Shades of Change II

It is lunch and tour day at The Groves. While I take mom to get her hair done, Betsy and Dennis drive to two other facilities for pricing and to get a glimpse of their interiors.

Apparently, they are beautiful, however, their monthly cost is significantly higher than $2400.00/month. Additionally, neither offer “Medicaid beds.” A Medicaid bed is where a privately owned independent/assisted living facility is willing to allot a certain number of spaces (beds) in their building to Medicaid patients. We assume that Ginny’s health and financial situation will eventually qualify her for the program, so this is an important requirement. There are places that accept a lot of Medicaid patients, but it’s important to find a “bed” at a higher level facility.

We spend two hours there. The lobby is, indeed, beautiful. The food is average. We tour the whole building. Ginny asks to see the pool (she used to attend a swim class several years ago). It’s tucked far away around the corner of the building. Personally, I think it’s a long walk for seniors.

We see the perfectly designed independent living model and then we ask to see the actual available units. There were two. They both had parking lot views on a busy road and we all thought that they were a long walk to the dining room for Ginny to tackle twice a day.

As we stand in the lobby to say goodbye, the sales person has not taken us behind closed doors to talk finances or to try and get us to sign. I find this odd. There had been no moment to negotiate. We had asked about Medicaid beds during lunch. Perhaps that was a red flag to her.

Her answer had been promising though. “We allow Medicaid diversion supplements for our assisted living program. The rent amount doesn’t change, but Medicaid can offer $1000 monthly towards care.” Their current rent for assisted living is $3200.00/month.

I reviewed this term later.  The formal name is the Statewide Medicaid Managed Care Long-Term Care Program better known as the “nursing home diversion program”. (This is also located in Interesting Links.) It may vary per state.

Basically, the objective is to keep a senior either at home or in assisted living for as long as possible since nursing home managed care carries a much higher cost. It helps Medicaid save money.

Not that long ago, I thought that assisted living and a “nursing home” were interchangeable terms. Not so. Although both do offer increased medical care/supervision over independent living models, a nursing home offers 24/7 medical care, and less freedom. Residents downsize to single rooms, and sometimes that room is shared. Assisted living offers more independence and more space. They live in their own small apartments but the staff do check in frequently.

Standing in the lobby, Dennis speaks up.

“Ginny’s income is not enough for the monthly rent. We will be sharing her costs.”

I thought I should try to speak up too.

“Given that, is there any room for negotiating here, either on the rent or the community fee.”

“Well, we are currently having a sale this June on the fee. We are waiving it” she replied.

“That is fantastic” I respond, wondering why she had not previously mentioned it.

“I know there is no way we can pull this together in two weeks. Will there be another sale?”

“We do offer this sale a few times a year. So yes, you will have a chance. And if it isn’t on, talk to myself or the manager and we may be able to do something.”

My original thinking had been that all we needed to do was to determine the difference between her monthly contribution and the $2400.00 fee. Then we would split that difference. On paper, our contribution seemed reasonable, and that is why we were all comfortable encouraging Ginny about The Groves.

But I had made a mental error. Every single dollar of her monthly income would be going towards rent. She did have other expenses, however, outside of the monthly fee. They include prescriptions, hair appointments, clothes/shoes etc., food/snacks, dental appointments (she has several a year), phone, drugstore supplies etc.

We return to our cars and head to mom’s place to specifically break down those expenses. I’m a little nervous now about my miscalculation, but I’m hoping that it will still work.

In truth, this move would require that we each spend almost double than I had first anticipated. This was a problem. Our families both have assets, but we are also both retired. I am too young to collect Social Security. Dipping into my 401k at my age would require that I pay an additional withdrawal fee; not an ideal solution.

Ultimately, we couldn’t rationalize the increased spending. For now. Also, we weren’t 100% sold on the facility. But, it was not a failure. We had broken through mom’s reservations about retirement living. Plus, we have one facility “Ginny-approved.” We can take it month by month.

In addition, although Dennis’s scouting of other facilities confirmed even higher prices out there, we could keep looking and/or approach the idea of managed care in a new way. It’s just going to take some time.


Ginny finally found Lois. She had come up with a brilliant idea. I have to hand it to her. She thought she should WRITE Lois. She knew that the mail would be forwarded and Lois could call Mom with her location and phone number. They did connect.

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