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Well, as a registered nurse who has worked in both a Medicare/Medicaid skilled facility and now as Director of Nursing in a totally private pay skilled facility I can tell you I really don't see that much difference in the level of care. In my opinion it has more to do with the particular facility and not so much as to whether the residents are privately paying or on Medicaid. In my experience most facilities who accept Medicaid usually have some private pay residents also, and except for the possible private rooms I really have not noticed any discrimination in the care.
My mother is presently receiving Medicaid assistance in an Assisted Living Facility, and had I thought the care was any different I would have done anything to keep her from going on Medicaid. And of course unless you're filthy rich you're probably all going to end up on Medicaid as it doesn't take very long at all to use up what assets you have and there aren't very many long term care insurance policies I've seen which are very beneficial.
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