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Does anyone have any experience dealing with pushy admission staff from private pay facilities? Ideally, if my parent is admitted somewhere I prefer one that accepts private pay as well as Medicaid when her assets run out.
My friend. I've got news for you. EVERY facility is private pay if a person has any money and assets. After it's all spent down on paying for care the facility makes sure the Medicaid gets done if they're planning on keeping a resident. Sometimes they don't. If a resident is too difficult they will put them out as soon as the cash-paying stops.
I'm going to let you in on something you may not know. Unless the person entering a Long Term Care facility is extremely wealthy or has a spectacular LTC insurance policy, they start doing the Medicaid application the day that person walks in the door. So don't worry about that.
Also, don't ever let the administative staff or social workers of these places ever get pushy with you. NEVER sign any documents from these people unless you read it thoroughly and fully understand it. If you don't understand a document, tell them you will be having your attorney look over it and explain it to you. Under no circumstances should you ever just sign your name to something an admission person hands you. I say this because many people have signed documents for a loved one at a care facility because they were told they were something else. Turns out, they put themselves on the hook financially for payment.
The people who do admissions at nursing homes, AL's, and memory care facilities are for the most part despicable low-lifes who would rip off their own mothers. Skilled, greedy liars who have no problem tricking and screwing over a person's whole family to squeeze every dime. These people are real snakes in the grass. That's their job.
Tour some facilities that have availability and pick one for your mother. Then have a lawyer look over the paperwork they want you to sign.
Ideally that would be the case; it is however quite rare. Private places are usually now corporate owned. They are in it for the big bucks. That means when you run out of money you are run out for the most part. Some rare ALF will accommodate this. Most will not. As to pushy, if you are being hounded you can easily have them off the phone by saying that your parent is applying for Medicaid and soon broke.
It's an unpleasant process, but we are the Corporate States of America, and they are just a small part of that.
Agreed. It's what I call the "Citizens United" mentality. As I've said before, when Big Bux is in charge of delivering healthCARE, care usually takes a huge hit! Unfortunately, it is what it is in 'Merica these days.
You don’t have to let mom go broke if you see elder law attorney before..they’ll come up with a plan so her assets can be saved at same time making her Medicaid eligible. Make an appointment asap. Don’t talk to Medicaid person at facility. They want all her $$$ & then some. They’re all crooks. Just deal with the lawyer when you get one. Hugs 🤗
Her assets are subject to the 5 year lookback rule like everyone elses. Please don't imply that taxpayers should pay for the mother, when we have our own mothers to pay for.
My own feeling is that since hedge funds have taken over ownership of most healthcare facilities, I view their admissions staff as salespeople, like the stereotypical car salesman or real estate salespeople. . And now disabled and ill people are viewed as "customers" The admissions staffs' new compensation has become linked to company metrics comparing the rate of potential customers to admissions. Top bonus for admitting Medicare or private pay customers, no bonus points for admitting Medicaid customers. Other employee compensation, bonuses and "perks" based on similar metrics, too, all about profits.
Summer, something to be aware of is LTC Medicaid “at need” requirements are BOTH financial AND medical. The being “at need” financially is what families fixate on but the medical aspect is just as important and can pose way waaaaaaay more hurdles especially if this is a direct placement into a NH, which your post sounds like.
$ stuff the elder / their POA have control over….. do a spend down; get their home/car sold if that’s what they want to do; create Trusts if feasible, etc. But the “medically at need for skilled nursing care” which LTC Medicaid absolutely requires depends on others (eg MDs, PTs, OT, hospitalization & rehab notes, etc) for your parent to have a nice fat health chart that beyond clearly shows an assessment as to “need” for skilled nursing care. NHs can and will admit an elder who is not at this level if they are private pay. Usually elder is in their 90’s with $$$ to private pay so moving them into a NH is better than doing an IL 2 AL 2 NH multiple moves. A 1 & done approach. This elder could in theory be totally OK in an AL or even maybe in a very proactive IL but due to their age and the medications they are on, it just makes sense to ensconced into a nice private room in a NH. But this type elder will not be able to pass medical “at need” assessment for LTC Medicaid. Medicaid does review health charts and can send out actual assessment team to do in person evaluation.
FWIW vast majority of SNF/NH admits are this scenario: Dad living at home/apt has a bad fall; Dad goes to ER/ED; Dad is hospitalized (MediCARE as his health insurance is paying); Dad gets hip replacement surgery (MediCARE pays); Dad then discharged to rehab done in a SNF that has a IRF (in patient rehab unit) and again MediCARE pays for a period of time based on discharge paperwork and how they progress. Majority of time, Dad stops progressing in his rehab around week 3 or 4, so Medicare stops. Dad cannot feasibly return to his old life so this Dad stays put BUT goes from a rehab patient to a custodial care resident. Custodial care is private pay, LTC insurance or this Dad & his POA file for LTC Medicaid. Medically this Dad has a nice super fat file to show that he is oh so definitely “at need” medically that’s recent and with all the codes in his chart to support this determination. The financial part that’s your/ the POA & Dads problem to show he’s “at need” financially for LTC Medicaid which for most States is a max of $2829 income, under 2K in nonexempt assets and no 3-5 year lookback issues.
Just being old, frail, needing help taking meds, cannot shop / cook for themselves is not enough to be medically “at need”. Is your parent documented medically at need??? If not, you will have to work with their physicians to build up their charts to show that is the case. Or ya wait till they have a fall or super ill, either way hospitalized then go to rehab in a NH and stay there.
Also when looking at places that participate in LTC Medicaid, clearly ask if they do “Medicaid Pending” or if not, how they do the contract btw POA or responsible family member for billing in the interim btw filing and approval. Also ask if # of LTC Medicaid beds are fixed (so limited). Ask if the Share of Cost is done from day 1 once application filed or all the SOC gets paid upon approval even if it’s 3-5 months (this kinda is State dependent). SOC is the monthly income your parent gets ea mo., like their SSA $. SOC paid to NH less sm personal needs allowance (tends to be $50-$75, & all the $ they will ever have once on LTC Medicaid and is restricted spending).
For a widowed parent, to me, if you have been involved in their life & are POA & signature on bank accounts, imho you can DIY all this. If they are still at home or in IL, you do whatever visits, labs, etc to get their chart done. But if not, or if they are a strong personality and you are not, it’s best off being done by Medicaid experienced attorney.
My father is in memory care. My sisters and I were thinking of moving him to a facility closer to where one of us lives. I called A Place for Mom for recommendations and their representative gave my contact information to places in that area. For the next few weeks, I was inundated with phone calls and texts. It felt very aggressive. I wish that facilities didn't even have salespeople, but instead had health care consultants that really cared about whether they are a good fit for someone.
Pushy salespeople--arrgh. That's one reason why I hesitate to communicate with local facilities now. I have done personal tours in the past. I have taken virtual tours recently, checked Medicare ratings, read reviews and talked with an aging life care professional.
Although there are probably many explanations for why eldercare is not a priority, I think we have vulture capitalism to thank for the current situation. Make no mistake: the hedge fund/private equity corporations that are buying up hospices and eldercare facilities are NOT about care. They are ALL about MONEY/ROI (return on investment) also known as shareholder value. How much money the wealthy can expect as profit--THAT is what governs the quality of "care" available to many older adults.
Like I said. Corporations-R-Us. That's the case in the US of A. Dad has become a commodity. Like Hospice, he is now traded on the exchange. That's a part of our lives lived daily in every way. How do schools spend their money? On consultants. On textbooks changed every month (how often did my Mom tape mine together; she swore I was given the rattiest books because she did the best repairs).
Follow the money. That's how it works. It's OK. It's a choice. It's apparently OUR choice because we cannot stop shopping for a single second.
They’re trying to sell you. As long as you have their attention, I would ask what their policy is on Medicaid. If they don’t accept it what policies if any do they have to liaise with facilities that do?
Yes, be careful. Sometimes they paint too rosy a picture or promise things that then are not done or possible . For example , salesperson told my dad they will provide a microwave in the room, but after assessment that revealed his dementia , appropriately the care director said a microwave would be unsafe and not allowed . some places do have a combo of private pay and Medicaid. There may be a state website where you can look up which ones do?
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
I'm going to let you in on something you may not know. Unless the person entering a Long Term Care facility is extremely wealthy or has a spectacular LTC insurance policy, they start doing the Medicaid application the day that person walks in the door. So don't worry about that.
Also, don't ever let the administative staff or social workers of these places ever get pushy with you. NEVER sign any documents from these people unless you read it thoroughly and fully understand it. If you don't understand a document, tell them you will be having your attorney look over it and explain it to you. Under no circumstances should you ever just sign your name to something an admission person hands you. I say this because many people have signed documents for a loved one at a care facility because they were told they were something else. Turns out, they put themselves on the hook financially for payment.
The people who do admissions at nursing homes, AL's, and memory care facilities are for the most part despicable low-lifes who would rip off their own mothers. Skilled, greedy liars who have no problem tricking and screwing over a person's whole family to squeeze every dime. These people are real snakes in the grass. That's their job.
Tour some facilities that have availability and pick one for your mother. Then have a lawyer look over the paperwork they want you to sign.
As to pushy, if you are being hounded you can easily have them off the phone by saying that your parent is applying for Medicaid and soon broke.
It's an unpleasant process, but we are the Corporate States of America, and they are just a small part of that.
$ stuff the elder / their POA have control over….. do a spend down; get their home/car sold if that’s what they want to do; create Trusts if feasible, etc. But the “medically at need for skilled nursing care” which LTC Medicaid absolutely requires depends on others (eg MDs, PTs, OT, hospitalization & rehab notes, etc) for your parent to have a nice fat health chart that beyond clearly shows an assessment as to “need” for skilled nursing care. NHs can and will admit an elder who is not at this level if they are private pay. Usually elder is in their 90’s with $$$ to private pay so moving them into a NH is better than doing an IL 2 AL 2 NH multiple moves. A 1 & done approach. This elder could in theory be totally OK in an AL or even maybe in a very proactive IL but due to their age and the medications they are on, it just makes sense to ensconced into a nice private room in a NH. But this type elder will not be able to pass medical “at need” assessment for LTC Medicaid. Medicaid does review health charts and can send out actual assessment team to do in person evaluation.
FWIW vast majority of SNF/NH admits are this scenario:
Dad living at home/apt has a bad fall; Dad goes to ER/ED; Dad is hospitalized (MediCARE as his health insurance is paying); Dad gets hip replacement surgery (MediCARE pays); Dad then discharged to rehab done in a SNF that has a IRF (in patient rehab unit) and again MediCARE pays for a period of time based on discharge paperwork and how they progress. Majority of time, Dad stops progressing in his rehab around week 3 or 4, so Medicare stops. Dad cannot feasibly return to his old life so this Dad stays put BUT goes from a rehab patient to a custodial care resident. Custodial care is private pay, LTC insurance or this Dad & his POA file for LTC Medicaid. Medically this Dad has a nice super fat file to show that he is oh so definitely “at need” medically that’s recent and with all the codes in his chart to support this determination. The financial part that’s your/ the POA & Dads problem to show he’s “at need” financially for LTC Medicaid which for most States is a max of $2829 income, under 2K in nonexempt assets and no 3-5 year lookback issues.
Just being old, frail, needing help taking meds, cannot shop / cook for themselves is not enough to be medically “at need”. Is your parent documented medically at need??? If not, you will have to work with their physicians to build up their charts to show that is the case. Or ya wait till they have a fall or super ill, either way hospitalized then go to rehab in a NH and stay there.
Also when looking at places that participate in LTC Medicaid, clearly ask if they do “Medicaid Pending” or if not, how they do the contract btw POA or responsible family member for billing in the interim btw filing and approval. Also ask if # of LTC Medicaid beds are fixed (so limited). Ask if the Share of Cost is done from day 1 once application filed or all the SOC gets paid upon approval even if it’s 3-5 months (this kinda is State dependent). SOC is the monthly income your parent gets ea mo., like their SSA $. SOC paid to NH less sm personal needs allowance (tends to be $50-$75, & all the $ they will ever have once on LTC Medicaid and is restricted spending).
For a widowed parent, to me, if you have been involved in their life & are POA & signature on bank accounts, imho you can DIY all this. If they are still at home or in IL, you do whatever visits, labs, etc to get their chart done. But if not, or if they are a strong personality and you are not, it’s best off being done by Medicaid experienced attorney.
Although there are probably many explanations for why eldercare is not a priority, I think we have vulture capitalism to thank for the current situation. Make no mistake: the hedge fund/private equity corporations that are buying up hospices and eldercare facilities are NOT about care. They are ALL about MONEY/ROI (return on investment) also known as shareholder value. How much money the wealthy can expect as profit--THAT is what governs the quality of "care" available to many older adults.
Dad has become a commodity. Like Hospice, he is now traded on the exchange.
That's a part of our lives lived daily in every way.
How do schools spend their money?
On consultants. On textbooks changed every month (how often did my Mom tape mine together; she swore I was given the rattiest books because she did the best repairs).
Follow the money. That's how it works. It's OK. It's a choice. It's apparently OUR choice because we cannot stop shopping for a single second.
some places do have a combo of private pay and Medicaid. There may be a state website where you can look up which ones do?
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