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I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
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V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
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Tired1, the reason for the pages and boards on this website is for people to get information from people who have already had these experiences and willing to share what we've learned. Medicare and Medicaid can only offer "rules are rules", and depending on the representative you get, some of them don't always, well...care about your issues. On this site, we can ask for suggestions from people who aren't bound by the rules of their company, and like I did with my mom, maybe find a way around those rules.
My mother never had a private room, neither while we were private pay or when we went to Medicaid when funds ran out. There were just a few private rooms at her nursing home, occupied by all private pay individuals. What worked for us was having a roommate, twice over the years, who was basically bedbound and out of it. It was quiet and peaceful from that side of the room. Actually sad to witness. But not any bother to my mother. If you can't get a private room perhaps a request for a certain type of roommate could be an answer.
The Medicaid reinbursement rate for room & board by & large is pretty low. National average is abt $ 180 a day. Profit margins to run NH are pretty narrow and co-sharing is one way to manage costs. But some states do allow for private room for Medicaid residents as those concerns for "privacy" have been heard. Usually there will be an up charge to private pay rate paid by family with a contract signed as to responsibility. Google Iowa / private NH room / medicaid to see how Iowa is approaching this.
If your state is not doing this (each state administers it medicaid program uniquely but within overall federal guidelines), then in my experience you've got to get creative. Like my moms 2nd NH had it so the rooms at the end of each wing that abutted the stairwell were too small for 2beds do they were single rooms all OK for Medicaid (& these usually had 1/2 of a married couple where he was in theNH but the wife still in the community & they would often spend a nite...). For my MIL her old NH in New Orleans was in a historic district and the rooms were all singles & dorm room big but with jack & Jill style big bathroom between 2rooms, and totally ok for single room paid by Medicaid. One of the NH I looked at for my mom & aunt was another older one which actually was built with a wing of "isolation rooms" which were single ok for Medicaid resident.
Pls keep in mind that it could end up that having a "roomie" is a good thing for your parent as they help each other remember dining & activities times.
Midkid- I know what you mean. Six years ago my father spent five weeks in rehab. It was an old building with a floor plan like spokes on a wheel with the nurses station in the middle. My father had a private room and to my surprise it was bright and cheery with a large window that looked in to a rhododendron garden. So about 18 months ago my mom gets sent to the same rehab. Moms room was down a different hall. I was surprised this time as well but not in a good way. Mom had a roommate who already had the bed next to the small window that looked into the parking lot - she kept the curtains closed and I didn't blame her. The room was dark, looked like it hadn't been painted since the day it was built, smelled funny and basically couldn't have been more depressing. No wonder mom called me the first night having an epic tantrum! To this day I wonder if the hall my dad was in was the one "for show" and I shudder to think what the other halls were like. My parents had the same insurance so I don't know why they got such different accommodations. But yeah - how could anyone be cheerful and motivated in such a depressing atmosphere- unless it's to get the heck out of there?!!
My mother had Medicare and Medicaid and at one point, required a private room due to lack of compatible roommates (they were all much older than her and either wouldn't talk to her or were grouchy as heck and yelled at her). Medicaid paid the base room rate that they would pay for anyone, and I had to foot the bill for the rest. With no help from family members, it left me paying over $450 a month on my own for her private room. About a month before she died, they finally got a compatible roommate and I had her moved to a shared room. The sad fact of the matter is, if you're in a nursing home, someone else has to die before you can get into a room with someone who may be more compatible as a roommate. That was the case here - the 2nd roommate passed away and Mom was moved into the room in her place.
Definitely look into this before making the leap to a private room. See if there are compatible roommates available.
Medicaid does not specify how many people are in a room. It simply specifies how much it will pay, and that generally is a rate that is lower than even a shared room, so care centers typically can't provide a private room.
If you need a private room for medical reasons, discuss this when looking at care centers.
My mother had private pay AND it was extremely "good" insurance, and although she was PROMISED a private room for her rehab stay, she wound up in a nasty room with a roommate. By "nasty" I meant, they'd spruced up the part of the rehab center for "show" and the rest of the place was just as depressing and dim as it was 30 years ago. It took almost a week, but we moved her to a nicer facility. The roommate is who I felt sorry for, she was obviously a "long termer". Mother never spoke to her, so I don't know.
My guess is Medicaid is going to do what they usually do: the bare minimum. It could have been worse--some rooms were larger but held 4 patients.
Do let the administration know of your physical and mental needs: I think had mother been more amenable and nicer she might have gotten her "private" room. Good luck!
I think if you are willing to pay the difference out of pocket, some (not all) facilities have private rooms. But you WILL pay more. My sister is totally off board with mother's care, but quick on the draw with the checkbook. She'll pay anything to "solve" a financial situation and that's great. I think she paid $75 a day extra for mother to be in a private room when she moved rehab places. Mother could never afford that, but my sis didn't bat an eye. Money DOES smooth a lot of things over.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
If your state is not doing this (each state administers it medicaid program uniquely but within overall federal guidelines), then in my experience you've got to get creative. Like my moms 2nd NH had it so the rooms at the end of each wing that abutted the stairwell were too small for 2beds do they were single rooms all OK for Medicaid (& these usually had 1/2 of a married couple where he was in theNH but the wife still in the community & they would often spend a nite...). For my MIL her old NH in New Orleans was in a historic district and the rooms were all singles & dorm room big but with jack & Jill style big bathroom between 2rooms, and totally ok for single room paid by Medicaid. One of the NH I looked at for my mom & aunt was another older one which actually was built with a wing of "isolation rooms" which were single ok for Medicaid resident.
Pls keep in mind that it could end up that having a "roomie" is a good thing for your parent as they help each other remember dining & activities times.
Definitely look into this before making the leap to a private room. See if there are compatible roommates available.
If you need a private room for medical reasons, discuss this when looking at care centers.
The roommate is who I felt sorry for, she was obviously a "long termer". Mother never spoke to her, so I don't know.
My guess is Medicaid is going to do what they usually do: the bare minimum. It could have been worse--some rooms were larger but held 4 patients.
Do let the administration know of your physical and mental needs: I think had mother been more amenable and nicer she might have gotten her "private" room. Good luck!
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