We are in Minnesota. We are bringing her here from Kansas. We found a place that seems nice. We had a long conversation about the ability for her to age in place. We understand there are situations where that might not be possible and she moves to a nursing home. So, can anyone say if they have had trouble moving to Medicaid in a Memory Care place after private pay runs out? Has anyone had experience with moving someone to a NH after their private pay runs out and their current place doesn't have a Medicaid bed available? Or, is there some sort of assurance that we can get from the MC place that they will keep her until a bed is available without expecting us to makeup the difference, which wouldn't be possible? Our biggest fear is that we have this great place that will deplete us of all her money and then when she really needs help/care, they say goodbye. What prevents them from doing that and kicking her out?
IF the facility is BOTH Private Pay AND MEDICAID-approved, then she "should," be allowed to stay, if her contract states that her bed will be converted into a Medicaid bed. (Yes, specifics need to be in writing), Ask if she will be changing rooms or if it's just a billing switch;it's best to know what's involved in the switch from private to Medicaid payer status. Usually it's just a billing switch, since Medicaid directly pays the facility.
In the meantime, look into creating a "special needs trust," and look into what needs to be done to get her into Medicaid, for when that time arrives.
What "prevents" them from evicting her? Federal laws mandate that a SNF/LTC resident cannot be evicted while waiting for his/her Medicaid approval.
As mentioned, ASK the facility if THAT specific facility is currently Medicaid approved. IF it's a Medicaid approved facility her contract needs to clearly state that her bed will be converted into a Medicaid bed.
BTW ONLY Medicaid approved facilities can convert a private pay bed into a Medicaid Bed. Ideally it's in the contract signed to stay in the facility. Transitioning to Medicaid billing"should" be problem free.
Social security sidebar: if she will be receiving social security, when she is approved for Medicaid, SHE will be billed a social security based amount as her co-payment.
What?? HOW?
-->The County where the facility is located will calculate her portion of the Medicaid charges due each month. As an example if she receives a notice that she will be getting $930 SS per month. the County will receive the same notice. The County subsequently will calculate her monthly portion due payable by her, to the facility.
It will be ALL of her SS minus a monthly allowance of about $50.
--> In my example the county will send the facility a calculation sheet that states the amount to bill the person; $930 - $50 = $880/month
Our facility has BOTH private pay and Medicaid pay residents/patients. One Private pay bed is billed at $10,400/month while One Medicaid bed is billed at $6,600/month. If the SS person in my example were staying here s/he would be billed $880 each month. The Medicaid co-payment is a federal law, meaning zero negotiation exists.
Sidebar: Augustana Care in Minnesota runs VERY NICE Private pay Medicaid approved facilities.
Their Colorado facility has individual private rooms for each person {Each Medicaid + Each private pay person is in an individual single private room "bed"}. It's in a crazy wealthy area.
Good luck.