Residential Care and Assisted Living Compendium: 2007. Waiting Lists

11/30/2007

Some states have long waiting lists for waiver services, which can present a significant obstacle to serving Medicaid beneficiaries in assisted living. If waiver slots are not available, Medicaid eligible persons who cannot be served at home will need to enter a nursing home (if they meet the state’s nursing home LOC criteria) and the ALF will have to look elsewhere for new residents. Recognizing this as a potential problem, lenders may require that facilities establish a reserve to cover low occupancy in the event that Medicaid funds are not as available as projected.

States that fund waiver services and nursing homes from a global budget (Oregon and Washington) or who allow funding to “follow the person” who transfers from a nursing home to community settings (Indiana, Maryland, Texas, and Vermont) have more flexibility.33 States with MFP policies allow persons transitioning from nursing homes to bypass the waiting list. States that have nursing home transition programs help nursing home residents re-locate to community settings and have staff that will generate referrals to ALFs.


33. Wisconsin has a special waiver to assure community placement for individuals who want to transfer when their nursing home closes.

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