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Assisted Living Medicaid Isn’t Necessarily Forever (Part 2)

                Last week I was telling you about Joe’s dad.  He had qualified for Medicaid in an assisted living facility (ALF) and been assigned one of the facility’s 10% of its beds that are set aside for Medicaid residents.  Everything was fine until he fell and broke his hip.  When the hospital was ready to discharge him, the ALF said they couldn’t take him back.

                The reason is because dad needed a hoyer lift to move him.  A hoyer lift allows a person to be lifted and transferred with a minimum of physical exertion.  The ALF told Joe that it was not equipped with a hoyer lift.  He offered to purchase one but the facility said they couldn’t accept that.

                Joe’s situation highlights the potential problem with ALF Medicaid.  Because an ALF is not a nursing home – meaning it isn’t licensed to provide nursing home level care – there are instances where a resident’s health is such that the ALF cannot care for that resident, despite the fact that he/she qualified for Medicaid.  In other words, being approved for Medicaid is not a guarantee that every resident can stay for the rest of his/her life.  That will depend in part on luck.

                In the case of Joe’s dad, the facility can’t care for him.  That is not to say that all ALFs won’t accept a resident who needs a hoyer lift.  Some will and some won’t.  However, the larger point is that because an ALF is not a nursing home there is some risk that Mom or Dad won’t be able to stay in the ALF even if they are receiving Medicaid.

                So where does Joe’s dad go from here?  He is on Medicaid so he can transition to a nursing home without losing those benefits.  It will be easier for Joe to find a facility than it would be for someone who is Medicaid pending – having applied for Medicaid but not yet been approved.  However, there is no assurance that Joe will be able to choose the facility.  There must be a Medicaid bed available for him at the facility at the time he is ready to be placed.

                Just another example of how complicated the long term care system and Medicaid are.