Parent in assisted living facility (ALF) needs help w/medication, bathing, incontinence, & wears a fall pendant. Can still transfer and dress but cannot manage money or other decisions. She's a diabetic, stage 3 kidney disease, COPD, hypertension, neuropathies in feet and hands, get's PT 3x/week. We have financial & medical POA. Money will run out in 2yrs. Three different case managers and Medicaid planner have recommended start Medicaid application 6-12 months prior to assets running out and then assuming Medicaid is approved move to a Medicaid accepted skilled nursing facility (SNF). This all sounds too easy since without a medical need for SNF I just don't get it. They also all said, "Based on her ALF level of care she already qualified, but keep her in ALF because the quality of life will be higher." Again, this sounds too good to be true. Current ALF does not take Medicaid. Am I just dense? Thanks in advance.
I don't know who these experts are, but if they are experts you trust, and you get the same info from two sources, I guess you have little to lose, but I would think that starting thusly early with thinking for someone this critically ill, and without knowing what changes for the good or the bad are coming for the person him/herself, is just causing you more grief and problem than you already have.
(I say this having cared for a brother who I broke my neck to plan for, and who unexpectedly died of sepsis from a teeny non-healing scrape on his shin).
I was POA and Trustee for my brother when he asked me to take this on after his diagnosis of probably early Lewy's Dementias. Now that, 4 years after his death, I am beginning to get rid of what files I can, I understand how I did SO much overkill. I was a bit OCD, but I put myself through many circles of Hades before realizing now after his death that there was no need to, including two days spent cooling my heels in DMV in San Francisco (while it WAS entertaining, I could have lived without it).
Igloo is our resident "expert" on all things Medicare and Medicaid stuff, and I hope she is around on the new year to add her advice to you. I sure do wish you the best. I know what a big job and what a big worry this is.
What you do is place Mom in a facility that excepts Medicaid. Then you pay privately until 3 months before the money is gone and apply for Medicaid. That way when the money is gone, you side right into Medicaid.
When I transferred Mom from an AL to LTC she had 20k left. I started the Medicaid application in mid April. Mom entered the LTC May 1st and paid May and June privately. In June I confirmed with the caseworker that Mom was spent down and that he had received all info needed. Medicaid started July 1st. Medicaid cannot be approved until the assets are spent down to the cap allowed. My States cap is 2k.
Your Mom should move to a facility that accepts Medicaid right now, before she needs it. This is because Medicaid facilities often have waiting lists for people who are not currently residents. Many good and reputable facilities accept Medicaid. Their residents get first dibs.
Please know that most of the time, a Medicaid bed means a shared room. She will have a roommate if she's a Medicaid recipient.
To qualify for Medicaid, one has to both medically and financially meet the criteria. Many states have a 5-yr "look-back" period on the fiinancial app so whoever manages her finances needs to be very careful and know what Medicaid will and will not accept.
In most states, Medicaid only covers LTC. A very few states will cover AL. I don't know if any cover MC.
They mean medically, right?
Do you have credible information that her level of documented medical need doesn't require nursing home level care?
Start the process early as you have been told.
once on Medicaid , it’s possible you may be able to move to an AL that takes Medicaid. But if that is not an option for whatever reason, then SNF would be the only option .