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I live in Texas & Texas as I have said often does not make good advocates for the elderly. There are medicare beds (of course only for 100 days & after hosp.), there are NH medicaid beds & private pay like any state I guess. My dad has been on NH medicaid since 2010 because of dementia. NH medicaid dumpings are much too frequent. His 100 days ends again on Tuesday & he will have his 3rd move since the first day of the 100 even tho this facility promised him a long-term bed when he transferred there from the rehab facility he had spent the 1st 30 days at. The rehab was 5 mins from my house, a private room & an excellent PT. He could have stayed there the whole 100 days & moved once to a medicaid bed & been healthier for longer since the PT was stronger but their suggestion was to move him while still having more of the 100 days left to get a long-term bed with. Well the place 40 mins away said they had every bed dual-certified in their bldg & that he would be admitted medicaid & they would just keep billing medicare so he could PT. This is a place with a very high ranking with the state & bragging rights in the NH comm. I believed them when they said he could stay long-term. I asked again every couple weeks. Today Frid. 2-21 was informed in the afternoon that in fact that was not a dual cert bed & that by Wed he would have to move or incur a private bill because even tho he has medicaid they would not pay his bill since he is tech in a medicare only bed. Every time I asked the state about this I was told that the bldg would have no reason to try this as they would be giving away free care now I call the state to tell them he is dumped again & they say oh yeah it isn't all dual. So today I am calling other fac. in the area & am told no problem that every bed in their bdg is dual certified so yes they have a bed for him. I call the state omb back to look this bed cert up & once again NO not every bed is dual certified but there couldn't be a problem because they wouldn't have anything to gain by admit. him then having no one paying past Wed. except that that is exactly what keeps happening. These NH are coined Dual cert. facilities because most beds in there are. But since the state & corp. offices don't choose how many beds in there are given to each insurance patient there is no prevention for this, there is no advocacy for this except the pat on the head & someone making sure the patient will not fall through the cracks in the lie & have no coverage which of course has brought on admission paperwork in each facility that a family is forced to sign at admit that will use the estate (a home if still owned & allowed) to combat the state rule of what is exempt. And still no prevention for this to occur since no one except the administrator of the building chooses which insurances are certified for each bed. So these demented patients are basically moved around like the homeless from corner to corner. Now on top of this since all that work for the state & all that work for the NH system every building exists in a make-believe world of every building operating like it says by state rule. You know the world on paper. And so as these patients are moved for money reasons each move has to go documented that it was family's or patient's decision to transfer out so in the future when you really need to move them for financial reasons or the fac decision again they are blacklisted for the family not ever being pleased with a building's care since no one will fall on their sword at that building & admit they are making you move. Especially if across the hall they are willing to move him to another non-medicaid bed (nothing they can give you in writing to back that up) & you are still choosing to move him. It's my fault for moving him instead of letting him go uncovered. And again the state can't do anything nor can corporate since there is no paperwork showing which insurance he was admitted under.

Any suggestions to avoid moving him Wed and having him unpaid Wednesday on his 100th day since I already tried everything to avoid this all along to no avail?

And people still think facilitation is a good idea?

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KatheleenPlano - do you think that dad may be "red-flagged" by Medicaid because of the Florida property? I would look to facilities up in McKinney, even up to between McK and the OK border….where there is less competition for dual beds.
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You have stated elsewhere that you don't want him to have painkillers or antibiotics, and argue with the facilities he has been in. You are correct in thinking that you are being blacklisted. You are running out of options now. So leave him where he is and give up your POA before the courts take it away from you for attempting to deny palliative care.
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You have a real problem on your hands, because effective 1/1/14 he no longer gets 100 days on Medicare, but only 20 days. You leave him where he is and refuse to pick him up. As far as the home being exempt, it is only exempt as long as he intends to return to it, which he won't. It is also no longer exempt when he dies, and Medicaid Estate Recovery Program (MERP) will put a lien on his entire estate. So they are going to get the house anyway. Leave him in there.
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