Paying for Assisted Living Facilities: Spend Downs

Author

Stacy's Helping Hand

Posted on

Sep 28, 2022

Book/Edition

Colorado - Denver Metro

share-this
Share This

Spend Downs at Assisted Living Facilities in the Denver

When professionals in the senior living industry discuss ways, an individual can pay for care and housing, you may hear terms such as private pay, spend down, and straight Medicaid. It can be confusing! In the Denver Metro area there are many assisted living facilities that only accept private pay funds for care and housing. They are not licensed to receive Medicaid funds from the state of Colorado.

Many facilities choose to only accept private pay residents because the Medicaid reimbursement rate is much lower than they can receive from residents who are able to private pay. Other facilities accept private pay and spend downs, while some facilities accept private pay and straight Medicaid. When a resident is allowed to private pay for a certain period of time and then go onto Medicaid, it is known as a spend down. The term Straight Medicaid is generally used for facilities that accept Medicaid payment without requiring a spend down; in this scenario a resident can move in if they are approved for Medicaid or are enrolled in the InnovAge PACE program, depending upon the facility.

A resident is not eligible for Medicaid at an Assisted Living Facility until they have less than $2,000 in assets and less than $2,094 per month in income. If the resident spends their assets for their care and housing at the “Medicaid approved” facility, but still has more than $2,094/month in income, the facility that accepts Medicaid will work with the resident and either allow the resident to pay the “Medicaid rate” or require that the resident pay their monthly income to the facility (and allow the resident to keep what they could keep for spending money on Medicaid – approximately $105/month).

There are a few Large assisted living facilities and numerous Residential Assisted Living facilities (also known as Personal Care and Boarding Homes) that will allow a one to two year spend down. Facilities which allow a resident to spend down, will either accept 1) Medicaid, 2) Medicaid and InnovAge, or 3) InnovAge, depending upon the facility. If a resident is enrolled in the InnovAge PACE program, facilities are reimbursed by InnovAge, and in turn, Medicaid reimburses InnovAge for the resident’s care.

If you refer to the Denver Metro Senior Blue book, it appears that there are lots of facilities that accept Medicaid, but there is one BIG caveat. Many of the facilities require an individual to pay privately for one to two years before they will accept Medicaid reimbursement. Some indicate that they accept Medicaid, but when you contact them, they actually accept InnovAge.

On another note, we also find many families are misguided and believe Medicare or supplemental health insurance will pay for care and housing. Medicare DOES NOT cover care and housing. Only private funds, Medicaid and InnovAge pay for care in Assisted Living facilities. Medicare may cover temporary stays at Rehab facilities, but never long-term care at an Assisted Living Facility.

Still confused or unfamiliar with the InnovAge PACE program? Our Advisors would be happy to discuss with you what would be your best option, based on your finances and care requirements.

Other Articles You May Like

Healthy Vision: Tips for Saving Your Eyesight

Our eyes are incredibly precious, yet its easy to take our vision for granted until problems arise. Lets focus on proactive steps to maintain and improve our eye health. Here are some tips to keep your vision in top shape:Schedule Regular Eye Exams:One of the best ways to safeguard your vision is by scheduling regular eye exams. Comprehensive eye exams can detect vision problems early on, allowing for prompt treatment and prevention of further complications. Make it a priority to see your eye doctor at least once a year, even if you dont currently wear glasses or contact lenses.Protect Your Eyes from UV Rays: Just like your skin, your eyes can be damaged by the suns harmful UV rays. Whenever youre outdoors, especially on bright, sunny days, wear sunglasses that offer UV protection. Look for sunglasses that block 100% of UVA and UVB rays to shield your eyes from potential damage. Give Your Eyes a Break from Screens: In todays digital age, many of us spend a significant amount of time staring at screens, whether its for work, leisure, or staying connected. Prolonged screen time can lead to digital eye strain, characterized by symptoms like dry eyes, blurred vision, and headaches. To reduce eye strain, follow the 20-20-20 rule: every 20 minutes, take a 20-second break and look at something 20 feet away.Eat a Balanced Diet:Nutrition plays a crucial role in maintaining eye health. Incorporate foods rich in vitamins and antioxidants, such as leafy greens, colorful fruits and vegetables, fish high in omega-3 fatty acids, and nuts and seeds. These nutrients can help protect against age-related vision problems like macular degeneration and cataracts.Practice Good Eye Hygiene:Proper eye hygiene is essential for preventing eye infections and irritation. Wash your hands frequently, especially before touching your eyes or handling contact lenses. Follow your eye doctors recommendations for contact lens care, including proper cleaning, disinfecting, and storage.Stay Hydrated: Dehydration can contribute to dry eyes, so be sure to drink an adequate amount of water throughout the day. Aim for at least eight glasses of water daily to keep your eyes and body hydrated.Get Plenty of Sleep:Adequate sleep is crucial for overall health, including eye health. During sleep, your eyes receive much-needed rest and replenishment. Aim for 7-9 hours of quality sleep each night to help reduce eye fatigue and maintain optimal visual function.By incorporating these simple yet effective tips into your daily routine, you can help protect and preserve your precious eyesight for years to come.Your eyesight is irreplaceable, so take care of your eyes today for a brighter tomorrow!

Moving Made Easy: Simple Tips for Seniors

Moving to a new home can be scary and stressful, especially for older people. But don't worry! Here are some easy ways to make moving day less scary and more fun.1. Pick the Right HomeFirst, choose a new home that feels good. Think about what you like. Do you want a garden view? Do you need help with cooking? Make sure your new home has what you need to be happy.2. Make ListsWrite down everything you need to do. This helps you remember important things. Start early and take your time. Don't rush!3. Choose Special ThingsWhen you move to a smaller home, you can't take everything. Pick the things that mean the most to you. It's okay to feel sad about leaving some things behind.4. Get Help from MoversHiring people to help you move can make things much easier. They know how to pack and move your stuff safely.5. Use Good BoxesUse boxes that stack well. Plastic boxes with lids are great because they're easy to pack and unpack.6. Say Goodbye to Your Old HomeHave a party to say goodbye to your old home. Take lots of pictures to remember it. This can help you feel better about moving.7. Think Happy ThoughtsMoving can be exciting! Think about all the fun new things you'll do in your new home. You might make new friends or try new activities.8. Pack a Special BagPack a bag with things you'll need right away in your new home. Put in things like:MedicineToothbrush and toothpastePajamasSnacks and waterThis way, you won't have to search through all your boxes on the first night.9. Make a Moving Day PlanPlan out your moving day. Know when you'll leave and when you should arrive at your new home. Don't forget to plan for breaks along the way.Remember, moving can be a big change, but it can also be the start of a great new adventure in your life!

Moving to Senior Living: What to Pack and What to Leave Behind

When moving to a senior living community, it's important to know what to bring and what to leave behind. This guide will help you pack smart for your new home.Before You Start PackingVisit Your New Home: Take a look at how big your new space is.Talk to Residents: Ask people who already live there about what they brought and what they wish they had.Check with Staff: Find out what furniture and items the community provides and which items are not allowed.Involve Family: Let your family pick items they might want to keep, especially heirlooms.What to BringClothes and Personal ItemsEveryday clothesToiletries like toothbrush and shampooMedicationsMobility aids, like walkers or canesSpecial ItemsPhotos and artwork that you loveSmall mementos that make you feel at homeFurniture (if there's room)A comfortable chairA small table or nightstandA bed (if not provided)Lamps for lightingOther Important ThingsBedding and blanketsKitchen items if you have a small kitchen areaTV or radio (if allowed)Pet supplies if pets are permittedWhat Not to BringExpensive jewelry or valuable items that could be lost or damagedClothes you no longer wearLarge furniture pieces that won't fitBig appliances that the community providesHeaters or air conditioners that may not be allowedLarge rugs that could be a tripping hazardRemember, your new home will be smaller, so you'll need to choose carefully what to bring. It's perfectly okay to ask for help from family or friends if packing feels overwhelming.

Local Services By This Author

Stacy's Helping Hand

Housing Placement & Resource Specialists 1040 South Gaylord Street, Denver, Colorado, 80209

Let us help you find the best care and housing option for your loved one - Assisted Living, Independent Living, Memory Care or Skilled Nursing. As Senior Care Advisors with over 12 years experience, we know the level of care each community or small home provides, their reputation and cost. We will help determine your loved ones physical care needs and what will be the best fit for them socially. As a neutral party, we tour the communities/homes with you and help you ask the right questions. We stay with you as your liaison, sounding board, and advocate for 3 months after you move in.  Read our 5 Star reviews on Google and Yelp!

Stacy's Helping Hand

Assisted Living 1040 South Gaylord Street, Denver, Colorado, 80209

Let us help you find the best care and housing option for your loved one - Assisted Living, Independent Living, Memory Care or Skilled Nursing. As Senior Care Advisors with over 12 years experience, we know the level of care each community or small home provides, their reputation and cost. We will help determine your loved ones physical care needs and what will be the best fit for them socially. As a neutral party, we tour the communities/homes with you and help you ask the right questions. We stay with you as your liaison, sounding board, and advocate for 3 months after you move in.  Read our 5 Star reviews on Google and Yelp!

Stacy's Helping Hand

Memory Care 1040 South Gaylord Street, Denver, Colorado, 80209

Let us help you find the best care and housing option for your loved one - Assisted Living, Independent Living, Memory Care or Skilled Nursing. As Senior Care Advisors with over 12 years experience, we know the level of care each community or small home provides, their reputation and cost. We will help determine your loved ones physical care needs and what will be the best fit for them socially. As a neutral party, we tour the communities/homes with you and help you ask the right questions. We stay with you as your liaison, sounding board, and advocate for 3 months after you move in.  Read our 5 Star reviews on Google and Yelp!