My uncle is in an assisted living facility and will run out of money before he will be eligible to go to one of their Medicaid rooms. What do we do?

I live in NJ and have gone thru this.

He must be living in the AL and private paying for at least 2 yrs. If you want to make the two years, someone has to pay for his care. In Moms AL there was no guarantee that a Medicaid room would be available when she went thru her money. The AL only allowed a certain number of residents to be on Medicaid.

I was waiting for Moms house to sell and it hadn't. Mom had been in an AL for 8 months and was down to 20k. I took the 20k and placed her in Long-term care. I started the Medicaid application in April. Mom moved to LTC May 1st, paid May and June. That spent down her 20k. I contacted the caseworker in June and proved Mom was spent down and they had all the info needed. Her Medicaid started July 1st.

You don't wait till he is out of money to find a NH. If he has enough to pay for a NH for a month or two then I would place him and and start the Medicaid application. In NJ you have 90 days to complete the process. You need to spend down to 2k, you need to supply all info needed, and you need to place him or have a place ready to take him when Medicaid is approved. His monthly income can be no more than $2523.

I don't see how you can do it any other way if he can't meet private pay for 2 yrs.

Contact a state elder care social worker for assistance. Don't pay for an attorney out of your own money, and if uncle doesn't have much money left it may not make sense for him to pay for one either. a lot is going to depend on Uncle's medical needs. Is he medically eligible for nursing home Medicaid? Does he need assistance with most or all of his ADL's? Seek assistance now, start by contacting your local Agency on Aging, they may have a social worker there that will assist him, if not, contact the state social service, they will know how to transition him to another facility.

I would look for either an CELA (certified elder law attorney) who is experienced in Medicaid matters or a Medicaid Planner for NJ. Either of them will require a fee, but it will be less than the cost of private paying for the facility.

Yup my moms in the same boat! 3 years of self pay {$4655 a month} in an assisted building. She will run out of money soon. My plan is a 2 bedroom apartment with me taking care of her IF she does not meet criteria for a nursing home bed. Dementia is not automatically a qualifier in Virginia for a nursing home…hmmmmmm. The state of Virginia is a tough state for elderly people.

Your profile says your uncle is in another state. You either seek out an attorney in his state or move him to yours first. This long distance thing will not be easy if you are responsible for him.

The director would probably lie in order to not take the lower payment of Medicaid. I would check with an elder law attorney, social worker, and the ombudsman.

Who's in charge of Uncle's affairs? You or someone else? This should have been planned forf and applied for via Medicaid assistance (spend down)- Who is the PA for Uncle? Sounds like you need to consult an elder care attorney, pronto.

Good Luck!

What JoAnn29 said is true even in my state of Iowa. And they don't tell you that there is a waiting list for those rooms. So he may get one or not.

I would get him into a nursing home where he can spend down his money and apply for Medicaid. I have done this for my BIL, we had to spend down what he had in finances to get him on Medicaid. Which happened this Dec 2022. When on Medicaid what they don't tell you is they take everything that he has in finances except for $50 that is what he can have out of all his finances the rest goes to the nursing home. My BIL has a pension and social security so out of that he gets $50 which pays for his room phone that he needs. He is in a memory care unit at the nursing home. And in my state of Iowa the cost of a room is $260 a day which provides him with everything he needs.

And if your uncle would ever need memory care I would look for a nursing home that has that in their home. We were lucky my BIL went from the hospital to the memory care unit in the nursing home no waiting. He has dementia and his short term memory is gone. I am his rep payee for social security which is a blessing for him because of his family they would steal him blind and he wouldn't be where he is now.

Prayers

I would sit down with the director to ask for help, guidance, and resources to deal with the situation. You may be surprised how helpful they can be as I'm sure they have dealt with these situations before. If not or in addition to his/her recommendations, seek out a government or not for profit agency for seniors to help you navigate the system. They could refer you to an elder law attorney. Make sure that you have the copy of the contract for the ALF with you.

It is worth it to see an elder law attorney and get the true facts.
also be referred to a social worker who knows of how the housing is arranged for this situation.
If he has no assets then the state should be able to qualify him for services and housing