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careforpops Asked January 2015

Why would nursing homes deny my Dad?

We only want my father to go to the nursing home for the 20 days that the insurance pays for and the nursing homes are denying him due to his age and that he is going through cancer treatments they think he will stay longer we want him home he can't walk without assistance and needs rehab to get stronger on his feet

BarbBrooklyn Jan 2015
If dad is in the hospital, talk to the discharge team about what is realistic for expectations for rehab. Who is telling that the nh is denying because of age and cancer? That doesn't sound as though this is being explained by the discharge folks. Is the second hand info?

Countrymouse Jan 2015
If your insurers will pay for rehab but you can't find any, would they consider paying for PT and HCA assistance at home instead (assuming you'd be able to source those, of course)? Would that be a possibility? It can't hurt to ask.

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4grace Jan 2015
Thank you igloo. I was just trying to help.

pamstegma Jan 2015
No they don't deny because of age. They deny if the insurance is not approved, they deny if they don't accept Medicaid. If the family is not on the same page as the rest of the discharge team, namely the social worker, discharge coordinator and the MD's, it's a no go. You may have to give in a little, set aside the emotional issues and do what is best for Dad.

igloo572 Jan 2015
4grace - it's not you! What the OP wrote is somewhat confusing.

If care4pops is doing this on her own and trying to set the terms of stay, it is going to be most difficult to get a facility to take him. If this was all private pay & $$$ not an issue, no problems.
If her plan is for the facilty to get him ambulatory in the 20 day insurance paid window, well a good facility isn't going to ever agree to that. Christine73 summed that up spot-on.

also insurers have issues with a patient signing out AMA; insurer can decline to pay. If dad is not ready at day 21, and they still take him home, insurer may not pay the facility. Facility will have to chase family to pay.

It may be that the family needs to have a reality check on what the 90 day near future is likely for dad (cancer, perhaps advanced elderly, non ambulatory, pain management?) rather than 21 days insurance coverage.

Christine73 Jan 2015
This doesn't sound like a very good nursing home. I'm sorry, but it's better that you know. If they actually said they're "afraid" he'll stay longer, that's not good. If he needs to stay, they should accommodate him. On the other hand, if you've refused...

Your post does not indicate where your dad is now. If he's in the hospital, the social worker there is supposed to find him a rehab facility that is suitable for him. If you went in and told them you would only allow him to stay 20 days, that may be a different story. They may know from experience that he needs to be there longer and if you take him out and he falls again, they will look bad. There may even be liability issues. You need to talk to the hospital social worker. It sounds like finances are an issue. He may be able to get on "temporary medicaid." If he's not in the hospital, I would recommend taking him there. They will definitely admit him, and then finding him a suitable facility will become their problem. Good luck to you!

terryjack1 Jan 2015
In order for medicare to pay for skilled services, your dad must have had a 3 day hospital stay and a physician's order for rehab. It could be the facility is not a medicare facility, meaning they are not certified to have medicare as a payment source. It really sounds like they may be afraid if he uses all of his medicare days, he won't have a payor source and nursing home care is expensive, around $200.00 average per day. His age and whatever treatment he is receiving shouldn't matter. He can still continue with his cancer treatments like he has been. I'd speak with his physician and look at another nursing facility for placement.

4grace Jan 2015
My apologies. I thought dad was at home. If dad is already in the hospital and going to be discharged and needs addtl care before going home rehab.home appears reasonable. Ie with or without private insurance and or medicare or medicaid.

igloo572 Jan 2015
? Dad is in hospital & this is about a discharge from there to rehab within a NH?
OR is he home and you want him to go to rehab?

4grace Jan 2015
Trying contacting his primary care physician to see if he ir she can help. Another alternative: see if they will admit him into the hospital. I was able to have my dad admitted to the hospital for 28 days when I had to go away on business...he was also terminally ill and bed bound.
Good luck.

surprise Jan 2015
There's a lot of cost for setting up a file on a pt, making sure the papers are in order, disrupting other pt routines, etc.The NH is a business, and those first 20 days don't make them enough money to justify bringing in your father. If he needs rehab, perhaps a rehab center is the answer, not a NH. A friend has to go an hour from home for her father's residential rehab unit, the only one around which takes dementia pts. He's in for 3 mos for a broken hip.

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