harllee
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Some of the more established CCRCs in NC are Medicaid certified and thus have Medicaid residents. You can peruse the CCRCs in NC that have Medicaid certified status from this official NC Guide on CCRCs. https://www.ncdoi.gov/documents/continuing-care-retirement-communities/ccrc-reference-guide/open
There are nuanced reasons for some CCRCs to have Medicaid certified facilities. And perhaps some CCRCs initially created, when first operating, far too many nursing beds it needed to accomodate initial entry classes of CCRC residents and thus permitted "direct admits" in the skilled nursing facility wing of the CCRC to offset the cost of having too many bed vacancies; thus, these CCRCs were willing to take on Medicaid residents.
For those CCRCs that are not Medicaid certified, they seem to walk a careful tightrope of having enough nursing beds to accomodate current and projected needs of the CCRC residents. If a CCRC has too many vacant and unused nursing beds, it could be a drain on its financial resources -- I'd imagine state health regulations might require certain staffing requirements based on number of beds available. On the other hand, if it slowly builds and expands bed capacity, it might result in demand exceeding bed capacity with the result that many CCRC residents have their skilled nursing care outsourced to another SNF, off the campus of the CCRC. One should carefully look at occupancy levels and expansion plans for all wings at a CCRC, especially the skilled nursing wing.
Frankly, we haven't been viewing older CCRCs that have Medicaid certified status. But we are very concerned that a CCRC has Medicare certified status. It's important to us that the skilled nursing wing of a CCRC (and the nomenclature they use around here is "health center" as in Stewart Health Center, Embrace Health Center, or Asbury Health Center -- all part of the CCRCs down here) has Medicare certified status so that it can serve as a rehabilitation facility for Medicare purposes. If you're in a CCRC and have knee or hip replacement surgery, I'd want to be able to do rehab and PT on the CCRC campus and not have to go to another rehab facility.
For sure you would want your CCRC to be MEDICARE certified. The Medicaid certification issue is confusing to me. I know that my CCRC is Medicare certified and not Medicaid certified. In looking at the NC list I see there are some fee for services CCRCs listed as taking Medicaid but I don't think that list as accurate. For example, my mother is in a CCRC that is fee for services. The list shows that CCRC takes Medicaid but I have been told they do not and in fact they have a trust fund for people who run out of money. I was told that one of the reasons they do not take Medicaid is that they would have to open their skilled nursing units to the general public and would not be able to limit skilled nursing to just those coming from independent living.
If a CCRC says they take Medicaid I would take that with a grain of salt and do some independent investigation.