Paying for skilled nursing and assisted living at same time, any suggestions?

Squatch: I did see your update where the AL is going to drop her care portion of the payment.

Yes, going through this myself. Dad was in AL and Covid was not nice to him. Grew weaker from staying in his room all the time and developed skin ulcers on his lower leg - again. Home health had been the only one allowed in and they put up a flag in May that he needed to go to skilled nursing. After a week, he fell - again- and ended up with another compression fracture in his back in addition to the skin ulcers which by this time, were healing up nicely. Then off to the hospital for a week and then back to skilled nursing end of May. By mid June, it was decided he could not return to AL so I gave notice for July 16. Moved out his things on July 3rd. They did not charge me the care fee while he was in skilled nursing. On July 9, it was decided he was no longer accepting therapy at the skilled nursing facility so he went on self-pay at the skilled nursing facility on the 10th of July. It had not been decided until then what living situation he would need going forward but they told us memory care would be fine Found a great one, they accepted him (they had reviewed his medical records) so my husband and I moved his stuff and paid the move-in fee and first month on July 17 with a move date of July 21. On Monday the 20th, I received a call from the skilled nursing facility that the leg ulcers had returned worse than ever so memory care said no moving and they were setting a new date of July 30th. So at ths point, we've already spent over $10,000 to get him into the memory care plus paying for skilled nursing out of pocket. On Monday, July 27, memory care made the decision not to accept him after all so my husband and I went and got his things and brought them back home. They have told me I will receive a refund not sure if for the full amount or not. There is a lot of money going out right now and I want so badly to get him settled someplace. They tell me it will be a few more weeks before he can leave skilled nursing again, all the while paying out of pocket because he will not accept physical therapy.

They are going to drop her "care" portion of the rent, which is $800. I guess better than nothing (still over $4,000.) Will be an expensive month, but hopefully we will find out sooner rather than later if it looks like she will be able to return to ALF.

We had to private pay for rehab at the nursing home for Mom as well as her AL apartment. Ugh!

And then we were told AL would not take her back because they are only licensed for 1 person assistance and sometimes she needs 2.

Lots of money down the drain. The social worker at the nursing home was ZERO help. I ended up finding another AL which can take people needing 2 person assistance, and LO moved in.

I would suggest starting to have the conversation with her AL facility ASAP NOW so you can be prepared. You may have to start looking for another AL with a higher level of care or look at nursing homes and it all takes time (and $).

I hope your Mother’s AL will accept partial rent but my Mom’s would not.

Best of luck to you!

Interesting skilled nursing is not nudging you for her to stay there, longer or permanently unless they have broached the subject already?

You need to speak to the people at the Assisted Living. I am experiencing this with a friend of my bro's now.....what is agreed is that the rental portion of the room must be paid, of course, or the room must be cleared and rented to someone else. However the care portion of the Assisted Living, which is billed separately is eliminated until the elder returns.

Squatch is correct. In my Moms agreement, after 2 weeks of not being in her room we paid fully for the rent but did not pay for her care. It was credited on her next billing. Like said, if she had an apartment she would pay. Thats what an AL is, you rent a room.

Why does Mom need to be in rehab again, just to get her strength back? If so, I would check to see if she can have rehab at the AL with Medicare or her secondary insurance paying for it. Even if you have to private pay, it maybe cheaper than a room in rehab. At rehab she gets therapy about 2x a day, the rest of the time she is just sitting around. She can do that at the AL a lot more comfortably.

OP here. I just thought since she isn't using any care or eating or things like that. Her care level is $800 additional a month, so perhaps that may be flexible. Any little bit would help. I would certainly not ask not to pay at all, as the room is still occupied by her stuff; I get that.

Yes, long term nursing care may be a possibility. We will see what the next couple of weeks brings.

You can ask about reducing the care portion of her monthly AL.

They don't typically give any discounts but you may get lucky if her contract shows the assisted care as a separate line item. Then you can really push to not pay that as she obviously is not getting the service.

Just curious, have you thought about increased care for your mom? She is spending a lot of time in skilled nursing and maybe she really needs to be there instead of AL. I would ask the rehab doctor to do a needs assessment while she is there.

Best of luck getting this all sorted.

Incredibly unlikely. They can't rent out the room so they have no reason to give a discount. If you go out of town for 10 days you can't only pay 2/3 of your mortage payment even though you only used the house 2/3 of the time.