Using Medicaid to Cover Services for Elderly Persons in Residential Care Settings: State Policy Maker and Stakeholder Views in Six States. Admission and Retention Requirements, and Aging in Place


Most respondents were satisfied with admission and retention regulations, but several raised concerns.

  • They are about right, I would like minor variations for standard ALFs. For example, under current regulations, if a resident's doctor orders support hose, that person needs to go into an ECC. Also, portable oxygen is controversial, but you see people in the supermarkets with it, so why not in a standard ALF?

  • I think the regulations for retention are fair, but when residents deteriorate staff may not pick up on it. The press have reported horror stories of people in ALFs who did not get the care they needed.

  • Mixing old and young folks in the same facility can work but can also cause problems between residents and there are no regulations for discharging an undesirable resident. Facilities need to give notice of 30 to 45 days, and it must be an appropriate discharge.

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