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I have a relative in assisted living now and they are paying privately. They still have about $100K in personal assets. The rest of the assets were put into irrevocable Medicaid compliant trusts 6 years ago. We may get to the point soon where the ALF tells us his care levels exceed their ability to provide care and he needs to go into a nursing home long term.


What is that process like - if we want to get a Medicaid bed eventually? I'm assuming we would go around to all the local nursing homes that take Medicaid and say we need a long term bed, he has $100K in assets, X amount in SS and X amount in VA pension. Then I'm guessing some will tell us whether can accept that and how long it will take to get into a Medicaid bed - right? Once there, all the personal assets must be spent down to the nursing home, right? Then, once on Medicaid, all his SS and pension to the nursing home?

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I would consult with a certified eldercare attorney who is fMiliar with PA Medicaid. Was one used to set up the trust?
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Helperson132 Aug 2020
Oh, yes. We used a reputable local elder care attorney.
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In our state (PA), Medicaid pays nothing for Assisted Living and Memory Care that is part of assisted living. Medicaid will only pay for LTC in nursing homes in Pennsylvania. So, right now he is paying privately for AL out of necessity. There are some communities that offer continuum of care (Ind Living to Assisted Living to Nursing Homes) but they are almost all the higher end communities and almost all of those are private pay for nursing care - they never accept Medicaid, even for nursing.

The place he is at now is also a corporate run AL that is not attached in any way to a nursing home. When your care needs increase, you need to find your own nursing home.
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Doesn't the place he's in now accept Medicaid? If not I would find another reputable facility that does, and make sure they have a continuum of care so that when he needs MC or LTC he won't have to move out and be on a waiting list for a Medicaid bed. Once he's in a facility that does accept Medicaid, and he qualifies for it, he will be transferred into a shared room. The Medicaid app takes time to go through approval, at least 3 months. So he or his PoA will need to keep an eye on his funds and apply when he's running a low balance. Also your friend hopefully has a pre-paid funeral set up. Once he's on Medicaid it will be more difficult to purchase one and the cap is $1500.
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