I also think it's because they're having trouble receiving the money from Medicaid. It takes forever to get payment for the services from these people cuz it is taking forever to get things processed. The nursing homes are struggling with that and Medicare payments as well.
Assisted-living homes are rejecting Medicaid and evicting seniors
- Thread starter hawkdon
- Start date
Lethe200
Senior Member
- Location
- San Francisco Bay Area
Again, this is mixing up terms.
Asst Lvg is NOT covered by Medicare or Medicaid. It can be partially covered by newer LTC policies but older (pre-tax qualified) LTCi policies seldom included it; care was previously assumed to always be family-provided. The idea of hiring people as health aides is a relatively new industry.
If you are referring to Skilled Care Nursing, then if you are in any shape to ask hard questions and financially have the resources to choose, YES YOU SHOULD ask what the policies are at a specific SCN facility.
Personally, I can say that after coming out of two surgeries (relatively minor ones, at that) I wasn't in any clear enough mental state to make life-changing decisions that would have required hard research and careful consideration.
However, I would point out what I mentioned before: any change in ownership nullifies any previous mgmt policies. If you are already in a facility and it is sold, then IF you are in enough mental/physical health to ask the same questions as before, it would be incumbent upon you to make any decision to a removal to a different facility. Mgmt is under no obligation to assist you in finding a new facility nor in covering any costs incurred in a voluntary move.
Naturally
Senior Member
- Location
- Corner of Walk 'n Don't Walk
For those like myself who served 20 or more years in the military as enlisted personnel, there is a viable option.
There are two Armed Forces Retirement Homes (AFRH). One campus is in Washington DC and the other is in Gulfport MS.
I've always considered these campuses as my backup option. Cost of residency is based solely on income.
You must be able to live independently when initially admitted. This means you must be able to care for your daily personal needs, attend a dining facility for meals, navigate the community, handle emergency situations, deal with personal finances, and be self-sufficient when coping with healthcare by keeping appointments, making decisions, managing medications, following treatment plans, etc.
AFRH is a continuing care facility and offers additional support services to the members of AFRH should the need eventually arise including assisted living, memory support, and long-term care. You must be an existing resident to transfer into an advanced level of care at AFRH.
Once you have become a member, residents enjoy the benefit of knowing they will always have access to an affordable community where they will be safe, well cared-for, and worry-free among a group of fellow veterans who share a common bond of self-sacrifice, patriotism, and fraternity.
Armed Forces Retirement Home
There are two Armed Forces Retirement Homes (AFRH). One campus is in Washington DC and the other is in Gulfport MS.
I've always considered these campuses as my backup option. Cost of residency is based solely on income.
You must be able to live independently when initially admitted. This means you must be able to care for your daily personal needs, attend a dining facility for meals, navigate the community, handle emergency situations, deal with personal finances, and be self-sufficient when coping with healthcare by keeping appointments, making decisions, managing medications, following treatment plans, etc.
AFRH is a continuing care facility and offers additional support services to the members of AFRH should the need eventually arise including assisted living, memory support, and long-term care. You must be an existing resident to transfer into an advanced level of care at AFRH.
Once you have become a member, residents enjoy the benefit of knowing they will always have access to an affordable community where they will be safe, well cared-for, and worry-free among a group of fellow veterans who share a common bond of self-sacrifice, patriotism, and fraternity.
Armed Forces Retirement Home
StarSong
Awkward is my Superpower
- Location
- Los Angeles Suburbs
@Lethe200:
As I wrote in post #49, Medi-Cal will cover Assisted Living, at least in some cases.
Medi-Cal (California Medicaid): Assisted Living Waiver Program
"The state of California recognizes that individuals qualified for nursing home care can often receive the same level and quality of care in an assisted living residence at a lower cost. The Assisted Living Waiver Program (ALWP) serves seniors who need long term care assistance with personal care and household tasks. Most seniors and their families prefer an assisted living environment rather than a nursing home facility. This creates a win-win scenario for the state and for families."
From the horse's mouth:
https://www.dhcs.ca.gov/services/ltc/Pages/AssistedLivingWaiver.aspx
The Assisted Living Waiver (ALW) expires on February 29, 2024. The Department of Health Care Services (DHCS) intends to renew the waiver for another five-year waiver term beginning on March 1, 2024. The ALW provides eligible Medi-Cal members with the choice to reside in an assisted living setting as an alternative to long-term placement in a nursing facility. The goal of the waiver is to facilitate the transition of institutionalized members to a less-restrictive, community-based setting, and to prevent individuals who are at imminent risk of institutionalization from being admitted.
As I wrote in post #49, Medi-Cal will cover Assisted Living, at least in some cases.
Medi-Cal (California Medicaid): Assisted Living Waiver Program
"The state of California recognizes that individuals qualified for nursing home care can often receive the same level and quality of care in an assisted living residence at a lower cost. The Assisted Living Waiver Program (ALWP) serves seniors who need long term care assistance with personal care and household tasks. Most seniors and their families prefer an assisted living environment rather than a nursing home facility. This creates a win-win scenario for the state and for families."
From the horse's mouth:
https://www.dhcs.ca.gov/services/ltc/Pages/AssistedLivingWaiver.aspx
The Assisted Living Waiver (ALW) expires on February 29, 2024. The Department of Health Care Services (DHCS) intends to renew the waiver for another five-year waiver term beginning on March 1, 2024. The ALW provides eligible Medi-Cal members with the choice to reside in an assisted living setting as an alternative to long-term placement in a nursing facility. The goal of the waiver is to facilitate the transition of institutionalized members to a less-restrictive, community-based setting, and to prevent individuals who are at imminent risk of institutionalization from being admitted.
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Lethe200
Senior Member
- Location
- San Francisco Bay Area
Thank you, StarSong, for that correction re CA's MediCal program! We know someone who is on MediCal and has been struggling by herself, no family here, on a difficult convalescence from Stage 4 breast cancer (her third reoccurrence, so both painful and exhausting). I don't think she's quite ready for AL yet, but it's likely that time is drawing nearer.
I will let her know of this, I think it will relieve at least some of her worries about her future! Thanks again for that timely info!
Yet another reason why I'm glad we live in CA. The safety net here isn't perfect, but it's stronger than it is in many states.
I will let her know of this, I think it will relieve at least some of her worries about her future! Thanks again for that timely info!
Yet another reason why I'm glad we live in CA. The safety net here isn't perfect, but it's stronger than it is in many states.
StarSong
Awkward is my Superpower
- Location
- Los Angeles Suburbs
This thread prompted me to do the research, which is when I learned of this quite sensible provision in CA law. Given the cost of nursing homes versus AL, it's a wise financial decision on the part of our state.
I'm also happy our state has many fairly good safety nets in place. If only we could manage the currently overwhelming trifecta of homelessness due to mental illness, substance abuse, and lack of affordable housing.
Robb.hisself
Member
MediCal and Medicaid are one and the same thing in California. MediCal participants were switched to managed care (Advantage Plans) many years ago. But, generally, Medicaid/MediCal participants have many more benefits than what Medicare pays. For example, in California under MediCal the government will assist in caring for dementia patients, but under Medicare the government will not pay for dementia care.
Robb.hisself
Member
There is such an organization that is 'supposed' to be addressing these issues on behalf of the elderly - The AARP. The AARP advertises itself as doing so. But, the AARP is more a rip off than really much else.
Michael Z
Senior Member
- Location
- Northern Wisconsin
All pretty scary! All the more motivation to get out on my jog this morning.
Lethe200
Senior Member
- Location
- San Francisco Bay Area
>>Given the cost of nursing homes versus AL, it's a wise financial decision on the part of our state.>>
Well...yes and no. If you looked at part-time AL care, it's cheaper. But full time home healthcare, on a 24/7 basis - and I do know of at least three seniors who use such services - costs MORE than a SCN facility. Remember that home healthcare is different than homemaker services.
There's an article in the San Francisco Chronicle that points out the high costs (Diane Feinstein is a CA senator). I'll give some excerpts since it's subscription only and I'm out of gift links for the month, LOL:
Home healthcare costs Diane Feinstein example
San Francisco Chronicle 28Sept2023
(excerpts)
... An Associated Press-NORC Center for Public Affairs Research survey found that 49% of people 40 and older expect to depend on Medicare to pay for their long-term care needs, even though such services typically are not covered. The survey also found that 69% of Americans have done little to no planning for their long-term needs, and only 16% are confident they will be financially prepared to pay for such care.
Add to that one more sobering statistic: “The federal government predicts 70% of people over the age of 65 will at some time in their life need long-term care,” said Bonnie Burns, a consultant with California Health Advocates — and the majority of them will start out needing that care at home.
... Most home-based services include personal care such as bathing and dressing, as well as taking medication and supervision to ensure safety. Effective in-home care can save money, improve health outcomes and reduce the need for hospitalization, experts say.
While the need varies based on a person’s situation, and will change over time, data shows 3.7 years of long-term care is required for women, and 2.2 years for men, according to the Administration for Community Living.
One-third of the population may never need the support, and 20% will need it for longer than five years. About 65% of people use in-home care for an average of two years.
... For example, according to a long-term care calculator from life insurance company Genworth, the estimated 2023 costs for a home health aide in San Francisco is $7,585 a month for 44 hours a week, and $91,025 annually. For homemaker services such as meal preparation, grocery shopping, laundry and cleaning, it’s an estimated $7,282 monthly and $87,384 annually for 44 hours a week.
Genworth follows industry guidance of 44 hours as the estimated hours per week for professional in-home caregivers.
There are several calculators available to estimate long-term care costs, including one from AARP and another from the American Institute of Certified Public Accountants.
=======
Note: You can go the cheap route through grey labor, but I've heard a number of horror stories about those, especially as elderly parents begin to develop dementia issues. Costs above are for bonded, licensed care.
Well...yes and no. If you looked at part-time AL care, it's cheaper. But full time home healthcare, on a 24/7 basis - and I do know of at least three seniors who use such services - costs MORE than a SCN facility. Remember that home healthcare is different than homemaker services.
There's an article in the San Francisco Chronicle that points out the high costs (Diane Feinstein is a CA senator). I'll give some excerpts since it's subscription only and I'm out of gift links for the month, LOL:
Home healthcare costs Diane Feinstein example
San Francisco Chronicle 28Sept2023
(excerpts)
... An Associated Press-NORC Center for Public Affairs Research survey found that 49% of people 40 and older expect to depend on Medicare to pay for their long-term care needs, even though such services typically are not covered. The survey also found that 69% of Americans have done little to no planning for their long-term needs, and only 16% are confident they will be financially prepared to pay for such care.
Add to that one more sobering statistic: “The federal government predicts 70% of people over the age of 65 will at some time in their life need long-term care,” said Bonnie Burns, a consultant with California Health Advocates — and the majority of them will start out needing that care at home.
... Most home-based services include personal care such as bathing and dressing, as well as taking medication and supervision to ensure safety. Effective in-home care can save money, improve health outcomes and reduce the need for hospitalization, experts say.
While the need varies based on a person’s situation, and will change over time, data shows 3.7 years of long-term care is required for women, and 2.2 years for men, according to the Administration for Community Living.
One-third of the population may never need the support, and 20% will need it for longer than five years. About 65% of people use in-home care for an average of two years.
... For example, according to a long-term care calculator from life insurance company Genworth, the estimated 2023 costs for a home health aide in San Francisco is $7,585 a month for 44 hours a week, and $91,025 annually. For homemaker services such as meal preparation, grocery shopping, laundry and cleaning, it’s an estimated $7,282 monthly and $87,384 annually for 44 hours a week.
Genworth follows industry guidance of 44 hours as the estimated hours per week for professional in-home caregivers.
There are several calculators available to estimate long-term care costs, including one from AARP and another from the American Institute of Certified Public Accountants.
=======
Note: You can go the cheap route through grey labor, but I've heard a number of horror stories about those, especially as elderly parents begin to develop dementia issues. Costs above are for bonded, licensed care.
StarSong
Awkward is my Superpower
- Location
- Los Angeles Suburbs
True. but triple those numbers for people who need 24/7 supervision and AL's are far less expensive than private care. Economies of scale: ALs don't need or provide 24/7 arms' reach care. AL prices also include room rental, food, utilities, some transportation, entertainment, etc. Homecare services mean the resident still pays all of the above on their own home.
Both my mother & my FIL needed to be kept safe from wandering, from unsavory characters who'd phone or show up trying to get money, from messing up their meds, from falling in a shower, forgetting to turn off the stove, lock the door, or a thousand other things that put them at risk. They needed food prep, housekeeping services, and so forth. They didn't need SNF levels of medical care (which costs between $9800 - $12,000 per month), so ALs were the perfect answer for them.
I'd personally greatly, greatly, greatly prefer being in a nice AL facility over having part or full time home health care or housekeeping services in my own home. I've seen both up close and personally. Home health care workers spend 95% of their time playing on their phones rather than interacting with their charges.
Long term SNF care? Kill me now.
officerripley
Well-known Member
- Location
- Porlock, Calif
No, it sure isn't always the case, especially since people are having fewer and fewer kids and more and more parents get divorced. A friend of mine, also in her 70s, has been running back and forth trying to care for an elderly mother and an elderly father and stepmother. And it was even more work back when her stepfather was still alive. And she's not even an only child, it's that she's the only one living here who can/will do it. Can you imagine if you were an only child in that situation; there wouldn't be even a chance of help from anybody.
StarSong
Awkward is my Superpower
- Location
- Los Angeles Suburbs
DH & I cared for my mother and his parents, but from an overseeing perspective. When they needed daily, intimate care we brought in professionals. Not everyone is cut out to be a caregiver, not all parents and children are comfortable with changing diapers, and many in their 60s or 70s aren't physically able to wrangle 150+ lb parents in and out of showers, transfer them from bed to wheelchairs, be there twice a day to dispense meds, and so forth.
I would neither want nor expect my children to do that for me.
Lethe200
Senior Member
- Location
- San Francisco Bay Area
+1 on StarSong's post #64: "...Not everyone is cut out to be a caregiver, not all parents and children are comfortable with changing diapers,..."
My MIL was very resistant to the idea of moving to an AL facility when we thought it was time. She kept insisting, "I'll know when it's time," but unfortunately, with dementia - even a mild-to-moderate case like hers - keeping time mentally was one of the first things to go. I realized that when one day she fainted, because she hadn't eaten sufficiently in almost three days.
People with dementia often lose their ability to "hear" when their body tells them it's hungry.
I finally got her to understand when I looked her in the eye and asked her, "Do you really want your son to change your underpants and wipe your butt?"
She was absolutely horrified at the idea! When we moved her to a full-care facility (had AL, Memory Care, SCN, and a senior center on-site), she finally gained some weight back because mealtimes were always at the same time, same place, and she sat with a regular group of tablemates so that eating was as much social as it was nutritional.
My MIL was very resistant to the idea of moving to an AL facility when we thought it was time. She kept insisting, "I'll know when it's time," but unfortunately, with dementia - even a mild-to-moderate case like hers - keeping time mentally was one of the first things to go. I realized that when one day she fainted, because she hadn't eaten sufficiently in almost three days.
People with dementia often lose their ability to "hear" when their body tells them it's hungry.
I finally got her to understand when I looked her in the eye and asked her, "Do you really want your son to change your underpants and wipe your butt?"
She was absolutely horrified at the idea! When we moved her to a full-care facility (had AL, Memory Care, SCN, and a senior center on-site), she finally gained some weight back because mealtimes were always at the same time, same place, and she sat with a regular group of tablemates so that eating was as much social as it was nutritional.
OneEyedDiva
SF VIP
- Location
- New Jersey
Hawkdon, your post reminds me of a conversation I had with a good online friend (may he R.I.P.) who wondered why I was still saving so diligently. When I said it was so I could pay out of pocket for a nursing home if I needed to, he asked why I didn't just get on Medicaid. I told him that I did not want Medicaid (aka the gub-ment) to decide what nursing home I could and could not be admitted to. Obviously, they would not approve top of the line places.
We were fortunate that my mother, who paid cash upon entry to a very nice home, was able to stay there once her money ran out and she had to be switched to Medicaid. The account manager there was very helpful and told me what to do and how to do it as we navigated the process. I feel so sorry for the elderly who are caught in the situation that poor woman has found herself in. And especially sorry for those who have no one to help them.
We were fortunate that my mother, who paid cash upon entry to a very nice home, was able to stay there once her money ran out and she had to be switched to Medicaid. The account manager there was very helpful and told me what to do and how to do it as we navigated the process. I feel so sorry for the elderly who are caught in the situation that poor woman has found herself in. And especially sorry for those who have no one to help them.
My very good friend - she died in May - has a smart daughter that paid to get her in a very nice place for a few months, then switched over to Medicaid. Now she is seeing if she can pay back the $80,000 to Medicaid by selling her mom's house. She will have the remainder of the house money.
That's the key, get into a nice place to begin with - pay out of pocket for a few months and then switch over to Medicaid.
We all pray we won't have to go into any place of course!
That's the key, get into a nice place to begin with - pay out of pocket for a few months and then switch over to Medicaid.
We all pray we won't have to go into any place of course!
TabbyAnn
Southern Indiana, U.S.A.
- Location
- Southern Indiana USA
The AARP is not an organization that addresses the needs of the elderly. The AARP is aimed at active Senior Citizens in their 50 and 60s who are clueless about the needs of the elderly yet want to give advice on things they've had no experience with. There should be a separate category and organization for the elderly.
TabbyAnn
Southern Indiana, U.S.A.
- Location
- Southern Indiana USA
Medicaid is a state program administered by individual states who have different benefits and contributions. Certainly not all workers in the United States pay into the NJ Medicaid program, and maybe not even into their own state program.
Lewkat
Senior Member
- Location
- New Jersey, USA
This is true, and those paychecks I made out were in NY state, not NJ.