Here are some things you need to know.
As a Marketing and Admissions Director, I get calls daily from family members who are worried about whether or not their loved one will be able to afford the cost of senior living or cost of assisted living in Milwaukee. They want to know “What does an assisted living facility cost?” and “Can I afford it?” They want to know what happens when funds run low. I’m here to provide some information so you can make an informed decision.
Assisted living communities can vary a lot in costs. The RCAC (Residential Care Apartment Complex) is typically for higher functioning, more independent residents while the CBRF (Community Based Residential Facility) is for those with higher needs, including memory care. Costs can vary by regulatory type, geographic location, size and type of apartment, and care provided. A registered nurse is likely to do an assessment before your family member moves in to see how much care they need and determine whether the placement is appropriate. It’s also up to you to decide whether that assisted living facility meets your needs and desires.
Private Pay and Medicaid
Many assisted living facilities require two or three years of “private pay” (market-rate costs) upon entry. What that means is they expect that the resident has the funds in their bank account to pay the regular rates for two years without going on Medicaid (Title 19) or Family Care. The money does not need to be paid upfront but would need to last. Some assisted living facilities do not accept Medicaid at all, or they limit the number of Medicaid residents since the reimbursement is lower than what they’d get directly from the resident who pays privately.
You may have heard the term Family Care, and that’s the program that is commonly seen in assisted living communities. Family Care provides a funding source for Medicaid-eligible residents in Milwaukee assisted living communities and is provided by a few different Care Management Organizations within the county. It is important to ask a facility whether they can accept Family Care (Title 19/Medicaid funding) and if your loved one can remain in place when they go on T19.
Villa St. Francis Accepts Family Care With Some Restrictions
There are some places, such as Villa St. Francis, that may accept Family Care upon admission, with some restrictions. Villa St. Francis can also accept people who are lower on funds. However, if your loved one needs a secured memory care facility, it’s important to act before they run too low on funds. There is a large demand now for memory care, and the options are fewer for those who are low on funding. As the needs of a resident increase, costs increase, which is why so many places will only take private pay residents for memory care. In many cases, the reimbursement does not increase with the added costs for dementia care.
Applying for Medicaid and getting on a Family Care program (or similar program) can also take a few months. The process can delay an admission if you’re needing to place your loved one quickly. This might be the case after a fall and a hospital visit. Then your loved one might go into rehabilitation in a nursing home for a few weeks, and if they can’t go home, families can often be in crisis mode to find a place for their loved one quickly, which can be very stressful. Once rehabilitation is completed and Medicare stops paying for the care at the rehab facility, funds can be depleted quickly if they remain there, which is why you need a good plan.
Medicaid Eligibility in Wisconsin
Another important thing to consider is Medicaid eligibility, which is based on assets and income. For someone going through the process, a financial investigation is done, and they use a “lookback” period of five years. When looking to protect family assets, be aware of the laws since “gifting” large sums of money and property can deem someone ineligible for Medicaid and Family Care. Not only can this cause a denial for eligibility but it could mean that a person could get denied admission to the assisted living community of their choice. Since so many places want a certain amount of private pay funds (regular rates), this is crucial. Having enough money set aside to allow for choices is important, especially for memory care.
Planning Ahead When Choosing the Right Assisted Living Facility
It’s important to plan ahead and ask these questions when visiting assisted living facilities.
What services are provided? What does your loved one need?
Will they allow you to tour? Touring is a great idea for anyone involved in the decision.
What is the cost? Is there an entrance fee? A deposit? Is it month-to-month or is there a longer leasing period required?
How long will it be before the savings account for my loved one runs out? It is important to know what your loved one has now so you can make an informed decision about options and affordability.
How much money does the assisted living facility require the resident to pay of their own money, and how long before a resident runs out of money? Some facilities require more private pay funds than others so it’s important to look around before your loved one is too low on funds. And a facility may require more available funds if you are working with a placement agency. This may be a company that you find online while searching “best assisted living in Milwaukee” and they act as an interface to help you find an assisted living community. They will only give you names of communities they are contracted with, and it may not be a complete list of options. There is typically no cost to you for using them in your search for assisted living communities, but the cost gets passed on to the facility for any new residents they send. If your loved one is low on funds, call the assisted living community directly as it’s likely they’ll be more lenient on the amount of funding required. It’s always a good idea to call the facility directly anyway, as you’ll get an employee who works there and knows details about the services provided, rather than an advisor who lives out of state and knows little about the property.
Will the facility keep my loved one when he/she is on Medicaid or will they have to move out? What facilities will take someone on Medicaid? Many seniors will run out of funding at some point, and it’s important that the assisted living community you choose is able to keep them so you don’t have to go through the search and moving process again.
Does your loved one need memory care? If so, it’s good to start looking sooner than later. It’s likely that more private pay funds could be needed for memory care than assisted living.
A final thought
It’s a good idea to look at your loved one’s finances now, and think about their future needs. If their funds are running low and they are considering assisted living at some point, it may be a good idea to think about it now while they have more options.
Villa St. Francis’ Solidarity with the Poor promise allows residents to age in place, regardless of their finances. We ensure that the needs of the poor and vulnerable are met through advocacy and action. At Villa St. Francis, close to our heart is Jesus’ healing ministry for vulnerable persons. We ensure that every resident’s human dignity is protected and they are treated with compassion and caring service. Villa St. Francis is a Community Based Residential Facility in Milwaukee, Wisconsin.