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Mom has Medicaid and Medicare, but the facilities offered under Medicaid do not look nice and have low reviews. The private pay facilities seem so much better, but I have no idea how she could get into one.


It breaks my heart to have so few options.

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Sad truth is without money your options are limited. Medicaid facilities may not look nice but if you visit often, make sure she gets engagement maybe even take her out on holidays and weekends you can make do with a crap situation.
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Same problem here. We think when the time comes, we'll have to sell the house.
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In most states, Medicaid only covers LTC, not AL or MC. Needing LTC is usually when one is bed-bound or has a profound medical problem (no, not dementia unless the person is bed bound). This is assessed by a doctor as medically necessary (usually).

Many states have what is called an Elder Waiver:

"The Elderly Waiver (EW) program is a federal Medicaid waiver program that funds home and community-based services for people 65 years old and older who are eligible for Medical Assistance (MA), require the level of care provided in a nursing home, and choose to live in the community."

You will need to contact social services/elder care for your county and talk to a social worker to see if your Mom qualifies for any of the services.

Also, please look into faith-based facilities that accept Medicaid residents. My MIL is in an amazing place run by the Presbyterian Church (and she's never been a Presbyterian). She's on Medicaid, has a private room and it's located on a beautiful lake with gardens and walk paths, with events and activities. It is really well run, and it is non-profit and mission-based. Prior to that she was in a smaller (but farther) NH run by the Moravian Church. Very affordable. These places do exist, you need to look for them.
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In our area the private, nice, well respected places have a limited number of Medicaid beds. Definitely with a shared room but they exist. Don’t assume you’ll have to be in a dump to use Medicaid
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Our old neighborhood had 2 'home owned' elder care facilities. Owned by 2 nurses who bought the homes and renovated them to accomadate the needs of the patients. Family could help out with the costs by 'volunteering' some hours each week, so the costs of, say, snow removal was not an issues b/c one of the residents' son had a snowblower and he'd clear the walks all winter in return for a portion of mom's 'rent'. Kind of a barter system, I guess. The local church also stepped in with weekly services and people who would 'adopt' an elder, if they had no family.

They were clean, very homey and staffed by family of the nurses. I knew a woman who was the main cook at one of them. She had done a school lunch program and knew how to cook in large-ish quantities very economically.

I think each home held 4-6 residents.

These places exist and are kind of hard to find--but they are not nearly as costly as the TajMahal of places, like Sunrise.
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Private pay have both single or shared rooms. Shared are cheaper rent. Some also charge additional costs based on the level of care required after a assessment. Need POA and 602 form completed by her Doctor for the facility to be placed. You would be required to handle Meds and Incontinence diapers. Most places increase rent by 5 % each year. I really don't care much about the beautiful decor and other nice things. I don't mind having a cheaper rent and older building with good care. I use a excel spreadsheet to project costs and compare different places to help with the decision process, I wish you well. I know, this is really difficult. By next year her funds will become a huge issue. Already trying to get ahead of it. Very stressful. Good Luck
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