Filling Your Assisted Living Facility with Medicaid Residents
May 27, 2024
Medicaid can be a vital revenue source for your assisted living facility. When you have Medicaid residents, you receive payments from different channels, primarily through a daily rate and a resident's Social Security contribution. For instance, you might receive around $100 per day per resident from Medicaid, totaling $3,000 monthly. Additionally, residents contribute a portion of their Social Security income, often around $800, bringing the total to $3,800 per month per Medicaid resident.
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Certification Process
Your facility must be certified to accept Medicaid residents. This involves applying through your state’s Medicaid office or third-party administrators. The process requires strict adherence to guidelines and thorough documentation. It’s crucial to follow all instructions meticulously to avoid delays, as I experienced in my Colorado facility, where certification took longer due to administrative hurdles.
Finding Medicaid Residents
Once certified, finding Medicaid residents is pretty straightforward. Partner with healthcare providers such as rehab facilities and hospitals, as they can refer patients to your facility. Work with social workers and case managers to help their clients (your residents). And highlight that you accept Medicaid in your marketing efforts to attract potential residents.
Maximizing Revenue
While Medicaid rates might be lower than private pay rates, you can maximize revenue by placing two residents in one room. This strategy can effectively double your income per room. For example, two residents, each contributing $3,800, would generate $7,600 from one room. This approach can be particularly helpful in states where private pay residents willing to pay higher rates are harder to find.
Pros and Cons of Medicaid
The high demand for Medicaid means a large pool of potential residents, and regular payments from Medicaid can provide financial stability. On the downside, managing Medicaid billing and staying compliant with state regulations can be time-consuming, and some reimbursement rates may be lower than private pay, which can affect profit margins.
The Importance of Staying Updated
Staying updated with state regulations and billing practices is essential to ensure timely and full payments. Any lapse in updating PARs (Prior Authorization Requests) or PETIs (Personal Expenses and Trust Income) can disrupt your revenue flow. If you need help figuring out the process, check out the Success System to help you get started.
Final Thoughts
Accepting Medicaid residents can be a strategic way to fill your assisted living facility and ensure a steady income. Despite the administrative work and lower reimbursement rates, the benefits of consistent occupancy and predictable payments make Medicaid a viable option for new assisted living facilities. If you’re ready to explore this option, download our comprehensive Underwriting Calculator to start planning your Medicaid strategy today. Share your experiences with Medicaid in assisted living or ask questions in the comments below—we're here to help you succeed.
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Transcript
00:00:00
hey everybody welcome back to Assisted Living investing happy to have you on the channel today for our topic today we're going to get into how to fill your facility your residential assisted living facility with Medicaid residents and why you might want to consider doing that as you get started on your assisted living facility if you're interested in learning about that make sure you stick around for today's video [Music] thank you hey everybody welcome back to the channel I'm Brandon Gustafson with
00:00:32
assisted livinginvesting.net excited to have you here with me today our topic for the video is how to fill your residential assisted living facility with Medicaid residence for your assisted living facility this is something that uh people I don't think they're aware of how this works or they they see Medicaid and they uh you know during the headlights they don't want to go down that path I'm going to try to kind of coach you through how it's actually not that scary and why it can actually
00:01:02
benefit your facility but before we get into that I wanted to remind you to get over to assisted livinginvesting.net get access to our free underwriting calculator we'll link that down below if you get over there and get access to the calculator you will also get on an email list that has a 12-step process with action items it's going to help you get started uh with your own assisted living facility so if you're interested in that make sure you get over to assisted livinginvesting.net and get access to
00:01:29
that free calculator you also be made aware once we release some of our other content that we're trying to put out on the website working on that right now and excited to get a lot of this information out to you so let's get into the topic for today again we're talking about how to fill your beds with Medicaid residents at a residential assisted living facility my facilities I own two of them they're both 16 bed facilities one in Colorado one in Idaho they are both largely Medicaid actually
00:01:55
and uh you know for me I've worked in healthcare for a long time I've actually worked in government program funding things so Medicare Medicaid VA care those types of things I'm very familiar with it because I have I have experience working in them I kind of understand the process for how they work and so I wasn't scared when it came to to Medicaid and what I found is it actually is pretty um it's actually a pretty good way for you to get residents keep your house full and still make a pretty good chunk
00:02:26
of money so before we get into like how to how to get the rest residents I wanted to explain to you a little bit more about Medicaid I've got another video where I talk about this in the Medicaid process but basically when you receive payments from Medicaid or you have a Medicaid resident you're getting payments from a few different areas one is what's called a daily rate so you get a daily rate that you build to the to Medicaid and that Medicaid could be run by the state or it could be run by a
00:02:54
third party administrator and different states have different rules and regulations so Medicaid is a federally funded program but it's administered at a state level and they kind of do the things that they they feel like they want to do to administer Medicaid so you could have the state is doing it specifically or in Idaho we actually have three different Medicaid payers so we have to be certified and licensed with each of those payers in Colorado there's just one pair but it's a third party it's not done through the
00:03:22
state and so we that's who we bill for those but we're given from the case managers for our residents what is called a par and a petty and I don't remember what those stand for but it basically is telling us this is the the level of care that these residents have here's their diagnosis blah blah blah and here's their daily rate for what you can Bill Medicaid to receive for the services that you are rendering to that to that Resident and let's call it a hundred dollars a day just for quick and
00:03:54
easy Mass math um it's typically like a hundred dollars is definitely within the range in my experience with these I've seen them like 80 to 130. so a hundred dollars is you know it's pretty decent actually and I think realistic your State's going to be different so make sure you do the research on your specific state to figure that out but let's just call it a hundred dollars a day and you've got 30 days in a month so every day that that Resident is at your facility you are billing Medicaid for those for
00:04:24
those days and so if it's a hundred dollars a day you multiply that by 30 days that's three thousand dollars that's coming to you for the resident from Medicaid which is great you know three thousand dollars is is pretty good for that facility and if you want to learn the truth about kind of how how you get paid and the truth about you know can you make Thirty forty thousand dollars in residential Assisted Living I'm gonna link up one of my uh best videos up there and kind of walks you
00:04:50
through the process so you can kind of really get a feel for what that looks like but uh you know quick answer yes you can uh just let you know a little secret there you can easily make 30 to 40 Grand a month uh in residential Assisted Living now there's some caveats to that so make sure you go watch that video uh to learn a little bit more about that but uh you know you've got three thousand dollars there the next part of it on that part on Petty is actually going to tell you a little bit more and
00:05:15
they call us different things in different areas it could be share of costs it could be rough which is rent utilities and food but your resident is also going to have to pay you a portion out of their own Social Security money to stay at your house the there are standards that they have to be able to keep a certain amount of money call it 150 a month that they can use however they want but the remaining amount of their social security income actually comes to you through that share of costs or that rough payment and and you
00:05:45
collect that directly from your resident and it's outlined for you in the par and Petty uh that is that you receive from the case manager so you're going to receive that information it tells you you can bill this resident 800 a month and so that you build that Resident the 800 a month and now you've got 3 800 a month for each Medicaid resident their rates and things are going to fluctuate but that's you know that's a pretty uh I would say realistic number that you'd be looking at based off of the experience
00:06:11
that I have in my facilities 3 800 a month for a Medicaid resident you know that that that seems pretty realistic so that's kind of how Medicaid works and how you get funded how you how you get paid for it getting paid uh by Medicaid you have to be certified with Medicaid so you want to go through the process talk to the state talk to those 30 part third party administrators figure out what their application process is like and make sure that you follow it to a t when they tell you to do something make
00:06:37
sure you give them exactly what they ask for um if not I've got Horror Story I think I've told this before where it took us forever to get uh things in line at our facility in Colorado and uh it was pretty stressful for a little bit there just because the application process with the Medicaid administrator was just a pain anyways so you you've got those things you've got you've got everything in line and then once you have done that um now you can accept residents Medicaid residence and you can bring them into
00:07:10
the facility Medicaid residents are actually really easy to find um there's a ton of them a ton of people are on on Medicaid especially in Colorado and Idaho and you know I think this is pretty common throughout a lot of facilities actually don't want to work with Medicaid it can be a bit of a headache and you could maybe make more at your facility if you went private pay especially if you're a high-end facility but something that you can do with Medicaid is you can have shared beds and
00:07:38
it doesn't affect their their daily rates that that you're paying so you can have two people in a room so if I'm getting paid 3 800 per resident I've got two residents in a room I'm making 7 600 out of that room is for me especially in Idaho and Colorado for me to get paid that much from a private pay resident it's going to be pretty hard it's also going to be really hard for me to find those residents that are willing to pay that much money um that need the level of
00:08:07
care that I'm willing to offer whereas I can do Medicaid residence all day and I can get them into the facility and I'm making a pretty good amount of money from those types of residents so this is why Medicaid is actually a pretty good thing this might be the best kept secret in assisted living and you know people don't want to deal with it especially the big box ones some of these larger types of facilities because there's the headache of billing and trying to go through that and yeah it can it can be a
00:08:35
pain and sometimes you know if you forget to do the daily radio you don't get the updated parm Petty or you're you don't stay up to date with the different State updates and things like that it can it can be a pain but if you are up to date and you're staying up to date on those things it's a super easy way to to bring residents into the facility oftentimes what you're going to see the best way for you to do this is to work with rehab facilities and hospitals and working with them to help you find new
00:09:05
admits for your facility and when you go through that process you're going to be able to find a lot of residents and you're going to the other nice thing about this is you're going to kind of have The Pick of your residence they you know they'll be able to you'll have multiple residents that are on your waiting list because they want to get into the facility and then you can do your interview and intake process and if you find ones that need more cares that you can handle or you're in the
00:09:29
interview process and you're just like I don't think this person is going to be a good fit for me in my facility based off of the type of culture we're trying to build here they're going to disrupt things in the house you don't have to accept them because there's just another one that's that's down the line that you're going to be able to find and help bring into the facility so it's a really good way especially if you're getting just getting started in assisted living
00:09:50
and you need to fill those beds and start getting income quickly it's actually a really good way for you to to do that if you are a Medicaid provider if you are an assisted living facility that accepts Medicaid make sure you comment down below I'd love to hear from you what your experience is like what state are you operating in and what's that reimbursement model look like in your state if you have done Medicaid and you have horror stories of why you don't think Medicaid is the best way to go
00:10:18
comment those down below as well I think people would really benefit from learning some of that information from you I think that would be really insightful and helpful as people get started on their journey and if you have just general questions about starting your own assisted living facility make sure you comment those down below it helps me build content that is specific to you I'm really trying to make some changes here on the channel and give you content that you are actually looking for as you get started on your Assisted
00:10:44
Living investing Journey are you interested in getting started in a residential assisted living but you don't know where to get started here at assisted livinginvesting.net we're here to help you through that process start to finish make sure you get over to the website assisted livinginvesting.net for access to our free calculator thanks for watching and have a great day foreign [Music]
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