Author Topic: How do I search for nursing homes that accept Medicaid?  (Read 1539 times)

mrs sideways

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How do I search for nursing homes that accept Medicaid?
« on: July 10, 2022, 11:42:48 AM »
I'm trying to find long-term care for a relative who recently had a stroke and might not ever live independently again. We're still hoping for some kind of turnaround or improvement, but if not, he's going to have to live in a nursing home, and since the rest of his body was pretty healthy, that might be for a very long time. What money and assets he does have will get eaten up in a matter of months, and then we're dealing with Medicaid (aka "Medi-Cal" in California).

The problem is I'm having a hard time trying to find nursing homes that accept Medicaid. Google Maps results are polluted with people running "care centers" out of their homes (and I have no idea how to filter them out, since Google has decided physical proximity to me is more important than keyword relevance), online lists of facilities (including the official Medicare/Medicaid ones) are filled with hospitals and rehabilitation centers which don't actually do long-term care, and even IF I find the name of an actual nursing home their website never mentions if they take Medicaid or not.

So, does anyone know a better way to look around, or am I just going to have to spend a few days web searching and calling?


Morning Glory

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Re: How do I search for nursing homes that accept Medicaid?
« Reply #1 on: July 10, 2022, 12:05:19 PM »
His doctor's office should be able to put you in touch with a medical social worker.  They will know which facilities take what, and if some are better than others.  There may be a few hoops to getting him admitted,  such as a hospital stay for a minimum number of days (rules vary by state on this one).

Cranky

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Re: How do I search for nursing homes that accept Medicaid?
« Reply #2 on: July 10, 2022, 12:40:03 PM »
Also, does he have any assets? Medicaid usually requires a spend down and we found quite a few places that would take people who came in self pay and then would switch to Medicaid but would not take people initially as Medicaid.
« Last Edit: July 10, 2022, 06:32:47 PM by Cranky »

Rural

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Re: How do I search for nursing homes that accept Medicaid?
« Reply #3 on: July 10, 2022, 06:17:11 PM »
We went through this with my father-in-law earlier this year.


The nursing homes that take Medicaid are not used to dealing with families but with hospitals, which cannot discharge someone who can't be cared for at home until they find a placement for them. They already know where the places are and have an incentive to find a bed. So if your relative is in the hospital already, the thing to do is to keep repeating to the hospital staff/social worker/etc "We cannot care for Relative at home."


If your relative is not in the hospital, then you start making calls yourself. There's likely a state or county agency for the elderly that can get you started (look for senior centers if you can't find the agency and they can point you in the right direction). But if the situation is that serious, it's likely your relative will end up hospitalized again for something before you get through all the red tape, and in that case, revert to pointing out the family can't care for the person. Usually they start with rehab, which Medicare covers for some number of days, and the nursing home works the switch to Medicaid (and they can't discharge, either, though they could switch the person to another facility if one will take them).

mrs sideways

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Re: How do I search for nursing homes that accept Medicaid?
« Reply #4 on: July 10, 2022, 06:42:29 PM »
The nursing homes that take Medicaid are not used to dealing with families but with hospitals, which cannot discharge someone who can't be cared for at home until they find a placement for them. They already know where the places are and have an incentive to find a bed. So if your relative is in the hospital already, the thing to do is to keep repeating to the hospital staff/social worker/etc "We cannot care for Relative at home."

Okay, I should probably specify this is my dad I'm talking about. Unfortunately he's in Illinois (he moved out from California to take care of HIS 90-year-old father, my grandfather) and he's already out of the hospital and in a short-term acute rehab facility. The plan is for his father to move in with his brother (my uncle), but after that Dad wouldn't have any family left in the state to visit him. So we're thinking of moving Dad back here to California where my brother and I live. In any event, the medical staff out there can't help me with places here.

If your relative is not in the hospital, then you start making calls yourself. There's likely a state or county agency for the elderly that can get you started (look for senior centers if you can't find the agency and they can point you in the right direction).

Both you and Morning Glory mentioned social workers, and you're right, that's exactly where I should start. The Health or Senior departments at the county should have someone I can talk to; I'll start calling Monday.

fraylock

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Re: How do I search for nursing homes that accept Medicaid?
« Reply #5 on: July 10, 2022, 06:47:55 PM »
As others have said, finding a SNF is most commonly done by a social worker.  As Rural said, if your relative is in the hospital, the hospital-based social worker would typically work to find options, though it sounds like they aren't able to assist given you're looking for out of state placement.  It doesn't sound like your dad will discharge home with you, though if he does, if he is plugged into home health services, their social worker could assist.

If searching on your own and finances are limited, consider using A Place for Mom (https://www.aplaceformom.com).  It is a free service that can help locate senior living needs.  I've seen numerous people find their service useful over the years.

Alternatively, if you can afford it, I would recommend searching for and hiring a local elder care consultant, which can also be quite helpful as you would have someone well familiar with your area and with how to navigate the system to help guide the way.

I wish you luck!

mrs sideways

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Re: How do I search for nursing homes that accept Medicaid?
« Reply #6 on: July 10, 2022, 09:01:10 PM »
Alternatively, if you can afford it, I would recommend searching for and hiring a local elder care consultant, which can also be quite helpful as you would have someone well familiar with your area and with how to navigate the system to help guide the way.

Oh, I didn't know these existed! There's several in our area with great reviews. Thank you!!

lhamo

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Re: How do I search for nursing homes that accept Medicaid?
« Reply #7 on: July 11, 2022, 02:28:23 PM »
Alternatively, if you can afford it, I would recommend searching for and hiring a local elder care consultant, which can also be quite helpful as you would have someone well familiar with your area and with how to navigate the system to help guide the way.

Oh, I didn't know these existed! There's several in our area with great reviews. Thank you!!

We worked with someone like this to find a place for my mom a few years ago.  It turned out we probably could have managed the process ourselves (I was already FIREd and did most of the research and legwork -- they came along to our meetings with the management and debriefed with us afterwards) because in the end we ended up going with a facility rather than adult family home care.  Fewer facilities to look at and easier to assess them due to annual reporting requirements and larger populations (I met with a few residents I was able to find through Nextdoor).  In my area one advantage of going with home-based care is that they will pay the fees for the consultant if you sign with them.  Because we went with the facility we paid the fee ourselves.

My mom's facility was one where you needed to be self-pay for a certain period (I think 12 months?) but then could switch to Medicaid if you had spent down the assets.  But I think Medicaid-funded residents may have had to share apartments.  Mom had plenty of assets and only lived 10 months after moving there....

mrs sideways

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Re: How do I search for nursing homes that accept Medicaid?
« Reply #8 on: April 17, 2023, 08:17:01 PM »
Hey all, I realized I should update this thread with things I've found out in the last 9 months, in case anyone else has the same issue.

To answer my own question, the answer is to start searching on Medicare.gov. You can do a map search for nursing homes and set filters for "Accepts Medicaid". Government ratings from inspections are built right in, too! From there you make a list and start calling.

If you live in a HCOL area, prepare to search elsewhere. Of all my local places, not a single facility had an open Medicaid bed. 1/3 had waiting lists. (In my area they were all over a year long.) 1/3 didn't have waiting lists and you just had to call at the right time. And 1/3 absolutely never called me back no matter how many messages I left, and the only way to get an answer was to go into their offices and find the admissions person face-to-face, who usually told me they were a "no waiting list" facility. I'm now looking at places over an hour drive away from me. This is because...

No one actually wants Medicaid patients. They don't make as much money on them as private pay patients. The only reason they have Medicaid beds at all is because the state makes them. But they certainly don't want to recruit Medicaid patients, and if they DO have X number of beds set aside for Medicaid they will, if at all possible, hold them for their own private pay residents who run out of money and go onto Medicaid. On a related note...

Senior Care Consultants aren't much help. These people exist to help private pay patients and they get a cut from the facilities they refer them to. You don't pay them, Sunset Villas does for bringing them a customer. If you're looking on behalf of a Medicaid patient you have to pay the consultant out of pocket, which costs thousands of dollars.

So, right now I'm applying to a place over an hour from me, which still has a waiting list, but a shorter one than any facility near me. I have two backup options, neither of which I'm crazy about, but the alternative is leaving my dad in Illinois and flying out there on a regular basis, because he needs a competent adult keeping tabs on him and making sure he's being taken care of. Every option kinda sucks.

cool7hand

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Re: How do I search for nursing homes that accept Medicaid?
« Reply #9 on: April 19, 2023, 03:33:56 PM »
We used a private social worker who was an elder care specialist, as well as an elder care attorney.

 

Wow, a phone plan for fifteen bucks!