OP, lots of good responses here. I'm more familiar with how this works in small cities, not major metro areas. Tends to be more "Medicaid beds," not "Medicaid facilities" - at least where I had to handle this. The difference I found was between corporate and non-profit nursing homes. My dad was in the former - great and kind staff, but the corporations stintedon patient supplies, etc. My mom was in the latter and there was no stinting. The staff were pretty comparable, though those working at the non-profit seemed to be happier and more content with the employer. Another difference: the nonprofit tended to have more activities for residents while the corporate seemed to rely on religious volunteers for this.

All the best here.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My loved one is in a Medicaid nursing home and I think that it is pretty good. The facilities are dated but very clean, well-maintained, and there are plenty of light-filled rooms, wide hallways, and a spacious courtyard for outdoor exercise. The home is not crowded and well-staffed. Medical needs were met right away (e.g. i suspected a UTI bc loved one started to get loopy and they dealt with it right away). Food is typical institutional food so not great, but they get enough. There are not that many social activities, but they have a few like movies and bingo. For an elder who is destitute it is actually a great deal. They get room and board, laundry, housekeeping, 24-hour nursing care, medicines, assistance with bathing, dressing, etc. My relative gets less than $2000/month in SS and has zero assets so would not be able to support themselves without help from the government. Facility charges over $12,000 a month and personal contribution is social security check minus $93 a month. I visit twice a week and drive to doctor appointments.

+1. I feel the same about my loved one's nursing home, where her stay is paid for by Medicaid. I have had other relatives who were private pay in nursing homes and this one does not seem very different.

The vast majority of nursing homes accept Medicaid. I feel like some people think that there are a small number of nursing homes that are "Medicaid nursing homes" that are horrible, but that's not exactly how it works.

+1 most nursing homes have a certain number of Medicaid beds, and the rest are private pay. There is no difference in care.

+1 the issue is more finding the bed at a good spot because each will only have so many Medicaid beds. You can definitely find a spot with good care op, and no matter what like others have said if you can - visiting and being very present will help immensely.

Anonymous wrote:

Anonymous wrote:My loved one is in a Medicaid nursing home and I think that it is pretty good. The facilities are dated but very clean, well-maintained, and there are plenty of light-filled rooms, wide hallways, and a spacious courtyard for outdoor exercise. The home is not crowded and well-staffed. Medical needs were met right away (e.g. i suspected a UTI bc loved one started to get loopy and they dealt with it right away). Food is typical institutional food so not great, but they get enough. There are not that many social activities, but they have a few like movies and bingo. For an elder who is destitute it is actually a great deal. They get room and board, laundry, housekeeping, 24-hour nursing care, medicines, assistance with bathing, dressing, etc. My relative gets less than $2000/month in SS and has zero assets so would not be able to support themselves without help from the government. Facility charges over $12,000 a month and personal contribution is social security check minus $93 a month. I visit twice a week and drive to doctor appointments.

+1. I feel the same about my loved one's nursing home, where her stay is paid for by Medicaid. I have had other relatives who were private pay in nursing homes and this one does not seem very different.

The vast majority of nursing homes accept Medicaid. I feel like some people think that there are a small number of nursing homes that are "Medicaid nursing homes" that are horrible, but that's not exactly how it works.

+1 most nursing homes have a certain number of Medicaid beds, and the rest are private pay. There is no difference in care.

Most long term nursing home care (actual skilled nursing--not assisted living) is paid for my Medicaid. Most acute nursing home care is paid for by Medicare. Percentage wise, few people are paying privately for skilled nursing care. So, it doesn't make a difference. Nursing homes are dismal because they are nursing homes.

Many places accept Medicaid and paying patients. Just ask when you’re touring. They will work with you to time it so a Medicaid bed opens when a patient needs it or help find one nearby.

Anonymous wrote:A nursing home might accept Medicaid but only for a certain percentage of beds. So it could be full for Medicaid recipients but otherwise have paid space available.

Yes. My mom's assisted living/memory care is private pay but also accepts Medicaid. The private pay residents and the Medicaid residents receive the same care. Once my mom's private pay funds are depleted, we will apply for Medicaid and she should be able to continue living there.

A nursing home might accept Medicaid but only for a certain percentage of beds. So it could be full for Medicaid recipients but otherwise have paid space available.

Anonymous wrote:My loved one is in a Medicaid nursing home and I think that it is pretty good. The facilities are dated but very clean, well-maintained, and there are plenty of light-filled rooms, wide hallways, and a spacious courtyard for outdoor exercise. The home is not crowded and well-staffed. Medical needs were met right away (e.g. i suspected a UTI bc loved one started to get loopy and they dealt with it right away). Food is typical institutional food so not great, but they get enough. There are not that many social activities, but they have a few like movies and bingo. For an elder who is destitute it is actually a great deal. They get room and board, laundry, housekeeping, 24-hour nursing care, medicines, assistance with bathing, dressing, etc. My relative gets less than $2000/month in SS and has zero assets so would not be able to support themselves without help from the government. Facility charges over $12,000 a month and personal contribution is social security check minus $93 a month. I visit twice a week and drive to doctor appointments.

+1. I feel the same about my loved one's nursing home, where her stay is paid for by Medicaid. I have had other relatives who were private pay in nursing homes and this one does not seem very different.

The vast majority of nursing homes accept Medicaid. I feel like some people think that there are a small number of nursing homes that are "Medicaid nursing homes" that are horrible, but that's not exactly how it works.

If there isn't a website where people can post reviews of their or their loved one's Medicaid-accepting facility, there should be one

It really depends on the facility and staff at the time. I don't think our faculty treated the medicaid patients differently but they weren't very good for any patients and were neglectful most of the time. Real issue is that it's hard to find anyone to accept someone with Medicaid.

My loved one is in a Medicaid nursing home and I think that it is pretty good. The facilities are dated but very clean, well-maintained, and there are plenty of light-filled rooms, wide hallways, and a spacious courtyard for outdoor exercise. The home is not crowded and well-staffed. Medical needs were met right away (e.g. i suspected a UTI bc loved one started to get loopy and they dealt with it right away). Food is typical institutional food so not great, but they get enough. There are not that many social activities, but they have a few like movies and bingo. For an elder who is destitute it is actually a great deal. They get room and board, laundry, housekeeping, 24-hour nursing care, medicines, assistance with bathing, dressing, etc. My relative gets less than $2000/month in SS and has zero assets so would not be able to support themselves without help from the government. Facility charges over $12,000 a month and personal contribution is social security check minus $93 a month. I visit twice a week and drive to doctor appointments.

Also consider if assisted living might be appropriate for your loved one. If they are somewhat independent, it might be more appropriate and more affordable.

Most nursing homes accept a variety of payor sources one of which is Medicaid.

At the simplest level, private pay facilities work for the clients/residents and answer to them. Medicaid facilities in effect answer to the government (and themselves) and this significantly disempowers the clients/residents.

While it is impossible to generalize (there are good Medicaid facilities, and private pays where it would be immoral to board a dog), Medicaid facilities tend to be more crowded and less well staffed. They are not well positioned to compete for the best employees, at least financially.

My experience was that distance and convenience matter. If you are visiting regularly you can advocate for your person and ensure they are less likely to be neglected even when you are not there.

Perhaps the most important factor is the staff. There are amazing people who work for peanuts and still give every patient 100%. There are activities directors who are fountainheads of enthusiasm even with minimal resources. There are directors who make it their business to wring every possible benefit for the patients, not the employer.

And then there are the others.

Can someone who has done the search for nursing homes provide some unvarnished commentary on the difference between private pay and Medicaid nursing homes?