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Five Things To Consider Before Moving To Assisted Living

Traditionally people wanted to avoid going to a nursing home. In some cases assisted living was often an option to avoid the nursing home if the daily care needs were greater than the family could provide. Now most people who need long-term care are going to assisted living facilities instead of a nursing home. Many assisted living facilities can provide a wide range of care and specialty care for memory loss, dementia and Alzheimer’s.

For all of the benefits involved, there are also special challenges involved with making the transition from living at home to living in an assisted living facility. Here are five things to consider when moving to an assisted living facility:


Hire A Geriatric Care Manager. Finding the right assisted living facility can be overwhelming. There are so many different facilities to choose from and there are a lot of different factors to consider. On top of it all, people have little time and almost no experience to sort through all of the information and decisions.

A Geriatric Care Manager knows the different assisted facilities available, talks the special language of long-term care and understands how different medical and family issues will play out while a resident lives at a facility. Hospital social workers, the staff at rehabilitation facility and the staff at assisted living facilities themselves all know how things work, but they do not really work for you and they all have different priorities agendas. Just like you would hire an accountant to handle tax matters and a lawyer to handle legal matters, hiring a Geriatric Care Manager can give you an invaluable resource on your side when you make decisions about an assisted living facility.


Confirm That The Facility Accepts Medicaid. Not all assisted living facilities accept Medicaid (which is called “Family Care” when it covers assisted living bills). If your family will need to access government benefits at some point, you need to start with a facility that accepts Medicaid or be prepared to move at some point in the future.

Sometimes it is complicated even if the facility accepts Medicaid. In some cases only a small part of the facility accepts Medicaid, meaning that a resident will need to move from one part of the building to another or even one building to another if they start to receive government benefits. Other facilities have a limited number of spots for Medicaid recipients. In that case you can only move into a Medicaid spot if one of the current residents on Medicaid dies or moves to another facility and there is not someone else already on a waiting list.

In order to make sure that you have a good fit with a facility, you need to dig into the details and get the whole picture before moving to a particular facility.


Accept That There Will Be Some Private Pay. Assisted living facilities provide valuable services and we need them to stay in business. Medicaid does not pay the private pay rate, so the facilities cannot afford to have every resident covered by Medicaid. It is important

Facilities are generally up-front about this. A resident’s family should also be open to talking about private pay. Beating around the bush just confuses everyone involved. Families should talk to the facility about how long the resident must pay the private pay rate and what that cost will be.


Control the “Asset Conversation.” Assisted living facilities routinely ask a family to complete a comprehensive financial statement as part of the admission process. This requirement is often presented as a way to demonstrate that the resident can pay for two years of the private pay rate or some other financial standard.

If there is any chance that the family will apply for Medicaid, it is in the family’s best interest to control their financial information and provide the assisted living facility with the absolute minimum necessary. If the facility requires two years of private pay, then the family should show assets sufficient to cover that total cost and only those assets.

Disclosing additional assets can confuse things and build expectations that the family will pay the private pay rate longer than the required amount of time. The facility and its staff are not financial counselors who need to see all assets in order to develop a comprehensive financial plan. The facility is a creditor who needs proof that you can pay. Anything more than necessary to establish the ability to pay is unnecessary.

Of course, controlling the “asset conversation” absolutely requires that the family and the facility are open and clear with each other about the cost of care and Medicaid (if it is in the picture). If the facility does not clearly state that they have a two year private pay requirement and tell the family what the cost of care will be, the family cannot decide how much financial information.


Be Clear About Medicaid And Government Benefits. In some cases the assisted living facility accepts the idea of a Medicaid application in theory. However, if the family actually files an application for benefits these facilities act as if they have been betrayed or may claim that they have been lied to.

This is another point where it is important to be very clear with the facility. If there is a promise to pay private pay rates for a period of time, then any Medicaid planning will respect that promise. However, it is possible to apply for Medicaid benefits and pay the private pay rate at the same time. To avoid confusion and unnecessary drama, families need to be clear with the facility and confirm that the facility will not retaliate if a Medicaid application is filed, provided that the private pay rate is paid for the time period agreed to.

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