How do we confirm that the Memory Care place that we are entering will keep her when the private money runs out?

This is up to the memory care facility and they well MAY NOT let the person stay when the money is gone. It was made CRYSTAL CLEAR to my bro when he went into his assisted living that--not put this bluntly but definitely made clear--when the money is gone so is he. This in fact was in the very long contract with them that deliniated EVERYTHING and which had to be signed page by page. They told what the levels of care were, how much they cost, when you would move to another level of care, what the memory care was, what it cost, how much you could expect in raises by the year (3% to 5% barring the unforeseen, and covid is that). Everything was in black and white. This is what you need.
A facility such as this is not regulated by the laws that nursing homes are regulated by. It is a business. When your money goes, you go. And there may be SOME that allow you to stay, but anymore, it's rare as hen's teeth.
The ones to ask are in administration at your facility. If you do not have this in black and white, a signed contract, then you have nothing.

Absolutely make sure you get any promises in writing, don't ever accept verbal assurances!

You are asking the wrong place. You need to sit down with the facility and ask all your questions. No matter what anyone tells you here, you need to hear it from the facility, and perhaps get their response in writing.

I think each state regulates insurance and nursing homes. You may want to speak to an attorney in your state who specializes in elder care.

If the facility does NOT accept Medicaid, then they cannot keep her when the private money runs out. (It would be unfair to expect them to provide free care to your mother - even for a short period of time. If you are her POA, then, yes, you would be expected to "make up the difference.")

You need to find out if the facility accepts Medicaid or not. If NOT, then you need to start looking for a different place before it becomes an emergency situation (i.e., she has no money left).

You are best to speak with the Facility itself. They all vary. They will discuss all of this with you by a phone call. It is very valid to worry about, and you should have all these questions answered for you.

In the state of Maryland, memory care facilities (MCFs) are private pay. Most nursing homes are private pay but a few accept Medicaid. I visited all 6 facilities within the 20 miles radius of my area that accepted Medicaid and they were all the same: terrible! I would not want to live there.

This is the time to call and ask them directly if they accept Medicaid clients when the money runs out. Some places will avoid answering the question directly because they do not want to lose a chance to get your money now, but ask again until you get a YES or NO.

Good luck.

Have frank discussions with the administration and social worker at the facilities you are considering. The places that accept Medicaid and Medicare should have protocols in place for applying for this assistance.

I spent 6 months trying to find a Medicaid eligible spot for sis-while at the same time only searching for communities that were above average 4-5 stars on the Medicare/medicaid site. only 10 percent of the 150 available facilities in a 4 county area-50 mile range from my house. A lawyer assisted us in applying for Medicaid-while sis was not in a Medicaid facility at the time-application was then denied for this reason.

We will have to reapply-new facility Medicaid eligible placement-self paying for now with family assistance as we were desperate to get out of the bad place she was in-injuires, being unclean. We did not have time to wait to re do Medicaid as was covid start we grabbed the spot. You should get it in writing that facility will guarantee you a spot after X time or the money runs out, who will do the application-them or you time line etc. I have not done this-no guarantee it will work.

During my facility search I asked to be on wait list. None have called in the last 10 months-probably never will. Really great place says 2 year wait list. Medicaid rules say a facility can approve more medicaid beds but getting facility to actually do that?????

Most of what I have learned from my research as that the facility will want some assurance of your ability to self pay for a period of time 1-2 years worth. They wlll always give first choice Medicaid to current facility residents. I was told this a few times when we were told a bed was going to be available-but then a day or so later-poof the spot was "taken". Which sis did not have a huge amount in the bank to pay for high needs care. Sis needs full on nursing care was combative in the past-limited places will take on difficult cases. She is not combative now but having other behavior issues.

The elder care attorney is the best angle. My family is also concerned about this, as her current MC situation does not accept medicaid. So a trust has been established for her, and we've negotiated with the MC to change a clause in their agreement so that the trust is responsible for her financial situation, not her children as individuals. It sounds cruel, and maybe even self serving but it isn't. None of us can afford what it would take to fund her care if her funds run out, though we'd try if push came to shove. It may also be possible to negotiate at least some sort of lengthier rate freeze for perhaps 18 months or longer, if the current agreement stipulates a 12 month rate freeze. As a side note, we also learned that age in place really doesn't mean what we think/hope it might mean, so we're girding ourselves for that eventuality. Good luck.