Residential Care Retention Policy

We suddenly and unexpectedly landed in residential care as I needed assisted living (AL) and my wife needed memory care (MC). Provision Living at Columbia (MO) was the only site with apartments available at the time and we had made a deposit as soon as reservations were available for this new facility, just in case.

At what point must we transfer to another site or level of care? There seems to be no single simple answer. Health, age, and money are important. The licensed services provided are another. See ALF and ALF** below for example.

Missouri state law provides one dividing line: Anyone who cannot exit the building unassisted in the time set for a fire drill must move to a nursing home (NH), to skilled nursing {SN) or an ALF**.

Some other examples of where me may fit as time passes, just in case, and the time to make that move without it again becoming another unexpected event:

• Mill Creek (ALF) policy includes retaining residents who can be assisted by one person and moves out residents requiring assistance from two people. It attempts to retain all residents who have paid the full rate for a period of years.
• Tiger Place (ICF) and Boone Landing (IL) retain all residents who are judged to not need SN or a NH, are not a threat to themselves or others, and are paid up.
• Lenoir Woods is a Continuous Care Retirement Community (CCRC). It provides all levels of service. You never have to leave (if paid up for a period of years).
• Provision Living at Columbia (MO) (ALF**) assists in locating other residential care when with in 6 months of running out of money. This appears to be an appropriate lead-time for finding and relocating to available NH options (See below).

For non-residential care persons, have enough money to cover two months private pay, and related costs, in a Medicaid bed nursing home (NH) of your choice (about $15,000/person). You want to be in the bed before qualifying.

http://matchnursinghomes.org/city/columbia-mo-nursing-homes presents Percent of Beds Occupied (64-97%, March, 2016), Overall Rating, and Number of Medicare-Medicaid beds. Call for current pricing and deals. When money runs out you stay in your selected bed and Medicaid takes over the remainder of the bill after applying your Social Security and other (pension) benefits.

http://health.mo.gov/seniors/nursinghomes/pdf/DirectoryCounty.pdf presents Level of Care licenses: ALF, ALF**, SNF, RCF, ICF, and Alzheimer’s unit.  See http://health.mo.gov/safety/showmelongtermcare/lvloflic.php for an easy to read two page list of definitions.