Mom Got Worse While Waiting on the Medicaid List — How a Rescreen Works
In this article
If your mom got worse while she waited for Florida Medicaid long term care, call her local Aging and Disability Resource Center and ask for a rescreening because of a significant change. Her place on the list comes from a priority score set at the last screening, so a fall, a hospital stay or a new diagnosis changes nothing until the screening is done again. Time on the list does not raise her score either.
Why waiting does not help
Many families assume the list works like a deli counter. It does not. The Agency for Health Care Administration says plainly that release from the wait list is not based on how long a person's name is on it. Each month the Department of Elder Affairs releases people based on their score and frailty level, as far as funded openings allow.
The score comes from one place, the screening your mom did over the phone. The state then sorts every score into a rank:
| Rank | What it means |
|---|---|
| 1 and 2 | Low priority, scores from 0 to 29 |
| 3, 4 and 5 | High priority, scores from 30 up, with 46 and above the most frail |
| 6, 7 and 8 | Aging out referral, imminent risk, and Adult Protective Services high risk referral |
People in the low ranks are not placed on the waitlist at all. They get information about community resources instead. So a decline since the last screening matters in two ways. A high rank can climb, and a low rank can become a place on the list.
What counts as a significant change
You do not have to guess. The state's screening page lists five situations, which come from section 409.962 of the Florida Statutes:
- A change in health after an accident or illness
- An actual or expected change in where she lives
- A change in the caregiver relationship
- Loss or damage to her home, or a home that has become unsafe
- The loss of her spouse or caregiver
A broken hip, a stroke, a first dementia diagnosis, or a husband who can no longer lift her all fit. A bad week does not. If you are not sure, call and describe what happened. The center can tell you whether it qualifies.
How to ask for the rescreening
Your mom or her authorized representative makes the request. An authorized representative is someone with legal authority to make decisions for her in the screening and eligibility process, such as an agent under a power of attorney or a guardian, and the center may ask to see that paper.
Before you call, write down the date of the event, the hospital or doctor involved, and what she can no longer do alone. Bathing, dressing, transferring, eating and medications are what the screening asks about, so answer in those terms.
Then work through these steps in order:
| Step | Who to call | What it settles |
|---|---|---|
| Ask for a rescreening after a significant change | Elder Helpline, (800) 963-5337, which routes you to her regional center | Whether a new screening is scheduled and who does it |
| Do the screening by phone, with the caregiver on the line | The center's screener | Her new score and rank |
| Ask for a copy of the completed screening | The center, or the Department of Elder Affairs | The exact answers behind the score |
| Dispute a result you think is wrong | The notice you receive explains how to request an administrative fair hearing | Whether the state reviews the score |
| Check the financial side at the same time | Department of Children and Families, (866) 762-2237 | Whether her income and assets would qualify once she is released |
| Ask what a stay would cost and whether Medicaid applies | Sugarmill Manor (352) 382-2531 or The Gardens (352) 794-7601 | What care she can get while the state decides |
The written notice after any screening tells you her rank and how to request a rescreening, a copy of the screening tool, or a fair hearing. Keep that letter. It names the right contacts for your county.
The part that works against us and against you
A higher score is not a date. Release depends on funded openings, and the state decides how many each month. A family can do everything right, get her moved up a rank, and still wait. We cannot move her up the list, and no community can.
There is a second catch. A community chooses whether to accept Medicaid, and not every community in Citrus County does. Approval from the state does not help if the building you want is not one of them. Sugarmill Manor in Homosassa and The Gardens in Crystal River both accept Medicaid, and both offer assisted living and a secured memory care section in the same building, so she would not have to move again if her memory declines.
What to do about the months in between
If her new rank is high, expect to wait and plan for it. Some families bridge with a short respite stay, some pay privately for a few months, and some bring in help at home. Our post on Medicaid pending and assisted living in Florida lays out the four common ways to bridge the gap, and the long term care benefit explained covers the screening itself. If she is currently in a nursing home, ask the social worker about the 60 day exception, because that route skips the waitlist.
The most useful habit is simple. Every time something changes, a fall, a new medication, a caregiver who burns out, call the center that week and ask whether it counts. Each call is free, and the score only reflects what the state has been told.
Frequently asked questions
Does time on the Florida Medicaid long term care waitlist raise my mom’s priority?
No. The state releases people each month by priority score and frailty level, not by how long they have waited. Only a new screening can change the score.
How do I ask for a rescreening after my mom gets worse?
Call the Elder Helpline at (800) 963-5337 or her regional Aging and Disability Resource Center. Your mom or her authorized representative asks for a rescreening because of a significant change. The screening is done by phone and takes about 45 minutes to an hour.
What counts as a significant change for a rescreening?
A health change after an accident or illness, a change in living situation, a change in the caregiver relationship, loss or damage to the home, or the loss of a spouse or caregiver.
Can a rescreening lower my mom’s rank?
Yes, the score reflects whatever the new screening finds, so describe her needs fully and accurately. If you disagree with a result, the notice explains how to request an administrative fair hearing.
Sources
Written by
Community Relations Director
Cameron Hernando Clark is the Community Relations Director for The Manors of Citrus. He writes this family guide to help Citrus County families make sense of assisted living and memory care, drawing on the day to day of running two family owned communities on Florida's Nature Coast.
Keep reading
Mom's Income Is Too High for Medicaid — Qualified Income Trusts in Florida
The Money Runs Out While Mom Is in Assisted Living — What Happens Next in Florida
Mom Needs Assisted Living Now but Medicaid Is Still Pending — What Florida Families Do
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