The Types of Long Term Care Facilities and Why It Matters – Part 3

In this third post of three, I continue to discuss why understanding the type of facility you are considering is so important.  Last week I talked about long term care insurance policies that may apply differently to nursing home care vs. assisted living care or home care.

The type of facility also matters when we have to consider Medicaid.  So often we get calls from families after they have made a move to an assisted living facility (ALF).  They are spending down assets and want help with applying for Medicaid.  When I ask what agreement they have with the facility, they might tell me that they have met a 2 or 3 year private pay requirement.  

That, however, may only apply to the ALF.  If there is a nursing home and an assisted living facility on the same grounds, you cannot assume that the private pay requirement you met in the ALF, will also be credited towards the nursing home.      In some cases it may but in other cases it may not.  You must clarify that with the particular facility, ideally before your loved one is admitted.

Additionally, a resident in the ALF may need to move to the dementia unit where higher levels of care and a more secure environment are provided.  While that unit is housed in the ALF, the facility may or may not provide Medicaid slots in that wing.  Again, it is important to clarify that before moving in.

One final important point is to be sure that whatever agreement you do reach with a facility is in writing.  It should be contained in the admissions agreement or an addendum to that agreement.  So many times, families will tell me that they did not get it in writing.  When it comes time to apply for Medicaid, the person who spoke with the family member at the time of admission is no longer there.  There is nothing in writing to guide the next facility employee, who cannot  honor any agreement that from their perspective they have no proof has been made.