Assisted Living Facilities – Transitioning to Medicaid (Part 1)

The topic of this week’s blog post is the transition from private pay to Medicaid in an assisted living facility (ALF).  We have had a number of calls recently to our office from families whose loved ones moved to an ALF two or so years ago with the expectation that they would spend down their loved one’s remaining assets towards the cost of care and then Medicaid would take over payment.

As funds are winding down and discussions had with the facility about next steps, some families are realizing that the transition from private pay to Medicaid isn’t as easy or simple as they first thought.  While it is impossible to know what was or wasn’t discussed in those initial sit downs with facility representatives at the time of admission, these calls lead to the conclusion that there is clearly a disconnect.

When the realization sets in that the transition may not be so easy sometimes panic sets in as the assets dwindle.  In some cases there are a limited number of Medicaid slots available.  In other cases the private pay requirement hasn’t yet been met – a requirement that several callers say they was never discussed. In yet other instances the resident’s physical or mental health has deteriorated such that the ALF maintains they can no longer provide adequate care.

Families are now scrambling to consider what options they have as it seems that the ground beneath them has shifted.  I’ll discuss that next week.