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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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First check with your Area Agency on Aging to find out if Medicaid will pay for Assisted Living in her state.
Much depends on your mom'smarital status and level of income and assets. If she has a spouse living, ahe needs to consult with an eldercare attorney to protect the spose that is remaining at home
I've got the same problem with my mother trying to figure out what to do and how to get on Medicaid for her she only has a certain amount of money her social security so no other assets.
My mom just moved into assisted living and Medicaid is paying for it. My mom also pays a portion of it out of her income. She gets to keep $163 a month for personal expenses, plus she keeps money to continue making payments on a couple of medical bills. The rest goes to assisted living. Medicaid pays the majority though. I started the Medicaid process by contacting senior and disability services in our county and went from there.
Medicaid is funded jointly by your state & the Feds BUT is administered uniquely by each state within overall federal guidelines. To me, its important that you understand the basics on what Medicaid is about both for its medical & financial aspects. Care in a NH aka skilled nursing care is dedicated & required funding for Medicaid & they will need to show the "need" for skilled nursing care in addition to being "at need" financially (basically impoverished). But AL funding is done via a waiver (or a diversion of $) program. States can decide just how or what or even if waivers will be done & what the qualifiers are. Like CA has an established waiver program which is the IHHS (in home health services) system done county by county.
Most states do not do waivers for AL. Some states do AL waivers but narrowly limit the program. For example, TX has 2types of AL's....CCF which is 24/7 custodial care and not ever paid by medicaid and CBAAL which is community based alternative assisted living which Medicaid will pay for. CBAAL has a limited enrollment & pretty strict requirements for participating ALs so for families the # of available beds are teeny tiny and drawn from a waiting list. I found - when looking for my mom in TX - that less than 10% of AL in her area (big city too) even participated as CBAAL & realitically if you needed them to have 24/7 that meant getting them eligible - both medically & financially - for NH Medicaid or private paying for AL.
As an aside on this, the trend for waiver funding are PACE type of programs where they stay living at home or their kids home but go to a PACE center 2 - 5 days a week for care, medical monitoring & care, meals, etc. Family is responsible for care outside of the time at PACE. PACE is funded by medicaid to usually a non-profit partner who works with other health care resources (like Visting Nurses Assoc. to do flu & pneumonia shots) as well. There is a PACE by us - the Benson Center - that is very well received & run by division of Catholic charities in a repurposed school. So well received, that another one is being done by Catholic Charities into an old orphanage & school. If your state is doing PACE, you may find that they will need to be evaluated for PACE first & foremost before they can apply to another waiver program.
Medicaid is totally an state managed "at need" program which they have to clearly show "at need" medically (either from existing health chart or an evaluation by a health care provider at the NH, AL, PACE, etc.) for whatever program they are trying to get into AND to be "at need" financially by whatever income & asset levels determined by your state (usually impoverished).
Even connecting all the dots and completing the extensive paper work, the reality of California Medicaid is there are thousands of applicants for nonexistent beds.
I think when it comes to the word "Assisted Living" and "Nursing Home" is can be interchangeable depending on where someone lives. And how someone thinks what the facility does.
In my area, a skilled nursing home is a far cry from being an assisted living facility. Nursing homes are more like small hospitals without all the beeping machinery, etc. And the furniture is already there. And you share a room unless you pay extra for a private room, and there a hospital like curtains between the room-mates.
Assisted Living is more like a hotel with a nice private room where one can bring their own furniture, set it up like a college dorm. There are aides to assist during the day, but most people are doing what they want. When a much higher level of care is needed, then one moves to the nursing home.
What others have written is true, but I do want to clarify, that, at least for Arizona, IF the medical need for care is based on a dementia or Alzheimer's diagnosis, that Memory or Dementia care IS considered Assisted Living, and IS covered by Medicaid...whether the resident goes into a specialized unit in a nursing home, or a specialized unit or section of an assisted living facility or is going to live in a separate, specific facility for just Memory Care. In AZ, Medicaid will also pay for placement in small group homes for those with memory care problems, but in ALL cases, the facility must be Medicaid approved in advance. Not all are. And where they are, many will have only a certain number of authorized beds for Medicaid residents, because they will get paid much less money from the gov't for the Medicaid resident. When we had to qualify my Dad for Medicaid, we had an eldercare attorney and his office staff helped with everything, but a person can call their state Medicaid office and get their own representative assigned to help them with the paperwork too. If you already have your mother placed in Assisted Living, and they ARE a Medicaid approved facility, they should have a caseworker or social worker who would help you get started with the application process too. My Mom is in Assisted Living right now, and the one she is in, requires that one be private pay for three years before they would convert her to Medicaid and they rarely, if ever, have a Medicaid bed just be opened, because the residents living there are first on the waiting list for the 20 beds they have licensed for Medicaid. In general, for a Medicaid approval, there must be both a medical need and a financial need determination on the application. If the medical need is approved, and that's generally the fastest, easiest approval part of the process, then the representative will look at 5 years back of financial statements, and help you determine what you must do to get the financial part approved. My Dad had a 'spend down' amount of excess money we had to use up, before approval....so we had to spend about $75,000 on medical expenses for both him and Mom and do a lot of home improvement/maintenance stuff to use up the money. Those were the only two acceptable uses of money. Burial expenses was also OK, but Dad's was already taken care of when we applied. So we paid privately for his Memory Care facility for nearly a year, until we had used up enough money for his approval to come through. Now, had he already NOT had enough money, he could have started on Medicaid paying, within 30 days, in Arizona. You can also go to the Medicaid government website and find lots of basic information there...and go to your state gov't website and find out which agency in your state handles Medicaid and nursing home/assisted living/memory care facilities etc. In Arizona, all this is through our State Health Dept. I hope some of this is helpful to get you started.
SSBG Home and Community Services Assisted Living, Medicaid Waiver
What is Assisted Living?
A facility licensed in the state of Nebraska to provide residential and support services and approved as a Medicaid provider for clients eligible for the Aged and Disabled Medicaid Waiver.
Who needs Assisted Living?
Clients eligible for the Aged and Disabled (A&D) Medicaid Waiver who choose residential and support services in an assisted living facility.
What are my needs?
Access Assisted Living Choices to identify your needs and what assisted living facilities may be able to meet these needs.
Do I qualify for Assisted Living funded through the A&D Medicaid Waiver?
You may qualify if you are:
18 or older Eligible for Medicaid Needing help with activities of daily living (such as bathing or dressing) Eligible for a DHHS program that has the Assisted Living service, and a Services Coordinator has determined that you need Assisted Living
No...Medicaid does not pay for assisted living. BUT....they do pay for Memory Care or Dementia Care admissions and many of those facilities are inside Assisted Living facilities....while some are inside Nursing Homes as separate wings. When I was referring to Assisted Living....I believe I specified that in Arizona, my state....Memory Care/Dementia Care, Alzheimer's wings....all of those types of places are in the state health dept licensing as Assisted Living facilities.....not nursing homes or skilled care facilities. And Medicaid will pay the bills for someone, qualified to be in Memory Care etc, no matter if the facility or wing is within an Assisted Living facility. NO...they will not pay for a 'well' elderly person to live in normal, non medical assisted living. Just wanted to clarify what I meant in my previous statements, trying to help this person.
The facility my mom is in is considered "assisted living". She has her own studio apartment...all of the residents do...has all of her own furniture, etc. My mom is not able bodied. She needs assistance with everything and they provide it. This place isn't a part of a skilled nursing facility
Oops, that posted before I was done. Anyway, i assume that the reason Medicaid covers this for my mom is because of the level of care that she needs. This place is different from a nursing home. She is free to come and go. Has all of her same doctors. She also keeps her Medicare insurance and supplements as well. Maybe our state is different? Maybe it's because we are in a rural area? I don't know.
This is not really answering the question, but more of a statement. In my opinion (Ohio), the system goverment is really screwed up, I think it is terrible that our elderly parents work all their lives, pay there taxes, and try to be law abiding citizens of this country, then @ the end of their lives when they need the most help, the goverment screws them again by giving them a small amount (ohio is 50.00 a mo) for assisted living and take the rest. If it wasn't for our senior citizens teaching us and our so called goverment officals what we ALL know where would we or they be?!? Our goverment should take better care of our seniors that helped make our country FREE in the first place...
Sorry, just blowing off some steam, and by the way it felt pretty darn good!! I wish u the best of luck, it was a long road for us, and I will always fight for what is right for my and everyone's parents.
I just wanted to add that various states have programs that are similar to Medicaid that pays for Assisted Living if the doctor says the patient needs it and their qualify according to their income. This is sometimes for those with dementia who cannot live alone, but may include other people who cannot perform their daily activities in their home.
In NC this program is called Special Assistance. It does NOT cover Nursing Home care. You would have to apply for that separately. The requirements are slightly different from regular Medicaid for nursing home care.
I would check to see what your state has available.
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.
Much depends on your mom'smarital status and level of income and assets. If she has a spouse living, ahe needs to consult with an eldercare attorney to protect the spose that is remaining at home
Most states do not do waivers for AL.
Some states do AL waivers but narrowly limit the program. For example, TX has 2types of AL's....CCF which is 24/7 custodial care and not ever paid by medicaid and CBAAL which is community based alternative assisted living which Medicaid will pay for. CBAAL has a limited enrollment & pretty strict requirements for participating ALs so for families the # of available beds are teeny tiny and drawn from a waiting list. I found - when looking for my mom in TX - that less than 10% of AL in her area (big city too) even participated as CBAAL & realitically if you needed them to have 24/7 that meant getting them eligible - both medically & financially - for NH Medicaid or private paying for AL.
As an aside on this, the trend for waiver funding are PACE type of programs where they stay living at home or their kids home but go to a PACE center 2 - 5 days a week for care, medical monitoring & care, meals, etc. Family is responsible for care outside of the time at PACE. PACE is funded by medicaid to usually a non-profit partner who works with other health care resources (like Visting Nurses Assoc. to do flu & pneumonia shots) as well. There is a PACE by us - the Benson Center - that is very well received & run by division of Catholic charities in a repurposed school. So well received, that another one is being done by Catholic Charities into an old orphanage & school. If your state is doing PACE, you may find that they will need to be evaluated for PACE first & foremost before they can apply to another waiver program.
Medicaid is totally an state managed "at need" program which they have to clearly show "at need" medically (either from existing health chart or an evaluation by a health care provider at the NH, AL, PACE, etc.) for whatever program they are trying to get into AND to be "at need" financially by whatever income & asset levels determined by your state (usually impoverished).
of California Medicaid is there are thousands of applicants for nonexistent beds.
In my area, a skilled nursing home is a far cry from being an assisted living facility. Nursing homes are more like small hospitals without all the beeping machinery, etc. And the furniture is already there. And you share a room unless you pay extra for a private room, and there a hospital like curtains between the room-mates.
Assisted Living is more like a hotel with a nice private room where one can bring their own furniture, set it up like a college dorm. There are aides to assist during the day, but most people are doing what they want. When a much higher level of care is needed, then one moves to the nursing home.
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Assisted Living, Medicaid Waiver
What is Assisted Living?
A facility licensed in the state of Nebraska to provide residential and support services and approved as a Medicaid provider for clients eligible for the Aged and Disabled Medicaid Waiver.
Who needs Assisted Living?
Clients eligible for the Aged and Disabled (A&D) Medicaid Waiver who choose residential and support services in an assisted living facility.
What are my needs?
Access Assisted Living Choices to identify your needs and what assisted living facilities may be able to meet these needs.
Do I qualify for Assisted Living funded through the A&D Medicaid Waiver?
You may qualify if you are:
18 or older
Eligible for Medicaid
Needing help with activities of daily living (such as bathing or dressing)
Eligible for a DHHS program that has the Assisted Living service, and a Services Coordinator has determined that you need Assisted Living
In NC this program is called Special Assistance. It does NOT cover Nursing Home care. You would have to apply for that separately. The requirements are slightly different from regular Medicaid for nursing home care.
I would check to see what your state has available.