My brother was the sole caregiver of my mother and has recently passed away. Only source of income is SS $1,800.00/month and funds are quickly diminishing; maybe enough to pay for a few months of rent. No assets, no estate, etc. She has Medicare but not Medicaid. Does applying for Medicaid take a long time to approve and can she live in AL just off of this income? Curious if there are similar experiences out there.
Each State administers its Medicaid program uniquely but under overall Federal guidelines. Medicaid as it was placed into law back in the 1960’s has dedicated funding to the States to pay for custodial care in a SNF for those “at need” both medically and financially. The amount of $ a State gets from the Feds is interdependent on their census data.
However a State can ask for some dedicated $ to be “waived” to instead be used for other projects that benefit the same demographic. Voila! Waivers to pay for AL & MC (if they are run under AL license). A state has to choose to do them.
The issue with waivers are many…… like they have to be reviewed and renewed, they have to have facilities that want to participate in the waiver, their # may be quite limited, etc. Most states don’t seek waivers.
But even if waivers exist, they may not be easily available. My mom’s was in a great IL within a tiered facility - IL, AL, NH & hospice wing - that actually did participate in the waiver program her State did. It appeared that she would be able to seamlessly go along and go from IL into AL and onto LTC Medicaid when she out lived her $. Well that did not happen. What this place did was had those few waiver beds set for those long time residents in AL who were totally ready for the NH/SNF side but waiting for an open bed. They were essentially waiting for someone to die in the NH in a LTC Medicaid bed so they could take that slot. The NH staff did oversight of their care plan. For this tiered facility, this was excellent as most every placement overlapped & they stayed at 100% census in the NH. But for families not so much.
Even in State with waivers, finding AL who want to participate can be difficult. The State sets daily room&board reimbursement rate within Federal guidelines. For State that do the baseline really low day rate for SNF (like under $200 a day), they will do an even lower day rate for that AL waiver. It may be not at all possible for an AL to be profitable under a low State paid day rate. NH can make the #s work as they tend to have 1/3 of their beds filled with rehab patients that are there with their health insurance paying. Rehab pays way waaaaaay more, like double or triple day rate. But an AL or MC will never have rehab patient $.
Why does mom need a caregiver?
You might want to check with her local Senior Service Center and see if she qualifies for any programs. They can also help with application for Medicaid if that is necessary.
Does mom have a POA?
If not is she cognitive to appoint you or other family member as POA?
If she is not cognizant you may have to become her Guardian. If you can't do that the Court may have to appoint a Guardian.
Contact your local Area Agency on Aging and ask if they have a caseworker who can help your mother find a place to live.
I’m sorry for the loss of your brother.