No. of Recommendations: 4
...Seems like the Federal Gov't needs to clean this up and offer some clarity on pricing like they did with Medicare Supplement Plans years ago (e.g., Plan A through N) Just about every LTC facility accepts Medicaid, so it's doable...

Oh, I'm a big fan of clarity. But in eldercare, there's also a lot of experimentation* and innovation, and I think that's good overall even though it's chaotic at the moment.

Per Atul Gawande's "Being Mortal," even though people have gotten old ever since people even existed, it's a new situation now for many reasons, the primary one being so many more people are old, and need help, in proportion to the number of younger people available to provide said help. So the hunt is on for efficiency, which is rather the opposite of hands-on individual attention.

And the underlying assumption of Medicare and Medicaid is that family will provide LTC (as has been the case historically), with Medicare/Medicaid stepping in only when the need crosses the line into medical care: specifically, skilled nursing, such as is required with IV and feeding tube maintenance. Help with ADL's is not medical, much less help with IADL's.

* to find out, from the provider's perspective, how much care people are willing/able to pay for. For example, Fox Hill in Bethesda, MD, opened as a luxury white-glove retirement community, but almost went bankrupt overestimating the number of people willing and able to pay for it.
* also, to find out how best to identify dementia: it's more than just Alzheimers.
* also, to find out how best to care for people with dementia. It's a moving target as research progresses.
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