Assisted Living Medicaid Isn’t Necessarily Forever – Part 1

                Dad is in an assisted living facility (ALF) and is close to running out of money.  I would like him to stay in that facility rather than moving him to a nursing home.  In the past I have discussed the hurdles of getting assisted living Medicaid, which is different than nursing home Medicaid in many respects.

                ALFs have to make 10% of their beds available for New Jersey Medicaid if they agree to become a “Medicaid facility”.  Most ALFs limit their Medicaid beds to that 10% number so even if you are approved by New Jersey’s Medicaid office you might end up on the ALFs waiting list until a bed opens up and may have to continue to private pay.  I have also talked in the past about the need to medically qualify as needing nursing home level care.  Not all ALF residents meet that test so a Medicaid application can fail even though the financial requirements have been met.

                Joe’s recent call highlights another important issue with assisted living Medicaid.   Joe had gotten past the hurdles I just mentioned.  His dad had spent down his assets and had applied for and was now receiving Medicaid. Everything was fine – until he fell and broke his hip.

                Dad went to the hospital and now was ready to be discharged back to the ALF, but they can’t take him back.  Why?  I’ll tell you the rest of the story next week.

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