staff become pariahs in the workplace--whistle-blowing is NOT as protected as laws might make it seem.
Each facility usually has a Social Worker, OR, you can find one, by contacting your local branch of Area Agency on Aging, or call a local hospice to find one who can help you.
A good Social Worker should be able to help find new facility your parents can afford using funds they have [like Medicare, maybe Veterans, maybe DSHS, etc.].
A good social Worker might also help them get hooked up with other sources of funding, though Veterans Services need contacted to deal with that System.
Medicaid [Welfare] is usually very fast to respond.
Veterans benefits, though, might possibly take months or years, depending on how effective the person handling application is at dealing with that system and it's paperwork. If one or both of your folks actually retired from military service, there are benefits to be tapped they may be unaware of---including some limited long-term care facilities in a few locations. Even a Veteran [not spouse] who didn't Retire from Service, can access Meds-by-Mail via the V.A., which can cost substantially less than Civilian Meds [Meds via Welfare Part D could be similar low cost].
Veteran's hospital and rehab services might be available nearby enough to use, too, which can cost the Ex-service member [Honorably Discharged] far less out-of-pocket--Veterans' Services do have a sliding-scale-per-income that helps cover remainder costs.
CAVEAT for Veterans Services:
It's extremely helpful for the person to have a good Advocate to make sure care rendered is appropriate, to prevent the person being used as a Lab Rat. The VA system manipulates people very adeptly for that--caveat emptor!
One can get Extraordinarily Good care, or be treated very badly, =depending on circumstances=.
A Doc or facility might =not want= to deal with Welfare/DSHS, but unless there's some other fund to pay for services.
A Medicare / Medicaid package is commonly used to pay elders' care, though Providers / facilities take substantial losses on that form of payment, and services are less-than-optimal. That's why it's so hard to find Providers who accept Medicare /Medicaid, and why some rules require facilities maintain at least a certain percentage of their patients in that category.
IF, as someone commented, one of your parents stayed in the Military long enough to retire from it, they BOTH then, Could get some Veterans assistance to pay part of their bill.
IF one of them served for a time during a war or conflict time, then had an Honorable Discharge, only the Veteran can access Veterans Services, and there are some things that do not apply.
Veterans benefits would come first, if they exist, then Welfare--Welfare is the last System in line to pay for facilitated eldercare--everything else pays first.
IF either of them has diminished in health, Assisted Living is NOT where they belong--they'd then need to move to a Nursing home/long-term care facility.
NOTE: It's common for Assisted Living Facilities to aggressively court clients with strong funding available, and hang onto them far longer than it is appropriate.
Assisted Living facilities also commonly sign up elders who need far greater level of care than is actually allowed in Assisted Living, just to get a person in with good funds available. When funds run out, or the elder's health gets so bad, only then do they relinquish those to Nursing Homes willing to accept Medicare/Medicaid patients. They're rarely brought up on charges for that, unfortunately; it's usually skillfully camouflaged to appear as though the Assisted Living place is doing the elder a favor, or that conditions are not so bad as they really are, etc.--the line is blurred.
There are transitional places with combination of levels of care, starting with little self-care apartments or units, then Assisted Living, then Nursing Home, then have agreements with nearby Acute hospitals.
A person usually contracts/buys-in for a substantial fee, then pays hefty monthly charges to start living in one of the apartments, then as needed, move up to higher levels of caregiving--all covered under the same monthly charges.
Those are costly to buy into, but provide a nice transition in familiar spaces for the contractees. SOME of those places have back-up funds to help a few years-established residents who might suddenly lose their income stream, stay with them.
But most areas across the country have few available nursing homes or care homes; beds must open first, before an elder can be moved into them.
An originating Facility must find an open bedspace elsewhere, before they can move a patient out.
They may be able to find one bed in one place, and another bed in a different place, splitting up the couple in order to re-house them elsewhere--elders can't really choose, at that point; it's commonly done.
AFTER they're re-housed, AND new funding streams are established, it's still possible for POA's to rearrange where they are placed; maybe moving one to be in same facility as the other, if conditions allow.
Depending on your elders' current behaviors and needs, and family tolerance and ability with elder care, you may, OR Not, want to allow those elders to live with you, even temporarily until new facility is found.
Once elders' reduced to only Medicare/Medicaid, are under personal citizen's roof [family or friend], that person is pretty much stuck, Unless the elder has a sudden emergency requiring hospitalization---then that hospital is responsible, and only then can the home-caregiver try to refuse to take the elder back with them.
The hospital will try to strong-arm home-caregivers to take the elder back with them, but the caregiver has a right to refuse with good cause--such as a caregiver's/family member's health impairments that might impair proper caregiving, or create endangerment of other family in that home.
Home caregivers have little other protection.
Much needed laws have been passed to protect elders, and more might be needed.
But No laws protect caregivers from elders who abuse, impoverish, endanger their caregivers or their families----we're kinda winging' it, having to resort to calling 911 to build up a file of reports, and caregiver's medical records, etc. to show cause why the elder must be taken in at a facility.
Hot Potato Elder Care: Caregivers get burned by it all the time.
Hot Potato Elder Care: Facilities and Providers get financially screwed all the time.
We need better designed systems and provisions.
The Profiteering systems largely designed by Insurance Companies, are failing fast, at sad ethics and real health costs to human beings.
Also, rocknrobin makes a good point, it's in your best interest to be completely open with the administration of the AL. Meet with them now and lay out your parents' finances and ask for their help with a plan. They may allow a period of non-payment while a move is coordinated. But, if they are full, they will have less leeway in doing that. You can't expect them to turn away a rent-paying resident.
PS - it really doesn't make sense to have Medicaid cover only SNF - the MOST expensive care option. We taxpayers are being robbed. So many SNF residents could be better (and less expensively) cared for in AL or PC, but they're relegated to SNF because they've run out of money. For someone with minimal to moderate care needs, an AL or PC can cost less than half what a SNF costs. You have to wonder what lobbying forces are keeping our legislators from changing the Medicaid laws with regard to nursing care.
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As rocknrobin pointed out, there was almost certainly a discussion of finances when your parents moved in. However, none of us knows how long we'll live nor how expensive our care needs will become before we die, so living beyond your resources is a possibility if money was tight to begin with. If your parents funds are completely exhausted, they will be eligible for Medicaid which will pay for skilled nursing care.