The Medicaid Blueprint for Adult Family Care Homes

Guest Speaker:

Jaretta Love, Medicaid Specialist | Saving Grace Advocates

This educational session is designed to help Florida Adult Family Care Home providers better understand how Medicaid works within the AFCH industry and how to successfully navigate the systems connected to resident care, reimbursement, and compliance.

Session Topics Include:

Understanding Medicaid Basics for AFCH Providers

• The role Medicaid plays in long-term care and supportive housing

• The difference between Medicaid, Medicare, and private pay

• Common Medicaid programs connected to AFCH residents

• Understanding Medicaid Managed Care and Long-Term Care plans

Resident Eligibility & Qualification

• How residents qualify for Medicaid-funded services

• Determining level-of-care eligibility

• What documentation residents need during the approval process

• Understanding waitlists, assessments, and case management

Medicaid Waivers & Long-Term Care Programs

• Overview of Florida Medicaid waiver programs

• How SMMC LTC impacts AFCH providers

• Coordinating services with support coordinators and case managers

• Understanding what services may or may not be covered

Billing, Reimbursement & Financial Expectations

• Who bills Medicaid in the AFCH setting

• What services are reimbursable

• Understanding payment structures and authorization requirements

• Common billing mistakes that lead to denials or delays

• Financial considerations when accepting Medicaid residents

Documentation & Compliance Requirements

• Required records and daily documentation practices

• Preparing for audits and compliance reviews

• Maintaining proper resident files and care plans

• Red flags that may trigger Medicaid concerns or investigations

Building a Sustainable AFCH Model

• Determining whether Medicaid is the right fit for your home

• Combining private pay and Medicaid residents

• Building relationships with hospitals, discharge planners, and case managers

• Positioning your AFCH for long-term growth and referrals

Interactive Q&A Session

Providers will also have the opportunity to ask questions directly and receive guidance on common operational and Medicaid-related concerns affecting Adult Family Care Homes in Florida.