How do we confirm that the Memory Care place that we are entering will keep her when the private money runs out?

My LO’s contract with her AL contains that language. Read every word of your contract before (her POA?) signs it.

Not sure if this is formulated within state or federal laws, but I feel fairly safe with the document in hand. May not apply in Minnesota.

This is up to the memory care facility and they well MAY NOT let the person stay when the money is gone. It was made CRYSTAL CLEAR to my bro when he went into his assisted living that--not put this bluntly but definitely made clear--when the money is gone so is he. This in fact was in the very long contract with them that deliniated EVERYTHING and which had to be signed page by page. They told what the levels of care were, how much they cost, when you would move to another level of care, what the memory care was, what it cost, how much you could expect in raises by the year (3% to 5% barring the unforeseen, and covid is that). Everything was in black and white. This is what you need.
A facility such as this is not regulated by the laws that nursing homes are regulated by. It is a business. When your money goes, you go. And there may be SOME that allow you to stay, but anymore, it's rare as hen's teeth.
The ones to ask are in administration at your facility. If you do not have this in black and white, a signed contract, then you have nothing.

You are best to speak with the Facility itself. They all vary. They will discuss all of this with you by a phone call. It is very valid to worry about, and you should have all these questions answered for you.

I spent 6 months trying to find a Medicaid eligible spot for sis-while at the same time only searching for communities that were above average 4-5 stars on the Medicare/medicaid site. only 10 percent of the 150 available facilities in a 4 county area-50 mile range from my house. A lawyer assisted us in applying for Medicaid-while sis was not in a Medicaid facility at the time-application was then denied for this reason.

We will have to reapply-new facility Medicaid eligible placement-self paying for now with family assistance as we were desperate to get out of the bad place she was in-injuires, being unclean. We did not have time to wait to re do Medicaid as was covid start we grabbed the spot. You should get it in writing that facility will guarantee you a spot after X time or the money runs out, who will do the application-them or you time line etc. I have not done this-no guarantee it will work.

During my facility search I asked to be on wait list. None have called in the last 10 months-probably never will. Really great place says 2 year wait list. Medicaid rules say a facility can approve more medicaid beds but getting facility to actually do that?????

Most of what I have learned from my research as that the facility will want some assurance of your ability to self pay for a period of time 1-2 years worth. They wlll always give first choice Medicaid to current facility residents. I was told this a few times when we were told a bed was going to be available-but then a day or so later-poof the spot was "taken". Which sis did not have a huge amount in the bank to pay for high needs care. Sis needs full on nursing care was combative in the past-limited places will take on difficult cases. She is not combative now but having other behavior issues.

Absolutely make sure you get any promises in writing, don't ever accept verbal assurances!

Ask them, but in most cases you cannot. We were told the same as Alvadeer. My MIL was in a popular chain of AL in NY. She paid $10K monthly to stay there. I asked what will happen when her money ran out as I had heard that perhaps the center would accept a Medicaid waiver and be allowed to stay but was informed that AL doesn’t take Medicaid waivers.

So yes, they would insist my 95 year old MIL apply for Medicaid and leave AL for a Medicaid NH after self paying $8-11K monthly for 3 years. My MIL passed last May @ 96, but for a while there we thought she would live forever. We were sweating bullets about the fact that after one more year her funds would be depleted.

As far as increasing the # of Medicaid beds, that requires certification from whoever regulates AL’s and the AL wouldn’t bother with it. My MIL’s AL had no Medicaid beds.

Assisted Living centers are businesses after all. Plus the overhead the AL’s must pay for employee staffing and benefits is probably high. The residents fund that as well as those “activities” for the seniors, meals, linen changes, housekeeping, etc.

Is this right? Not in my opinion but it is what it is.

With every State Medicaid is a little different when it comes to will they pay for an AL/MC facility. This is what you need to find out.

1. Will your State Medicaid pay for MC.

2. Does the MC except Medicaid and if so what is the criteria. Not all
except Medicaid and are not required to.

3. There may not be any guarentees.

With number 1, if your State Medicaid does not pay for MC the rest is mute. Be aware that you are bringing her from another state, Medicaid does not go over state lines. She may need to be in Minn. for a while to claim residency.

With number 2, MCs are private pay. Here in NJ you need to pay privately for at least two years before Medicaid can be considered.

With number 3, if MC excepts Medicaid it may only have a % of residents they allow on medicaid. Because of this, no guarantees can be made. If they have hit their quota when she runs out of money, then she will need to go into a NH on Medicaid. They do not make money on Medicaid. Medicaid does not pay what the private pay is. My Mom paid 9600 a month privately in a NH for 2 months then medicaid took over. When she passed, her SS had paid 1700 towards her care a month for 3 months. The Medicaid lean was for 6k in that 3 month period. Unless Medicaid doesn't recoup the whole amount, my Moms care was only 3700 a month in a room of 4. Lots less than the 9600 she paid privately.

In Virginia, it is not allowed by law for Medicaid to pay for AL. I think its stupid because AL, even MC is cheaper than NH, but thats the law.

I think each state regulates insurance and nursing homes. You may want to speak to an attorney in your state who specializes in elder care.

I would suggest finding a NH that you would prefer her to go to once the money runs out and get on their waiting list.  If it is a nice place with a good reputation, they will have a waiting list.

The assisted living facility that my mom is in keeps raising their pricing structure and moms money is dwindling down quickly.  So, we are in the same boat as you.  I am still looking for the right place to be her next step.

Good luck.

In the state of Maryland, memory care facilities (MCFs) are private pay. Most nursing homes are private pay but a few accept Medicaid. I visited all 6 facilities within the 20 miles radius of my area that accepted Medicaid and they were all the same: terrible! I would not want to live there.

This is the time to call and ask them directly if they accept Medicaid clients when the money runs out. Some places will avoid answering the question directly because they do not want to lose a chance to get your money now, but ask again until you get a YES or NO.

Good luck.

There is probably a clause in the contract about it being null and void in a number of different circumstances. What if the home goes bankrupt? What if she develops behavior issues and is a danger to herself and others.

Why from Kansas to Minnesota? That is a long way if there are problems that you need to respond to.

The elder care attorney is the best angle. My family is also concerned about this, as her current MC situation does not accept medicaid. So a trust has been established for her, and we've negotiated with the MC to change a clause in their agreement so that the trust is responsible for her financial situation, not her children as individuals. It sounds cruel, and maybe even self serving but it isn't. None of us can afford what it would take to fund her care if her funds run out, though we'd try if push came to shove. It may also be possible to negotiate at least some sort of lengthier rate freeze for perhaps 18 months or longer, if the current agreement stipulates a 12 month rate freeze. As a side note, we also learned that age in place really doesn't mean what we think/hope it might mean, so we're girding ourselves for that eventuality. Good luck.

Have frank discussions with the administration and social worker at the facilities you are considering. The places that accept Medicaid and Medicare should have protocols in place for applying for this assistance.

If the facility does NOT accept Medicaid, then they cannot keep her when the private money runs out. (It would be unfair to expect them to provide free care to your mother - even for a short period of time. If you are her POA, then, yes, you would be expected to "make up the difference.")

You need to find out if the facility accepts Medicaid or not. If NOT, then you need to start looking for a different place before it becomes an emergency situation (i.e., she has no money left).

You are asking the wrong place. You need to sit down with the facility and ask all your questions. No matter what anyone tells you here, you need to hear it from the facility, and perhaps get their response in writing.

I think you are better off in a Not For Profit place  I know someone whose parent was in a for profit place, that got sold, and there were a lot of issues.

You can find out if they have Medicaid beds. But, you should remember that these facilities can change hands and perhaps next owner will only take private pay and no Medicaid beds. This facility, if they have no Medicaid beds, should have a social worker who will help you with the paperwork to apply for Medicaid when private funds are about to run out - and assist in finding a Medicaid bed at another facility.

The only kind of real assurance that current facility will keep her after funds are gone is to have it in writing. A verbal conversation will be a moot point several months or years down the road. It will probably be a moot point if the facility sells out to someone else.

My Mom's Memory Care has a 2yr private pay requirement before going on Medicaid. When the funds start getting low, we'll put her on the list for a Medicaid slot.
Also, for anyone who was in the military, or their spouse, check into the VA Aid & Attendance program. Assets need to be less that $129k. Monthly checks are around $1200. So far, our claim has taken 8 months, but when they approve, we will receive pay from the first date of application.
Take care of yourself. Your assistance will still be needed when he does go to a facility. But, much less.

Be careful. I placed My husband in a rehab/nursing home after he fell and broke his back. When they said he was not progressing with rehab we were told they did not have a long term care bed available
these homes are tricky.

I called my daughter who lives in Washington and cares for her father. She said the AL place where he is, has limited medicaid beds, but if you self pay for 2 years they will do their best to keep him in the same room and not move him to a Medicaid room. He self paid for 3 years and he was able to stay in the same room.

I think you have a lot of work to do. If you get discouraged or it feels overwhelming, just remember this saying, "How do you eat an elephant? One bite at a time". In other words, do a little bite into each phase. or as in cleaning a dirty room, pick a corner and start.

I think there is a host of good advice here. Consider purchasing a notebook, start chapters, like Medicaid, assisted living, or memory care, whichever it is. Maybe a chapter on Attorneys and other legal stuff like POA. That helps me. I have a file for my husband, who is home with me, included is two files for the two times someone has complained to APS about me. etc.

Imho, you may do yourself a favor by seeking out legal counsel on this matter since Medicaid can he tricky and you may he applying for Medicaid.

I asked my friend, who's mother went through this. She said there was a contract guaranteeing that her mother would not be kicked out for inability to pay through Medicaid. They did all the Medicaid application stuff so that the family did not have to do anything. In her situation there were 3 levels of care, and her mother was taken care of through all 3 levels without a problem.

Hope this helps.

Edit - Medicaid can be tricky.

Look into putting her $ into a First Party Special Needs Trust, which, as I understand it, protects her $$ and makes her eligible for medical benefits the very next day. Talk to a lawyer to verify this info, but there are definitely ways to safeguard your parent's $$ and be sure they can have services.
You can Google to get more info. Definitely worth exploring.

I don't know how different states handle money running out. However, I do know that there are a few places that WILL keep residents who run out of money after being there a certain period of time - subsidy. You have to call and talk to them as who will and who will not do this. I am also guessing they might put her into a nursing home that will accept Medicaid. Medicaid does not pay for assisted living, only nursing homes. I don't think I would worry too much but you have to start searching and asking questions now. Good luck.

If they say they will keep him, get it in writing! Personally, my experiences are such that I've become cynical & don't trust what I'm told verbally. If you have a written contract where this is promised, regardless of who owns the business then I might believe it. One of the ways Assisted Living & Long Term Skilled Nursing Facilities get around something like this is to say a resident threatened suicide & pack them off to a psychiatric hospital. (They're lucky if it's one strictly for geriatric patients.) Then you have to pay the facility to "keep the bed" & even then the facility can refuse to take them back on the grounds they aren't capable of providing the services the individual needs. The social worker can manipulate a person into saying something that if taken out-of-context can be made to look as if the person is suicidal or they can report that a resident became violent when that wasn't really the case. Sorry, but I haven't had the best experiences with either type of facility. I hope you have far better ones than I have had.

ci

Make sure you ask them before you put her in a Memory Care Facility.. My husband is in a private owned Memory Care Facility and they do not offer Medicaid. We are now in a position to find a home that does offer Medicaid. We are going to see an elder care Lawyer that deals with Medicaid to see what our options are. Here in Il it seems mostly Nursing Homes offer Medicaid.Get everything in writing.

When I was looking at places for my mom, several private-pay places came right out and said "We don't accept Medicaid." They were quite clear without saying as much that we weren't going to get her in for a few months with private funds and then transition to Medicaid. Smaller care facilities seem to be more flexible and compassionate. As others have pointed out, absolutely, positively get any promises in writing. (Although if the facility were to change hands, even that written promise might not be honored.) Ideally, I would try to find a placement that does accept Medicaid just so you don't have to make a move down the road, when it will probably be even more traumatic to do so.

Yes, there is a way. Get the promise that they will convert a bed to a Medicaid bed should private pay run out; get this statement in writing in the contract that they will ask you to sign. And before you sign it, have it reviewed by your attorney.
I can't tell you the number of places that have not had available Medicaid beds when a long time resident runs out of private funds. When NJ maintained government run LTC facilities, we often took these residents but government facilities were not beautifully designed and decorated as the private facilities so both families and residents had to accept big changes. Remember, the promise is not to keep the resident IF a Medicaid bed is available. The statement you want is that they will CONVERT a resident bed to a medicaid bed when/if private pay runs out. Please feel free to message me if you want to further discuss.