I’ve Become Eligible for Medicaid, but Now I Have to Leave the Facility
Residents are forced out of facilities more often than you might think. A lot of times, the reason for it happening may simply be because the person requires a much higher level of care than a particular facility may be able to provide them. This type of situation most often happens in assisted-living care and does not happen in nursing home care. If a facility is no longer able to provide the care your loved one requires, then your loved one will be unable to stay. However, this situation can become questionable when the patient was using private pay and staying at the facility without problems, but then, suddenly, the facility rejects the patient right when the patient has started an application to receive Medicaid benefits. If you are applying for Medicaid benefits, then you should stay in consistent communication with the facility during the Medicaid spend down and application process to ensure that your loved one will be able to receive care at the facility from now on.
A second scenario where someone would have to suddenly leave the facility when they become eligible to get Medicaid benefits is when no more Medicaid beds would be available. Many assisted-living communities have a limited number of beds for those people receiving Medicaid benefits. This is an issue that should be discussed with you and your loved one when you enter the facility. In many instances, facilities will be open and explain that when resources run out and benefits are needed, if no beds are currently available, they will either have to continue paying privately (which is incredibly hard to do when all private pay funds are depleted) or leave the facility and go somewhere that has an available bed. A lot of times, the first facility will try and get your or your loved one in a sister community, however there may be times when no beds are available within a company. If this happens, you may have to look for care in a different assisted-living community or nursing home.
Given the scenarios we described above, it’s very hard to force a facility to keep your loved one. This is especially true if you were aware of the policy from the beginning. Keeping in communication with the facility during the spend-down process of Medicaid is essential to predicting if your loved one will be able to stay at the facility, or if you should start looking for a new community before your private funds ultimately run out.