If the money runs out

Last reviewed: August 27, 2026

This page is for adult children on Colorado’s Western Slope whose parent is paying privately for assisted living, or is about to, and who need to know what happens if that money runs out. It is educational only. It is not legal or financial advice, and it is not a recommendation of any home.

This directory is a separate business from High Desert Assisted Living in Clifton, Colorado. Jason and Laura Cheney operate both; the directory is not an official state list and is not a CDPHE, HCPF, or Medicare rating tool. Nothing on this page is a recommendation of that home.

Colorado does not automatically convert a private-pay assisted living home into a Medicaid home. It does not require that home to keep someone who cannot pay.

The short version

A private-pay (Licensed Only) home is not required to become an Alternative Care Facility (ACF) or to keep someone who cannot pay the resident agreement.

An ACF is a licensed Assisted Living Residence plus HCPF certification. Health First Colorado (Medicaid) may pay services only if the person is on the EBD waiver, the CMHS waiver, or the Medicaid Buy-In Program. The resident still pays full room and board.

Certification is not a reserved bed. Not every ACF has a vacancy. HCPF’s Alternative Care Facilities page has no public facility list. Confirm the official type on CDPHE Find and Compare and with the Case Management Agency.

There is no Chapter 7 “Medicaid pending” hold. If a home offers to hold a bed while an application is pending, that is their contract, not a state right. Get it in writing.

This page does not walk through a spend-down that “keeps you in this house.” No official HCPF consumer page opened for this guide fills that gap. This page does not promise that any named home will convert to Medicaid.

If the home starts a nonpayment discharge: 30-day written notice, possible discharge on day 31, a 14-day grievance, and a path back if the process finds the resident was substantially current. That is a clock, not a right to stay unpaid.

VA Aid and Attendance can be extra cash for an eligible veteran or survivor. It does not turn the home into a Medicaid provider.

Two kinds of licensed homes

	ACF-certified ALR	Licensed Only (private-pay-only)
What it is	A CDPHE-licensed Assisted Living Residence and HCPF-certified as an Alternative Care Facility.	A CDPHE-licensed Assisted Living Residence that is not HCPF-certified as an ACF on the official record.
What Medicaid may pay	Services in the ACF package (24-hour protective oversight, daily-living help, personal care, homemaker) if the person is enrolled in EBD, CMHS, or Buy-In.	Nothing for that home’s ACF services. A Licensed Only home is not certified to bill them. Do not invent a path that “they will go on Medicaid here.”
What the resident still pays	Full room and board. HCPF’s glossary: “You pay the full cost of room and board and may have to share the cost of the services.” Room and board is not an ACF benefit.	Whatever the signed resident agreement says.
Must they keep someone who cannot pay?	No official page opened for this guide says that. Nonpayment of basic services is still a discharge reason. ACF certification does not replace Chapter 7 discharge rules.	No. A Licensed Only home is not obligated to become an ACF or to keep a resident who cannot pay.
Must they become an ACF if someone spends down?	Already certified — still not a guarantee of a bed, a waiver slot, or financial eligibility.	No official page requires that conversion. Do not say they “will go on Medicaid.”
How to tell	Ask in writing: “Are you currently HCPF-certified as an Alternative Care Facility, and which waivers do you accept?” On Find and Compare, the official ACF type string on the August 27, 2026 roster export was `Assisted Living Residence/Alternative Care Facility (Medicaid)`. Confirm with RMHP CMA. A payor source that merely says “Medicaid” is not enough by itself.	Same tools. Type string `Assisted Living Residence (Licensed Only)` means ACF is not shown on that CDPHE record.
A bed	Not every ACF has a bed. Certification is not a vacancy.	Same. A Licensed Only home may also be full.

This page does not name a home that will convert, become an ACF, or keep a resident when private pay ends. No official page opened for this guide states that home-specific fact.

Treat ACF as licensed assisted living plus HCPF certification. This page does not name a single controlling HCPF rule number.

Ask this in writing before you move in

Get the answers on paper or email, not a tour pitch. Ask now if money may run out later.

Are you currently HCPF-certified as an Alternative Care Facility? Not “do you take Medicaid,” not “we have helped people apply.” Current certification.
Which waivers? HCPF’s ACF page lists EBD, CMHS, and Buy-In. Ask which they actually accept today.
If I spend down, do I stay here or move? If I become eligible for Health First Colorado, will you accept it for services in this building, or must I move? A Licensed Only home is not obligated to become an ACF or to keep the person. An ACF still may not have a bed, and the resident still owes room and board.
What is room-and-board vs care in this agreement? Chapter 7 11.6(C) requires a list of services included in the agreed rate and every optional service with the specified charge. In an ACF, the member pays full room and board and may share the cost of services.
Is 30-day discharge for nonpayment in this agreement? 11.6(G) requires the agreement to list the involuntary-discharge reasons from 11.11 and 11.12. 11.12(A) is “Nonpayment of basic services in accordance with the resident agreement.” Confirm the list actually names nonpayment.
Who does this agreement bind — the resident only, or a family signature as guarantor? Chapter 7 and CRS 25-27 are silent on “guarantor.” Ask. This page does not invent a “never sign as guarantor” statute.

There is no Chapter 7 “Medicaid pending” hold. A search of the current rule found zero hits for “Medicaid pending,” “pending Medicaid,” or a required hold while an application is pending. No CDPHE consumer page opened for this guide states one. If a home offers a hold, that is their contract term — get the amount and the rules in the 11.6 list. Do not treat it as a state right.

A hold-a-place fee in 11.6(D) is about holding a bed while the resident is away (hospital, visit). It is not a Medicaid-pending hold.

The agreement must also list charges, refunds, and deposit policies (11.6(A)); a security-deposit refund if the home closes without 30 days’ written notice (11.6(F)); and the involuntary-discharge reasons, including nonpayment (11.6(G)).

If you are already there and the money is running out

Do this early. Eligibility and a Case Management Agency assessment take time. A discharge clock can be 30 days.

1. Apply for Health First Colorado and ask the CMA for a functional assessment

These are two tracks. Financial eligibility is Health First Colorado / the county. Waiver / ACF functional eligibility is the Case Management Agency.

Financial — Health First Colorado

Fastest: Colorado PEAK. The apply-now page says PEAK “is the fastest way to apply.”
Phone: 800-221-3943 / Relay 711, Monday–Friday 8 a.m.–4 p.m. (healthfirstcolorado.gov/apply-now).
Existing members: same 800-221-3943; Monday–Friday 8 a.m.–4:30 p.m. except state holidays and the third Thursday 2–4:30 p.m. (get-help).
PEAK tech support: 800-250-7741, Monday–Friday 7:30 a.m.–5:15 p.m.; CBMS.Help@state.co.us.
In person: Mesa County Department of Human Services, Community Services Building, 510 29 1/2 Road, Grand Junction, CO 81504. Mesa Health First Colorado page: 970-241-8480. Building hours on the Human Services page (checked August 27, 2026): Monday–Thursday 7:30 a.m.–5:00 p.m.; Friday 7:30 a.m.–12:00 p.m. Economic Assistance walk-in: Monday–Thursday 7:30 a.m.–4:30 p.m.; Friday 7:30 a.m.–11:30 a.m.

Mesa’s Health First Colorado page still describes Medicaid mainly as a program for children, parents, and pregnant women. That is incomplete for older-adult long-term services. Use HCPF and RMHP CMA for EBD / ACF.

Functional / waiver — Rocky Mountain Health Plans CMA (Mesa is Designated Service Area 17)

2775 Crossroads Blvd., Grand Junction, CO 81506
800-346-4643 or 970-243-7050; CMAintake@uhc.com
Adult waivers listed on that page include EBD and CMHS
HCPF’s EBD page: if already enrolled in Health First Colorado, contact the local CMA to start the waiver process; if not enrolled, apply for Health First Colorado first.

RMHP CMA is a Medicaid long-term-services navigator. It is not a CDPHE complaint line and not a license lookup.

EBD financial tests — quoted from the official HCPF Elderly, Blind, and Disabled waiver page (reopened August 27, 2026):

Income must be less than three times the current Federal SSI limit per month. The HCPF page points to the SSI website. This page does not multiply that figure.
Countable resources less than $2,000 (single) or $3,000 (couple).
If those financial tests are not met, the person may be eligible through the Buy-In Program for Working Adults with Disabilities.
The same page says the person must need services at a level comparable to a nursing facility, and be willing to receive services in home or community. That is a functional test for the waiver. It is not a promise that Medicaid will pay a nursing home instead, and not a promise that assisted living continues in this house.

2. Ask the administrator in writing

Send (and keep a copy):

Are you currently HCPF-certified as an Alternative Care Facility? Which waivers? If Health First Colorado is approved for services, will you accept it in this building, or must we move? What is room-and-board vs care on our signed agreement? If you are not ACF-certified, what is the last date you will keep [name] if we cannot pay the private-pay rate?

If they are not ACF-certified, they cannot bill ACF services. Plan a move. Confirm any ACF they name on Find and Compare (Assisted Living Residence/Alternative Care Facility (Medicaid)) and with RMHP CMA. Not every ACF has a bed.

3. What this is not

Not a published HCPF walkthrough that says “spend down until Medicaid keeps you in this house.” That walkthrough is unverified. Medicare.gov spend-down language is about nursing homes, not assisted living residences.
Not a conversion of a Licensed Only home into an ACF.
Not a guarantee that an ACF will have a bed, accept the person, or waive room and board.
Nursing-facility Medicaid is a different level of care. EBD requires a nursing-facility-comparable need to get the waiver. That is not a promise that assisted living continues, and it is not a same-building transfer right.

4. An income trust exists. It is not a house-conversion tool.

HCPF publishes an official Irrevocable Income Trust Agreement for people who are required to establish one to receive or keep medical-assistance eligibility. Consult the eligibility site to learn whether one is necessary. Trusts must be submitted to HCPF Trust Policy and Recoveries (medicaid-trusts).

The form’s own recital says it is used when gross income exceeds 300% of the individual SSI benefit but is below the average private-pay rate for nursing facilities in the region, to establish income eligibility for long-term-care services (including HCBS and PACE).

That is an income-eligibility instrument. It is not a promise that a private-pay assisted living home will convert or keep the resident. This page does not invent asset-spend-down steps, look-back penalties, or a “this house stays yours on Medicaid” script. Ask HCPF or the eligibility site for the rest.

5. VA Aid and Attendance — extra cash, not conversion

VA Aid and Attendance / Housebound (updated May 8, 2026) is a monthly add-on to a VA pension for qualified veterans and survivors who need help with daily activities (or meet the other A&A / Housebound tests). Cash to the person. Not a program that converts a civilian assisted living home to Medicaid. A person cannot get Aid and Attendance and Housebound at the same time.

Apply online, by mail (VA Form 21-2680 to Pension Intake Center, PO Box 5365, Janesville, WI 53547-5365), or at a VA regional office. Local filing help from the Mesa VSO page (checked August 27, 2026): Anthony “Tony” Lee 970-248-2733, Laura Stanley 970-257-2218, VSO@mesacounty.us. By appointment except Tuesday walk-ins 8 a.m.–3 p.m. The Workforce Center building is 512 29 1/2 Road, Grand Junction, CO 81504. This page does not invent a VSO desk street address or reprint pension-ceiling dollars.

Nonpayment discharge is a clock, not a right to stay unpaid

Sources: 6 CCR 1011-1 Chapter 7 Parts 9.3 and 11.11–11.18 (adopted January 15, 2025; effective March 17, 2025), and CRS 25-27-104.3 (2024 official printout, as used in the companion contracts guide). Chapter 7 9.3 says the home’s involuntary-discharge grievance policy “complies with Section 25-27-104.3, C.R.S.” Later session amendments to that statute were not confirmed in a newer official HTML edition.

This is not legal advice on any one notice. If a notice arrives, call the ombudsman the same day.

The home may discharge for nonpayment of basic services under the resident agreement, or for failure to comply with a valid, signed agreement (11.12). (11.11 is a different list — care-need and safety.)

Default: written notice of any discharge 30 calendar days in advance, to the resident, the legal representative, and anyone the resident named to get discharge notice.

The level-of-care / danger exception (shorter notice) does not apply to nonpayment. Nonpayment uses the 30-day default.

The notice must include detailed reasons with facts and evidence; a recounting of events and steps taken to avoid discharge; the right to file a grievance within 14 days (even if already removed); that the home must respond in five business days; appeal to the CDPHE Executive Director; and names and contacts for the state ombudsman, the local ombudsman, and CDPHE.

A copy of any involuntary-discharge notice goes to the state and local ombudsman within five calendar days (11.18).

Grievance clock (9.3)

File within 14 calendar days after written notice, in writing or orally (keep proof if oral).
Home’s written response no later than 5 business days, to everyone entitled to notice plus the state and local ombudsman.
Appeal to the CDPHE Executive Director within 5 business days of that response.
No retaliation. The home must keep helping plan a discharge or transfer while the grievance or appeal is pending.
A further hearing under CRS 24-4-105 is available if someone is dissatisfied with CDPHE’s findings.

Use the official ALR Involuntary Discharge Notification Form linked from CDPHE consumer resources. If you need help, call the ombudsman.

Day 31, and return if they were current. If the stated reason was nonpayment of monthly services or room and board, the home may discharge on the thirty-first day after written notice. The resident shall be allowed to return if all of these are true: the reason was that nonpayment; the home discharged on or after day 31; and the grievance and appeal process finds the resident substantially complied with payments due.

That is not a right to stay without paying. It is a notice-and-appeal clock, plus a return duty if the process finds the resident was substantially current.

Who can help

Phones below were read on official pages opened August 27, 2026. Call to confirm.

Long-term care ombudsman — a free, confidential, resident-directed advocate for people in licensed assisted living. They may help investigate, prepare, and file a discharge grievance or appeal. They do not license or fine homes. They are not a lawyer.

State office: 303-862-3524; fax 303-292-1139; cdhs_ltcombudsman@state.co.us. Address: 1575 Sherman St., 9th Floor, Denver, CO 80203. coombudsman.org/contact. Every licensed long-term-care facility must display a poster with the assigned ombudsman — start there if the person is already in a home.
Mesa / Region 11 — call to confirm which line is current intake. Official pages list more than one number. This page does not pick one: 970-248-2717 (state directory / Associated Governments of Northwest Colorado), 970-683-2676 (Casey Ashlock on the Mesa AAA page), and 970-644-0407 (Dana Weseman on the same AAA page). 970-248-2717 is also the AAA Heather Jones line on that page. Ask which number is current intake.

Marilyn Richardson is Colorado Legal Services, not the ombudsman. The Mesa AAA page lists her under an ombudsman heading with 970-243-7940 ext. 286 and a CLS email. The ombudsmen named on that page are Ashlock and Weseman. Do not call her the ombudsman.

Colorado Legal Services — nonprofit, free civil legal help (not criminal) for eligible low-income Coloradans and seniors. The Grand Junction office serves Delta, Garfield, Mesa, and Montrose counties. By appointment only. Official get-help phone: 970-243-7940. Mailing address on that official page: P.O. Box 327, Grand Junction, CO 81502. Apply: applyonlinecls.org. CLS is not the ombudsman. They may be able to help with civil issues (housing, public benefits, discharge paperwork) if the person qualifies and they have capacity. Apply. Do not treat an application as a promise of representation. This page does not pick a street address; official CLS lists the mailing box.

Hilltop ADRC — free options counseling on long-term-care options, Medicare/Medicaid benefits, and local services (htop.org/adrc). Mesa AAA: 970-248-2746, option 1. Hilltop also operates senior-living communities (The Commons of Hilltop, The Fountains of Hilltop, The Cottages of Hilltop, plus Senior Daybreak). The ADRC is options counseling, not a referral to Hilltop housing.

Area Agency on Aging of Northwest Colorado: Heather Jones 970-248-2717. Eldercare Locator 800-677-1116. Same 970-248-2717 is Region 11 ombudsman intake on coombudsman.org — confirm with whoever answers.

Rocky Mountain Health Plans CMA: 800-346-4643 or 970-243-7050. Waiver / ACF path. Not a complaint line.

Look the home up yourself on CDPHE Find and Compare. That tool is not a star rating.

Official pages this guide used

This page does not invent conversion promises, ACF dollar amounts, or a spend-down that keeps someone in a named house. It is not a quote and not a recommendation.