Advice on dealing with pushy admission people from private pay facilities?

They’re trying to sell you. As long as you have their attention, I would ask what their policy is on Medicaid. If they don’t accept it what policies if any do they have to liaise with facilities that do?

My own feeling is that since hedge funds have taken over ownership of most healthcare facilities, I view their admissions staff as salespeople, like the stereotypical car salesman or real estate salespeople. . And now disabled and ill people are viewed as "customers" The admissions staffs' new compensation has become linked to company metrics comparing the rate of potential customers to admissions. Top bonus for admitting Medicare or private pay customers, no bonus points for admitting Medicaid customers. Other employee compensation, bonuses and "perks" based on similar metrics, too, all about profits.

Ideally that would be the case; it is however quite rare. Private places are usually now corporate owned. They are in it for the big bucks. That means when you run out of money you are run out for the most part. Some rare ALF will accommodate this. Most will not.
As to pushy, if you are being hounded you can easily have them off the phone by saying that your parent is applying for Medicaid and soon broke.

It's an unpleasant process, but we are the Corporate States of America, and they are just a small part of that.

Yes, be careful. Sometimes they paint too rosy a picture or promise things that then are not done or possible . For example , salesperson told my dad they will provide a microwave in the room, but after assessment that revealed his dementia , appropriately the care director said a microwave would be unsafe and not allowed .
some places do have a combo of private pay and Medicaid. There may be a state website where you can look up which ones do?

A lot of these "salesmen" get a commission for every room they fill, they have a vested interest in saying whatever it takes to get your signature..

If you need a list of senior living facilities in the DMV, here is a good source. www.washingtonian.com/best/retirement-communities I don't know if they first will accept private pay and then later accept Medicaid.


When my Dad checked out Sunrise, across the river here in northern Virginia, we found the sales staff not pushy at all. Hopefully that hasn't changed.

My friend. I've got news for you. EVERY facility is private pay if a person has any money and assets. After it's all spent down on paying for care the facility makes sure the Medicaid gets done if they're planning on keeping a resident. Sometimes they don't. If a resident is too difficult they will put them out as soon as the cash-paying stops.

I'm going to let you in on something you may not know. Unless the person entering a Long Term Care facility is extremely wealthy or has a spectacular LTC insurance policy, they start doing the Medicaid application the day that person walks in the door. So don't worry about that.

Also, don't ever let the administative staff or social workers of these places ever get pushy with you. NEVER sign any documents from these people unless you read it thoroughly and fully understand it. If you don't understand a document, tell them you will be having your attorney look over it and explain it to you. Under no circumstances should you ever just sign your name to something an admission person hands you. I say this because many people have signed documents for a loved one at a care facility because they were told they were something else. Turns out, they put themselves on the hook financially for payment.

The people who do admissions at nursing homes, AL's, and memory care facilities are for the most part despicable low-lifes who would rip off their own mothers. Skilled, greedy liars who have no problem tricking and screwing over a person's whole family to squeeze every dime. These people are real snakes in the grass. That's their job.

Tour some facilities that have availability and pick one for your mother. Then have a lawyer look over the paperwork they want you to sign.

Like I said. Corporations-R-Us. That's the case in the US of A.
Dad has become a commodity. Like Hospice, he is now traded on the exchange.
That's a part of our lives lived daily in every way.
How do schools spend their money?
On consultants. On textbooks changed every month (how often did my Mom tape mine together; she swore I was given the rattiest books because she did the best repairs).

Follow the money. That's how it works. It's OK. It's a choice. It's apparently OUR choice because we cannot stop shopping for a single second.

Summer, something to be aware of is LTC Medicaid “at need” requirements are BOTH financial AND medical. The being “at need” financially is what families fixate on but the medical aspect is just as important and can pose way waaaaaaay more hurdles especially if this is a direct placement into a NH, which your post sounds like.

$ stuff the elder / their POA have control over….. do a spend down; get their home/car sold if that’s what they want to do; create Trusts if feasible, etc. But the “medically at need for skilled nursing care” which LTC Medicaid absolutely requires depends on others (eg MDs, PTs, OT, hospitalization & rehab notes, etc) for your parent to have a nice fat health chart that beyond clearly shows an assessment as to “need” for skilled nursing care. NHs can and will admit an elder who is not at this level if they are private pay. Usually elder is in their 90’s with $$$ to private pay so moving them into a NH is better than doing an IL 2 AL 2 NH multiple moves. A 1 & done approach. This elder could in theory be totally OK in an AL or even maybe in a very proactive IL but due to their age and the medications they are on, it just makes sense to ensconced into a nice private room in a NH. But this type elder will not be able to pass medical “at need” assessment for LTC Medicaid. Medicaid does review health charts and can send out actual assessment team to do in person evaluation.

FWIW vast majority of SNF/NH admits are this scenario:
Dad living at home/apt has a bad fall; Dad goes to ER/ED; Dad is hospitalized (MediCARE as his health insurance is paying); Dad gets hip replacement surgery (MediCARE pays); Dad then discharged to rehab done in a SNF that has a IRF (in patient rehab unit) and again MediCARE pays for a period of time based on discharge paperwork and how they progress. Majority of time, Dad stops progressing in his rehab around week 3 or 4, so Medicare stops. Dad cannot feasibly return to his old life so this Dad stays put BUT goes from a rehab patient to a custodial care resident. Custodial care is private pay, LTC insurance or this Dad & his POA file for LTC Medicaid. Medically this Dad has a nice super fat file to show that he is oh so definitely “at need” medically that’s recent and with all the codes in his chart to support this determination. The financial part that’s your/ the POA & Dads problem to show he’s “at need” financially for LTC Medicaid which for most States is a max of $2829 income, under 2K in nonexempt assets and no 3-5 year lookback issues.

Just being old, frail, needing help taking meds, cannot shop / cook for themselves is not enough to be medically “at need”. Is your parent documented medically at need??? If not, you will have to work with their physicians to build up their charts to show that is the case. Or ya wait till they have a fall or super ill, either way hospitalized then go to rehab in a NH and stay there.

Also when looking at places that participate in LTC Medicaid, clearly ask if they do “Medicaid Pending” or if not, how they do the contract btw POA or responsible family member for billing in the interim btw filing and approval. Also ask if # of LTC Medicaid beds are fixed (so limited). Ask if the Share of Cost is done from day 1 once application filed or all the SOC gets paid upon approval even if it’s 3-5 months (this kinda is State dependent). SOC is the monthly income your parent gets ea mo., like their SSA $. SOC paid to NH less sm personal needs allowance (tends to be $50-$75, & all the $ they will ever have once on LTC Medicaid and is restricted spending).

For a widowed parent, to me, if you have been involved in their life & are POA & signature on bank accounts, imho you can DIY all this. If they are still at home or in IL, you do whatever visits, labs, etc to get their chart done. But if not, or if they are a strong personality and you are not, it’s best off being done by Medicaid experienced attorney.

You don’t have to let mom go broke if you see elder law attorney before..they’ll come up with a plan so her assets can be saved at same time making her Medicaid eligible. Make an appointment asap. Don’t talk to Medicaid person at facility. They want all her $$$ & then some. They’re all crooks. Just deal with the lawyer when you get one. Hugs 🤗

I live in Florida. My next door neighbors work looking to move to a private pay facility. The husband told me they all had young, extremely beautiful blond sales reps that stayed in contact with him. He thought they were very pushy.

REALLY? You are spending more than half a minute with a PUSHY place you are thinking of PAYING???
Whew.

My father is in memory care. My sisters and I were thinking of moving him to a facility closer to where one of us lives. I called A Place for Mom for recommendations and their representative gave my contact information to places in that area. For the next few weeks, I was inundated with phone calls and texts. It felt very aggressive. I wish that facilities didn't even have salespeople, but instead had health care consultants that really cared about whether they are a good fit for someone.

A Place for Mom drove me crazy with sales calls from my area! Never Again..I finally chose a place a friend had used…4 years now and ok…PS. In Virginia AL and MC are self pay…when broke {$2000 max} then a NH with medicaid!

We had a difficult time just even trying to find a place that my mom liked enough to want to move into from her home. We had no idea she would progress through the system by being forced by them (and justifiably much to our sadness) from IL 2 AL in 3 months, then AL to Memory Care in another 8 months. From there it was 2 1/2 years until they forced a move to NH due to frequent falling out of her wheelchair and needing a hoyer lift. She really loved the Memory Care Facility and the staff there so that was very difficult to wrap our head around. I cried.

We checked other places and looked for one she would like, and that also would eventually take Medicaid because the money was going very quickly. Very difficult to find a homier environment and a place that takes Medicaid as well when she would need it, so we stuck with the original self-pay facility.

No place is perfect, and the best we can do sometimes is to look at what our loved one wants, what they can afford, and accept that it's their money and we need to do the best for them that we can until they are forced to move when they need to go on Medicaid.

Say front you are not in need right now and to please remove you from their data base and tell them you will call them if and when the real need arises. You can ask if they have medicaid beds and if not, they probably won't call you back.

SummerHope: Unfortunately it is about the $$.

You are the customer. Demand respectful treatment and prompt answers.

They continue to call even AFTER your LO has passed. That is what happens to me. Mama gone over ten years Daddy gone almost four and phone calls continue to come in - even after I have already said they are not here anymore. ;(
Cannot get any information unless you give your information. I usually give them my "spam email" and when they want my phone number and if they continue to call I block them or I give them my landline number - which I never answer the phone calls go straight to machine

just to clarify, LakeErie has no understanding of Medicaid process. LakeErie said, “ Please don't imply that taxpayers should pay for the mother, when we have our own mothers to pay for.” This is a false accusation of my advice..I want you and administrators to know.

Lawyers specialize in this Medicaid process and will help..unlike the Medicaid person at facility..who wants to rob the resident of everything. Hugs 🤗

They are not your friend. They do not have you or your LOs needs as a priority. Their interest is in filling rooms with bodies that have money to pay for as long as they can squeeze $ out of them. They will take your last dime with a smile and evict you with false pity if you run out of money unless they take Medicaid and you can qualify for it. Read everything carefully before you sign and use an attorney if you have one. Take the papers home and don’t be pressured into signing anything before you have had time to read the them in detail. High pressure sales tactic’s encouraging you to “sign today” are signs you need to take control and command of the situation and slow things down. Get up and start to walk out if necessary. Many will claim they have a special that “expires” and that they need an answer right away. Trust me - unless there is a real shortage of facilities in your area, you could walk in the next week after the “offer” expires and they will find a way to “extend” it to you. Lock your monthly rate in for at least a year if you can and watch out for lowball care assessments that get you in the door and then jump up one or two levels. Don’t be pressured.
When my mother went to rehab, they tried to get me to sign a paper that said if there was any legal dispute over payments that we agreed to let their attorneys handle it and represent us. I declined saying that we had our own attorney and would not sign over those rights to anyone else. They later approached my 93 y/o mother and had her sign without my knowledge. She told me about it later and she recalled they were very happy with her saying “she signed it!” She did not know what she was signing and I did not find out about it until after she was out. In the end it didn’t matter because it was just a short rehab stay - but this is an example of how they operate. There are no ethics - just pure greed and desperate sales people trying to keep their jobs. Calling them snakes is an insult to snakes.

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