I’ve seen the difference in the quality of care given to folks paying their own way in residential care and folks who are Medicare/Medicaid dual eligibles.
All I can say is that if you’re one of those gaming the system to get Medicaid, you’d better pray your kids love you.
Because you’ll get the quality of care you’re paying for.
My mom started in a great facility. After three years she ran out of money. But she was “grandfathered” into the same facility. With the same staff. The quality of the care THOSE people gave her did not change.
That comes with spending time at the facility. They really cared for her, and it showed.