<p>Has anyone had any experience with Residential Care facilities?</p>
<p>This has been brought up as an option for my Mom to maybe explore while she’s qualifying for Medicaid and Veterans benefits. They may be less expensive than her assisted living facility, but that’s really not the point right now.</p>
<p>I need a backup plan for Mom if she’s unable to return to her assisted living facility.</p>
<p>Thanks for any input.</p>
<p>Those places are very much non medical in scope to a fair extent. </p>
<p>So, if you mother can go about her day alright, then it would be okay. </p>
<p>Now. I am just going to have to ‘go there’ a mite bit and I trust you will not mind that. </p>
<p>Since you state that your mother is in the process of trying to obtain Medicaid and Veterans Benefits, then please be careful about a Residential Care Facility. I state that because sometimes the Medicaid “folks” might call things a day with a thing or two if the Senior Citizen is coming around alright in a Residential Care Facility (or what used to be called a Board and Care Home) because of how those places are very much non medical in scope and all.</p>
<p>Thank you, sissy. I am so unclear about what these places are. </p>
<p>I am hoping to get objective, anecdotal information from people.</p>
<p>I have contacted lawyers, elder assistance agencies, but of course, many of these people work on commission or will earn a fee if you go with their recommendation, so I’m not sure if I’m getting “good” advice.</p>
<p>I have decided to hire a local lawyer to help me determine if my Mom in fact qualifies for any of these government programs, VA or otherwise, but I have started the VA process as it does take a while. </p>
<p>If the VA doesn’t pan out, then I’ll have to pursue Medicaid.</p>
<p>Many people I’ve called are trying to discourage me from even applying for VA, and just go straight to Medicaid, but I don’t know that my Mom is physically qualified for a nursing home at this point, which is what the Medicaid advisors seem to be working toward.</p>
<p>I’ve also recently learned that there is a possibility that Mom may even be able to go to a Veterans home, even though she’s a spouse, to get care, so it would seem to me it would be worthwhile to get her eligible for VA benefits.</p>
<p>I’ve been warned to not “go on a wild goose chase” to look into things that she isn’t even medically qualified for, but I do want to be educated should her physical condition change, which it is likely to do now that she’s had a medical setback.</p>
<p>Thank you all for any help you can give.</p>
<p>The short answer: It’s hard to go by anecdotal information because your experience will depend on the person and the facility. My anecdotes would send you running in the other direction, but someone else might have more reassuring stories. In our case, the place was too small, the staff (while caring) were too inexperienced, and the management was not good. My mom needed more stimulation, conversation, activities, etc.</p>
<p>A residential care facility is just another name for a type of assisted living. In my mother’s state (MD), the state agency that licenses long-term care facilities has fantastic consumer information available online to help families evaluate options in general and look at detailed reports on specific facilities. Check with your mom’s state agency if you haven’t already. This will help you avoid the wild goose chase. I am not familiar with the VA process at all.</p>
<p>The facility described above was more like a group home or “board and care” facility, and this may be what you’re talking about. My mother moved there when she needed level 3 care (could no longer transfer from her wheelchair, and some other things), and her assisted living facility only provided levels 1 and 2 care. </p>
<p>After the small residential facility, we moved her to a nursing home with our fingers crossed that she would qualify for level 4 care and thus qualify for Medicaid; the nursing home said after their preliminary assessment that they thought she would, and they were right. States vary on how hard it is to qualify medically for long-term-care Medicaid. You are very, very wise to become educated now, even though your mom might not qualify right away, because things can change literally overnight and it’s good to be prepared with information. I don’t remember what you said on your other thread about your mom’s condition, but she might be close. I also mentioned on your other thread that it’s a good idea to avoid multiple moves.</p>
<p>A lawyer can help you, but a professional geriatric care manager is likely to be more knowledgeable and probably less expensive. Check www dot caremanager dot org for more information. Finding the information yourself (online and in person) is free. All of it takes time, as I’m sure you are discovering!</p>
<p>I know you mentioned in other thread(s) that your mom was running out of money. It is my understanding that in such a situation medicaid planning is good because medicaid will pick up more that just nursing home. While this may vary based on where you live, it is my impression that there is coverage for the coinsurance piece of medicare for doctors services, for transportation for medical visits, for drugs, and probably a lot of other things. The pharmacy piece may have yet another name in your state. You are doing the right thing looking into the VA benefits as well. These also may provide for medical care and drug coverage. </p>
<p>Good luck.</p>
<p>The Medicare web site breaks down all those different kinds of places rather succinctly…</p>
<p>[Medicare.gov</a> - Types of Long-Term Care](<a href=“http://www.medicare.gov/LongTermCare/Static/TypesOverview.asp?dest=NAV|Types|Types|Types#TabTop]Medicare.gov”>http://www.medicare.gov/LongTermCare/Static/TypesOverview.asp?dest=NAV|Types|Types|Types#TabTop)</p>
<p>…Medicare only covers a wee bit of all of that ^ for a wee bit of time, though. But their proper web site does have information about Medicaid and all of that as well.</p>
<p>My mom is at Level 3 care now, which is provided at her assisted living, but before her hospital stay, she was able to move from her wheelchair to her bed, and wheelchair to commode. When she got too swollen from the leg infection to transfer herself from the wheelchair to the bed, it became time to go to the hospital. </p>
<p>As of now, she’s transferring from the wheelchair to the bed, but needs assistance to go to the bathroom. She’s still got a week of therapy before her Medicare paid Day 20, and will be evaluated, hopefully, by the assisted living facility shortly before then.</p>
<p>As stated above, her change in condition happened pretty quick, with not enough time to research facilities adequately.</p>
<p>Thank you for the link to the elder care manager. I may be able to cover legal matters with my local family attorney, but will need help in mom’s state of Texas as to what the rules are there for level of care, payment, etc.</p>
<p>Thank you again for your help.</p>
<p>“I have contacted lawyers, elder assistance agencies, but of course, many of these people work on commission or will earn a fee if you go with their recommendation, so I’m not sure if I’m getting “good” advice.”</p>
<p>There should be people and organizations you can consult that do not get a commission or fee. Try the county government where your mother is located. There should be a senior citizens agency. Also, Catholic Family Services and Jewish Family Services exist in many larger communities, and should have someone on staff who can give impartial advice. Doctors or staff in doctor’s offices can sometimes provide insight into the better facilities.</p>
<p>^^I agree. State and county government agencies have good online resources and in-person assistance. I think the OP does not live in the same state as her mother, though, so she’s doing this long distance.</p>
<p>You can find law and aging resources in your state by clicking on the law and aging resource guide link near the top of the resource list on this ABA page: [url=<a href=“http://www.americanbar.org/groups/law_aging/resources/links_of_interest.html]Resources[/url”>Links of Interest]Resources[/url</a>] A map will come up, and you can click on your state.</p>
<p>This is actually one of my areas of work expertise, so pm me and I can send you some info. The terms Assisted Living and residential care facility have no standard definition, and vary by state and community and custom. Some states regulate such living arrangements and some don’t. In general, though, the terms apply to residential living where non medical services are provided – services such as housekeeping, dining, service coordination, medication reminding and emergency call service. there may be onsite medical services, but they are there for convenience, the way dry cleaning may be in your apartment building… Medicaid will generally only pay for the medical portion of any service provided, it does NOT pay for the housing/residential portion. Medicaid DOES cover Skilled Nursing Facilities though. (I actually know much less about the health portion then I do about the housing portion, but I can try to get you the info.)</p>
<p>I don’t check CC every day, do if you pm me, be patient for a reply!</p>
<p>Looks like Mom will not be returning to her ALF. Now I’m faced with the choice of residential care or skilled nursing facility. All she has is Medicare and Blue Cross, but not the kind that covers SNF. Won’t be able to get SNF coverage now that she won’t be released to ALF.</p>
<p>Now I’m faced with the dilemma of private paying down her assets to qualify her for Medicaid in a “nursing home” or stretching the money longer in a residential care facility, where she will get more quality care, hopefully.</p>
<p>Anyone had to make that choice before, and will putting her in a residential care facility disqualify her from receiving Medicaid down the road?</p>
<p>In short: HELP!</p>
<p>My mother receives much higher-quality care in a nursing home than she did in a residential care facility (small assisted living by another name). Much, much higher. I wish we had made the nursing home choice earlier, and I can’t emphasize that enough.</p>
<p>You are in a very tough spot, because the system expects you to move quickly in making difficult choices that are both emotional and practical. You have a lot of questions, no time to get them answered, and little emotional support from those who are telling you she has to move, and move fast. </p>
<p>Being in residential care won’t disqualify her for Medicaid. If you need to spend down her assets, that’s what you’ll need to do. Where you do it is a decision you’ll have to make.</p>
<p>In your other thread you used the term “put her” in a nursing home. Please take a deep breath (many deep breaths are needed in this process, believe me!) and understand that people in nursing homes are not warehoused. They are not all bad places. There are nursing homes that provide respectful, high-quality care and activities. </p>
<p>Just this week, my mother has gone on “comfort care” (the equivalent of hospice) in her nursing home. When she returned there from a short and traumatic hospital stay, I was overcome with gratitude at how kind, concerned, good-humored, loving, and competent her nursing home caregivers are.</p>
<p>Hang in there!</p>
<p>^ All nursing homes or SNF are not necessarily the same. I think quality varies by the city and region that the place is located as well. You should look at the places very carefully to see how the residents are managing, what they are doing etc., as well as the medical care available. I know you said you are in Louisiana, and your mom is in TX. If none of your siblings are in TX, I would suggest considering options near you or one of your siblings so that you can look in on her and how she is doing, and what the place is like wherever she ends up. </p>
<p>If I were you, I would analyze the medical needs of your mom, and try to find a place that will meet her needs medically and then look to see if socially it will be satisfactory as well. </p>
<p>I wish you the best in sorting all of this out. The money issue is a troubling one in that care is so expensive, and I guess that once a person spends their assets and is in a nursing home, there are fewer alternatives to going elsewhere if the medical condition improves, due to the lack of assets to pay for something else.</p>
<p>I looked at you other thread, and while I could, I am adding this last bit here - if you mom is improving at rehab, I am under the impression that she can get to stay over the 21 days, as this is the point of rehab - to improve in the functions that she can do - there are many benchmarks, and each is specific to the patient, but if you can look into what it takes to get the longer stay. I know there is a money issue for you, but if she is improving enough, this might be the best thing for right now.</p>