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advocateforemd Asked December 2017

Told by ER doctor that Medicaid & Medicare will not pay for mom to return to nursing facility. Please advise.

My mother left the nursing home she was at against doctor's orders 47 days ago because she became extremely depressed being there. She lived with relatives for the time being and her health has once again deteriorated. She has many ailments (constantly falls, diabetes, bipolar, schizophrenia, dementia, severe clinical depression, high blood pressure, incontinence, UTIs) and the relatives can no longer take care of her. She has been to the ER twice since Thursday but is discharged because the doctors said that Medicaid & Medicare will not pay for a nursing home again. Please advice. We are at a loss.

advocateforemd Dec 2017
She is not being seeing by geriatric psychiatrist. When she went into the nursing home in May, we were told that she would be seeing both a psychiatrist on a monthly basis & a psychologist on a weekly basis, well since her admission in May, the psychologist never saw her until I asked to speak to her regarding an issue - in late October and that's when the facility admitted that they had dropped the ball.

jeannegibbs Dec 2017
I'd suggest talking to the medicaid case worker about this. Sometimes there are rule exceptions for persons with mental illness.

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BarbBrooklyn Dec 2017
She needs to have 60 days of no admission to the hospital before her NH eligibility gets reset, I think.

Are her mental health issues being addressed? Has she been seen by a geriatric psychiatrist to address them with medication?

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