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We're stuck between two communities

The questions that break a tie once the tours all start blurring together.

Quick answer

The questions that break a tie once the tours all start blurring together.

HomeBy SituationWe're stuck between two communities

By this point you have toured enough that the buildings have merged. These are the questions that still separate them.

Short answer

The questions that break a tie once the tours all start blurring together.

What to do, in order

  1. Compare the all-in numbers, not the base rents. Ask each community for the total monthly cost at your parent's assessed care level, in writing.
  2. Compare the rate increase histories. Three years of actual increases from each.
  3. Compare overnight staffing, not daytime. Daytime ratios look similar everywhere. Overnight is where they diverge.
  4. Pull both state inspection records. Read the surveyor narratives rather than counting citations.
  5. Ask the Medicaid waiver question of both. If private funds might run out, a community that does not hold a waiver provider agreement is a future forced move.
  6. Go back unannounced. Same building, evening on a weekday.

Questions families ask

Do I have to enroll in an MLTC plan for home care in Nassau or Suffolk County?

Yes - Managed Long Term Care (MLTC) enrollment is mandatory in both Nassau and Suffolk counties for dual-eligible Medicaid recipients age 21 and older who need community-based long-term care services for more than 120 days. NYSDOH extended mandatory MLTC enrollment to Nassau, Suffolk, and Westchester counties beginning in the 2013 transition period, and that mandatory enrollment structure remains in effect. MLTC plans coordinate home care, adult day care, nursing home care, and related services through a single managed care plan rather than fee-for-service Medicaid.

What is the NHTD Medicaid waiver and could it help my parent stay out of a nursing home?

The Nursing Home Transition and Diversion (NHTD) Medicaid Waiver is a federal 1915(c) Home and Community-Based Services waiver administered by NYSDOH through Regional Resource Development Centers. It helps Medicaid-eligible people age 65 and older, and younger people with physical disabilities, who have been assessed as needing nursing-home-level care receive services in the community instead, either transitioning out of a nursing facility or diverting from being admitted to one in the first place.

What is New York's Assisted Living Program (ALP) and how is it different from private-pay assisted living?

The Assisted Living Program (ALP) is New York's Medicaid-funded alternative to nursing home placement, operating inside licensed Adult Homes or Enriched Housing Programs rather than as a separate building type. It serves people who are medically eligible for nursing home care but can safely be served in a less medically intensive, lower-cost setting, covering personal care, room and board, housekeeping, home health aides, nursing, therapy, medical equipment, adult day health care, and RN case management. ALP is regulated under 18 NYCRR Part 494.

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