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My dad is in assisted living and mom is in memory care. Both of these are private pay. I have been trying to find out what happens when they run out of money, but haven't been able to get a straight answer from any one in the facility or where ever. All I have got from anyone is that they have a really good social worker or they change the subject. Obviously they can't just hand them their suitcase and send them to the curb - I hope. I have been told by friends that they have to find them a suitable place to go but if they have no money, what would this suitable place be since AL and MC are both private pay? And does the social worker find these alternate arrangements or is it my problem again? They have enough for a couple years providing nothing happens, so it's not a panic situation yet. I am in NY if that matters. I feel like I am constantly running in circles or up against brick walls with this caregiver role.

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Do the facilities where they are now have beds dedicated for Medicaid? If so since they are private pay now there is a good possibility they can remain there when they go on Medicaid. If the facility has no Medicaid beds then your parents will have to be moved to another facility. And it might be wise to look for facilities now so you can move them. A resident that is private pay has a better chance of getting a Medicaid bed.
Talk to an Elder Care Attorney NOW and discuss the application process and what needs to be done.
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I think you need to look NOW for facilities with Medicaid beds and ask them directly, how long must your parents be private pay first.  Do NOT wait for the money to run out, many facilities will find a way (the ER dump) to get rid of parent.  If your present facility is not answering your questions, I think they have no intention of keeping your parents and you need to look at other places.  You will have much better selection if your parents can be private pay at first.
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In our family, what happened was the AL repeatedly sent the patient to the ER for various reasons. Eventually, they told the hospital they were not able to be a safe discharge. The family then went through the "where can we find an open bed" dance.

If you are placing someone without assets, you will be limited to facilities with open "Medicaid beds" and these can be an hour away from the family. You want to avoid that situation by trying to get into waiting pools now. If you have access to a social worker, I would use them.

As the social worker for the facility has a vested interest in keeping your family member as long as possible, I would find a social worker elsewhere. Try the Office of the Aging in the county where the. person lives. Or contract with a social worker yourself. You may find someone on aginglife.org

Good luck!
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I have a feeling you're not getting the answers you need because the people you're asking either do not know, or the people you're asking don't want to tell you that your parents can't stay once the money's gone.

The staff probably really does like you and your parents and they don't want to be the one who prematurely tells you something unpleasant - since you said you still have years of private pay funds at this point.

As for the people who may truly not know the answer to your questions, there are a lot of social workers and "Medicaid Liason" people who truly mean well, but they really don't know the nuances of their own job. I have observed high turnover, etc in these positions. If you end up getting help from one of these folks, you must watch them like a hawk to make sure your parents' file does not end up at the bottom of the pile and left for the last minute - meanwhile you think it's been getting worked on for months! The squeaky wheel gets the grease, but then that adds to the turnover/burnout problem....

If you want a real answer to your "what happens when the private pay money is gone" question, my advice will be to ask the business office. The people who cash your check every month will be able to tell you what happens when funds are gone.

In terms of finding a new place, first stop (since you're happy with the current care) would be to see if the current place has a sister facility which would take Medicaid.
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Since November 2019,I have been exhausting myself looking for a Medicaid facility for my sister. I suggest you go to Medicare.gov to look up facilities in your area-get busy now touring and finding about self pay timeline etc-get assurance you will get a Medicaid bed when the time comes in writing. I have heard and read stories where promises were made by facility to take care of person "forever" and then try to kick the person out when they are eligible for Medicaid.

I personally have chosen to only look at places with a 4-5 Medicare star rating. Sis has been living in a place that supposedly had reasonable reviews online, but are not a Medicaid facility. I personally think they would have been cited for abuse and neglect from what has happened to my sister-injuries, horrible food, not keeping my sister clean with regular showers-has been awful and why I would never go to a place rated any lower than 4. I even had a couple of facilities including current one recommend places that have been cited for abuse as possible placements. I was willing to drive a fair distance to find a good place-but this has not done me any good. I have been turned down 5-6 places for lack of self pay funds-gee folks this is why we need Medicaid....A few others told me sister's behaviors are disruptive because she cries from time to time-frustrated-told a staff member to shut up, lonely, bored-and therefore would not take her either. 5-6 more we are on a wait list some told me a few months wait, others are a minimum of a year or 2. One place recently passed us over when we had a few questions about the financial responsibility did not return calls for several days. When they finally did reply-guess what they had given the room to someone else. A couple more just said we can not take sister with no explanation as to whether a condition or financial issue. I have given up and we are going to a traditional community that seems to have a broad scale of allowed conditions etc. they will take in memory care-it is a fairly new community in my area which does not take Medicaid. More affordable than NH we are currently in and family will contribute to make ends meet beyond sister's retirement income. For a time I considered bringing my sister to live with us but I have a son in college, elderly parents driving me crazy, would take a lot to make my home safe (steps) and easy access for sis to even get in the front door, keep her safe in the shower. Do not rely on social worker to do your work for you-aka vetting a facility-social worker will just be looking for an available bed nothing else other than maybe distance you are willing to drive. If you have your top 5 list prepared ahead of time-to say only call these places....

One of the communities I looked at had several with same ownership in my area-some buildings were newer and had better ratings, the last one we toured was an older building with tiny shared rooms and if someone was in the wheelchair in the hallway it was difficult to get past-building code was different back in the day vs what is required/built now to be wheel chair accessible etc. Just because one company has several properties does not mean management/ or executive director, nursing at each facility is going to be exactly the same quality-i just have not seen this during my search.

Lets be real here-Medicaid beds are not profitable for a community-facility agrees to accept a lower payment for a bed that could be given to self pay instead. Although a community may say they have 20 medicaid beds there is no law that says they must be filled with the next person that comes along-we have also lost spots due to "internal" move from AL or what ever. I am not sure I believe them-just a reason that I have to accept but also don't believe they will be calling me anytime soon.
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As said Medicaid comes next. An AL and MC are privately paid. They are not required to help you look for a new place. The ones near me don't have SWs but they are small.

I would suggest you make an appt with the Administrator. Ask if the AL and MC will allow Medicaid. In NJ after paying privately for 2 yrs, the ALs will except Medicaid if they haven't met their quota. Also, in NJ you only have 90days after you apply for Medicaid to spend down monies, meet the criteria (5 yr look back and paperwork) and find a facility. I suggest if Mom and Dad have any money, you may want to start the process now and private pay for the NH a few months. Easier to get them in that way and will help with the spend down. Then start the Medicaid process.
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If you want to get them in a good Medicaid nursing home you need to do some work by looking at facilities, going on a wait list to start out as private pay, and getting them in before Medicaid. Or you can choose the path of waiting to the end, seeking help form the social worker to apply for Medicaid. They will then go to the first facility that has an open bed. You may not have choices as to the location, if they can go to the same place or if they get into a great place or a mediocre place. You will still need to gather up the last 5 years of bank statements

Personally, if they are self pay, the facility would like to keep them as long as they can. Hence they are not ready to give you advice
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It's up to you to figure out what comes next! My mother will be running out of money in about a year's time and won't be able to stay in the Memory Care ALF she currently lives at. And yes it's my problem and no they won't keep her there if she can't pay her rent anymore, and I already know I'll be applying for Medicaid when the time comes. Her private pay ALF does NOT employ a social worker, so it's all up to me to handle her future, if she's still alive when her money runs out.

See an elder care attorney if you have questions or need help navigating the Medicaid application and 5 year look back. Don't rely on anyone but yourself to get your ducks lined up, and don't wait for the last minute either. Look over Medicaid nursing homes that you find nice and plan to place your parents there several months BEFORE their money runs out. That way, you can apply for Medicaid and have them situated by the time it kicks in.

Prepare for the worst & your experiences will be positive.
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mstrbill Mar 2020
It may be up to you where you want to place her based on your wishes and desires but at the same time the facility she is in now cannot "kick her to the curb". What would happen if you somehow became incapacitated and Mom had noone else who cared for her or was willing to help relocate her? The facility would then have the State find safe placement.
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They will go on Medicaid. They will have to go to a facility that takes Medicare. Definitely use the social worker. I didn't have this problem with my father, I took care of him at home and supported him. However, the social worker was invaluable when it came to help with health insurance and working through those areas.
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They can't send them to the curb so please don't worry about that. What they will do is transition over to Medicaid. If the facilities they are in don't have Medicaid beds, the SW will help you find a suitable location that does. Start looking into it around 6 months prior to their funds running out and start seriously planning at least 3 months prior to the funds running out.
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They would go on Medicaid when their money is gone. And you should work with the social worker when the time comes.
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