‘Assisted living’ was a relatively new concept 25 years ago but is now the most preferred long-term care option for the growing population of seniors. However, costs and restrictions often limit access to many.
Assisted living communities provide 24-hour supervision and limited health care to thousands of seniors and disabled Virginians. To live there, many residents must use federal benefits and Medicaid, and some also receive a small state auxiliary grant. The Joint Legislative Audit and Review Commission’s Walt Smiley told lawmakers that if community groups or families want to help financially, that could jeopardize eligibility for benefits.
“Payments from third parties cannot be used for food or shelter. These are the federal rules. And to use money from third parties for a private room or to provide better food, for example, would likely disqualify the individual from continuing to receive those benefits and maybe from Medicaid as well,” said Smiley.
But he said third-party payments for services such as medicines, eyeglasses, or dental care, would not hurt eligibility and could be helpful.
“The recipients have a significant problem paying for dental services. Many Auxiliary Grant residents get their teeth pulled instead of fixed because it’s all they can afford,” he said.
JLARC’s report proposed state legislation to clarify that third-party funds can be used—but not for room and board.
–Anne Marie Morgan