As our population ages, facilities and institutions find themselves facing a significant increase in future residents. Coupled with this growth in population, senior citizens want to maintain a degree of independence within their new limitations. Assisted living facilities meet the needs of the seniors and institutions facing a new influx of residents. Medicaid implemented a waiver program that allows seniors to live somewhat independently; those who don't have the needed financial resources will have their expenses paid by Medicaid.
Function
The Department of Health and Human Services tasked Medicaid with the responsibility of reimbursing assisted living facilities for care provided for qualified resident seniors. This waiver was established in order to allow residents who require assistance, but who cannot afford to pay, to access the services they need in order to delay entry into a long-term care facility.
Rules
Medicaid requires the home- and community-based services provider (HCSB) to provide staffing at a level of one RN, LPN or CNA on duty per shift. During the night shift, there must be at least one staff member awake at all times.
Safety Considerations
Medication reviews are carried out bi-monthly per resident; if a new medication is ordered, this requires a new medication review. If the resident is able to administer his medications to himself, he can keep his prescriptions in his room. For residents who share a room, both residents will be assessed for ability to self-medicate and safely keep medications in their room.
Potential
This waiver program allows elderly residents to maintain a degree of independence within their current abilities; for those functions they are no longer able to manage, assistance is available from licensed staff members. Medicaid allows residents who qualify based on need to stay out of a long-term care facility, which saves the state money.
Misconceptions
Medicare is administered by the federal government; thus, every state and facility operates under the same rules. Medicaid is state-administered, which means that rules vary from state to state. Medicaid also requires eligible individuals to pay a monthly deductible before they cover the individual medical expenses; this allows the individual to keep a small monthly income.
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