Can I refuse to bring my Dad home from hospital and demand he go to a SNF?

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Can I refuse to bring my Dad home from hospital and demand he go to a SNF?

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Thanks for all the input! He has not assets, is upside down on his house, and brings in ~$1600/month so I end up supplementing a lot of his expenses. I've got the Medicaid app ready to go - there's nothing to spend down and I've collected his financial records for the past 5 years. Anyway, I guess I'm wondering if he had a fall, but it isn't deemed serious, how do I get the ER to admit him for the 3 days? It sounds like a couple of people have dealt with this so . . . I should insist he's not safe, needs observation or rehab, can't come back to an unsafe environment? If there's no real medical reason for him to be admitted that's going to be tough. I know hospitals don't like to admit people on medicaid anyway. I guess this is why they try to guilt you into taking the person home. I'm kicking myself for not going this route in April when he had a COPD exacerbation and ended up in the ER. They sent him home on hospice! Still, there is a hospitalist there we've now seen twice and I think he likes me (not like that) so maybe I can sweet-talk him! Isn't it awful though? I don't WANT him to fall again, but I need him to so I can get him placed. It's utterly ridiculous. I've been trying to go through all the right channels and am getting nowhere. I'm trying to keep him safe, but have to have him fall so I can get him to a safe place.

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My mother fell and got a compression fracture. She was sent to the ER. Unbeknownst to me, she was released to go home which was the wrong thing to do. Actually they suggested admitting her to the hospital or dismissal to her home and I did not realize that she would not be capable of caring for herself in the condition she was in. Two days later she fell again and back to the ER she went. Fortunately this time the social worker worked with me to get her into a rehab facility that her Medicare would pay for.

Follow suggestions here to get your father into a rehab facility as it will make the world of difference in his recovery. Now my mother is back in her apartment and is receiving outside home care services. She actually needed the services long before her actual fall as she was destined to fall eventually what with her instability issues.

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This happened to my father. he fell 2 times within 24 hours, my mother called 911, he was checked out-no broken bones, when they said he was okay, i said he could NOT come home. my mother can no longer help him due to her arthritis and with his dementia, it was getting harder to care for him, let alone there was no way she would be able to help him in/out of bed. I am POA so they had pysc dr come in, yes he needs 24/7 care (uh yeah), so they kept him for 3 days but due to him not needing anything special medicare did not pay. so he was sent to NH, did therapy, but we also contacted an ELDER ATTORNEY who is helping us to get things in order for the pay down, then to apply for medicaid. We haven't got his bill yet, and it will come out of their money, but it is worth saving my brother/me/mom the hassle of trying to figure things out. And yes, you can refuse to have your father sent home, you just can't do it anymore for your own health sake, and he will get better/timely care in a home. even though we don't want to see our parents/spouse there, its better than killing yourself......so what good what it do your parent/spouse then......good luck and find a good elder attorney that deals with only this stuff.

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I've never heard of a house being padlocked (unless the applicant wasn't cooperating), but you will need to sell the house. Otherwise they will just refuse coverage. You can take any monies he has and buy him things that pertain to his well being only. Like new clothes, a coat, shoes, a new pair of glasses etc... Just save the receipts.

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Sorry about your situation. I think that I might be in your same boat. Both of my parents are 89 and refuse needed help. Know that the next shoe is going to drop soon. Believe that NH are telling you that they don't have a bed is because they wnat at least 2 years of private pay before they except a person on medicaid . They will not tell you this but it is true. If you have POA see about liquidating assets to pay 2 years and all of a sudden a NHF Bed will be open. In NJ a good NH is about $15,000 dollars a month. I know sad and scary. Know you are overwhelmed. Wish I could help but have trouble with following and doing things myself

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YES {Q}refuse to take him home. It is the quickest route to placement. The hospital needs to insure they are releasing him to an appropriate environment. ..For Medicaid nursing home placement must be medically necessary so the doctor needs to write orders.{EQ}

You say your his guardian. Talk with your elder affairs attorney ASAP. Find out who pays the bill. Was he sent to the hospital under the guardianship?

I would be interested in what that does regarding your financial liability

Do not sign any financial liability agreement in your name.

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MY understanding of the Medicaid recovery process is that they don't exactly "seize" the house--at least not while your dad is alive. But they will require that it be sold afterwards to recoup monies spent by Medicaid on his care, which only seems fair.

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All of the above information is true so follow the advice, As said there will be a lot of pressure put on you but stand firm. They can not put Dad in an ambulance and dump him on the door step. sounds as though Dad does not have assets as you already mentioned Medicaid. you do not have to contribute to his care but all of his assets including house vehicle etc will be seized. So if there are family mementos remove them now because the house will be padlocked. Not a pleaseant process but you have to do what you have to do. Blessings.

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I was able to get my husband into a Nursing Home by requesting he get rehab. He was very unstable after a fall and a concussion. I had him in the NH for three weeks. He did get better and I brought him home. I realize you want to have him admitted permanently. Usually they go from Rehab straight to NH daily living.

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Yes, you can and should refuse to take him home. It is the quickest route to placement. The hospital needs to insure they are releasing him to an appropriate environment. Simply tell them he needs more assistance than you are able to provide. For Medicaid nursing home placement must be medically necessary so the doctor needs to write orders.

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And let us know what happens; I'm so sorry you're going through this stressful time.

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Do as his physician suggested.

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Yes, you can refuse to have him discharged to you. Ask the nurse for a social worker. A social worker is very helpful in this situation and can usually find a bed easier than you would be able to.

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Yes, much of what you say is true. And do the ambulance thing. That is how it works. They have to admit him to the hospital and they can't discharge him if they know either no one is there to help him or it is unsafe environment. You might not have your choice of a SNF and that can be scary, but sounds like yo know what is best. Careful on the medicare to medicaid part though. Two things: Medicare will pay for more than the 20 days and more if he continues to improve. If he plateaus, which means he stops improving, then it becomes private pay or you start the Medicaid application process. It takes months and months to get Medicaid approved AFTER you have done all the leg work of mounds of paperwork and paying down his assets. There will be a 5 year look back period. Read up on this. Too much to type. I know it is hard, I went through it with my Dad, now in a NH and I will probably go through it with my Mom and no sibling support whatsoever. I have teenagers and run a small company. Oh yeah, a husband too who deserves better than the currently situation.

Good luck and stay strong.

xo
-SS

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Yes, you can refuse to accept discharge. They can get very nasty about this, but you need to stand firm. sometimes they are completely helpful; I've seen both situations.

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Can I refuse to bring my Dad home from hospital and demand he go to a SNF?

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