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Dad only has $240.00 left between his current rent and what he brings in from his pension and Social Security. The last level of care increase was $700.00. I don't know what to do with Dad if the rent is more than he makes. Unfortunately, hus pension and Social Security combined are more than the monthly maximum allowed with all of the assistance programs I have looked into. Perhaps you would be able to give me some guidance. Thank you.

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The facility is required to have a benefits person to help you make ends meet. If Dad has a house, rent it out. We did that for mom, it really helped. If he has assets, start liquidating them.
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You need to find out if his facility accepts Medicaid. If so, with the assistance of an elder care attorney, you can set up a Miller Trust. But first, I would talk to the social worker at the facility. She may have some other ideas.
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Have u looked into adult foster homes, some states call them different things. My mom lives in one here in michigan. She pays 3000 a month. Some are as low as 2500 a month. If you would like more information private message me and i will try and find out what your state has available. They can be a wonderful option for dementia clients.
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Memory care facilities are not required to have a social worker or someone there to help you make ends meet. Nor is a boarding home style arrange a chouce for memory care. Most memory care facilities do not take Medicaid. Some do, very few, so you will have to look around. I had to find a new facility ti move my mkm to when her rent went up. See if you can find a not for profit one. They maybe more willing ti work with your financial ability to pay. You can contact APlace For Mom to see if they can help. But i found them to only give my name out to a few facilities whi now call me constantly and they told me to look online for a list of facilities, which i already knew to do. There are some memory care facilities that are very small and in homes. Those are usually cheaper and have lower patient to caretaker ratios which is good. I dont know what kind of mentsl stimulation they offer tnough or if they have enough caretakers thete. I would never leave my mom with a place that only had one caretaker ar a time because there is no one else thete to make sure everything is on the up and up. If he was VA, see if you can apply for aid and attendance help. That takes a good year though, so better get busy with it. I do believe your only option is to find a new place or sell assets to subsidize his income.
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Re: rate increasing for higher level of care. Yes, it happens- - need more care, have to pay more. This is normal, need to plan for it. Please spend a few hundred in meetinf with an elder care lawyer, get all dadspaperwork together and make a plan now- - dont just apply for Medicaid, dont go giving stuff away and dont sell anything yet. If you sell below market value (wink wink) they will penalize dad. Lots of considerations, all your answers cannot come from an online discussion-- at this point you need personalized, professional lawyer help, who knows the Medicaid system in your particular state. Good luck, I hope you find a competent lawyer.
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Check with your state health dept....to determine if Memory Care is considered A.L. licensure. In Arizona, where I live, Memory Care facilitities are licensed as Assisted Living, and the State Health Dept or website for A.L. licensure, or Medicaid website, will send out a list of all facilities in your town, or area that are licensed with Medicaid and take Memory Care/dementia residents. In AZ, there are many that are small homes, who will take all Memory Care residents and do accept Medicaid. I saw great care for my Dad when he was in a licensed Memory Care facility versus a nursing home that had a separate wing for those with dementia. In Arizona, Memory Care is a flat fee that covers everything....and where my Mom is now living in Assisted Living, her care needs fees are about $1200/mo and her total monthly bill is $4100, with $2600 being base rent. That's pretty much the same for all the places around here for 75 miles. When my Mom has to go into their Memory Care wing, her rate will be $5100/mo, but never with any added on fees for the rest of her life. Memory Care in AZ is mandated to have 3 staff for every 15 residents...but I found, when looking at smaller homes, they were often licensed only for 10 residents, and would still have 3 on days and evenings....so a better staffing. Less on night times, but many residents do sleep well at night. Also, some places here, have the caregivers doing laundry, room cleaning and cooking, while other places, like where my Mom is, have housekeeping and kitchen staff in addition to caregivers, so they aren't so busy with other duties. Just giving you other ideas to consider.
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There is a 'board and care' here, rooms in a lovely old house with shared bathrooms. It's about $2000 something a month, paid out of their social security, but the residents get three meals a day and there is always someone in the house in case of emergencies. They don't accept Medicaid. No personal care, no health care, no medications - I guess you could say it's like an old fashioned boarding house.
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llama - regarding LTC insurance, I have no idea if this is a trend, but my mothers NH would not take at all any LTC policies. Payment was private pay, Medicare or Medicaid. Signs as to this posted in entry, elevator and admissions office. What the business office told me was that in the past they did take LTC policies but there was always ALWAYS something in dealing with LTC insurers that meant delays, refiling, more details wanted, payments clawed back. Since each LTC insurer had its own payment and contract, they each have their own reporting and documentation forms; each insurer could have different formats for information on care provided in addition to the ICD standard codes; different forms on staffing (even wanting professional registration/level; one even wanted CE status on staff)…. all of which required time by the NH. That there seemed to be a pattern of always needing another piece of paperwork submitted which delayed settling an account by weeks if not months. Just not worth it for this NH which was part of a small group (it was my mom's 2nd NH and was really a great facility imo). They put this policy in place before ICD-10 roll-out as they figured it was going to be even more of a nightmare to deal with.

I'd bet that this situation is common for a lot of smaller facilities or in-home care companies. If a facility or home-health agency can easily fill a bed or have clients on private pay, Medicare & Medicaid, then taking LTC insurance with the extra time needed to get paid just doesn't make sense for a business. If this is a trend, a lot of folks having LTC polices are not going to be able to use their policy easily.
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What does it say in the contract/agreement you and/or he signed?
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Also, the more care he needs the cost will go up (at least that was the way it was in my mom's case). We sold the house, got rid of all cd's, savings, etc. and set up a trust. Also, my dad was a veteran (has to have been in combat) so we were able to get VA benefits for him and my mom. With their SS, Teacher Retirement, VA, Annuity, we were able to make ends meet. We were very luck in the fact that my mom insisted on getting long term care insurance while she worked. It ran out about 6 mos. ago but it was a God send while it lasted. She just passed away 6 weeks ago so we don't have that worry anymore :( Now I just need to take care of 94 year old dad. Good luck and God Bless.
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