My mother is in a nursing home facility. The facility is new, and I have to be there every single night to make sure she is put to bed correctly. On time, and by directive of the doctor.

The CNA's are different every night, and nobody has the same routine. I worry about her and since I have to be there each night, Medicaid covered, couldn't Medicaid cover someone in my home to do this?

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amcollias, from what I read on your profile, it sounds like your Mother needs a village to take care of her. It would be difficult for one caregiver even working 8 hours per day to handle everything that is needed. Same with the 2nd shift, and with the 3rd shift.
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Actually medicaid In your state will pay for 24/7 homecare.
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I guess, the big question would be - how many seniors receiving round the clock nursing home care - wouldnbe able to live alone or in the care of a relative - in exchange for four hours of government provided in-home care. Four hours as a guess to off-set the ability of one employee being able to look after six seniors in a nursing home? Six to one being a generous ratio as usually it’s not that good.

(Thanks, igloo!)
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Here are some basic Medicaid figures. These numbers are from 2017 so keep in mind that for 2019 the numbers are even bigger.

Number of Medicaid recipients:
73,800,000 million

Of this 43% are children and 10,600,000 are individuals with disabilities.

So, doing the math - that leaves roughly 31,500,000 individuals assumed to be the elderly.

So - just for fun, let’s reduce that by half - assuming not everyone of these elderly needs in home care. 16,000,000.

Now, let’s just say we’re gonna provide these 16 million individuals with in-home care for just four hours a day - to be used for bedtime or showering or meal prep, medication - whatever.

Im picking four hours as I don’t think you’d get many employees willing to or needing to work less than that per shift. And - I’m gonna pay them $15 an hour, although that’s probably a bit low...

$960,000,000.00. That’s Nine hundred and 60 million dollars - A Day.

So - for simplicity, let’s just call it -
One Billion dollars - A Day!

Even if you only gave each one of these 16 million seniors one hour - and you could find a employee willing to put a senior to bed, hop in their car, drive to another senior - put them to bed... lather, rinse, repeat - we’re talking $240,000,000 - that’s Two hundred and forty million dollars a day.

Clearly - my numbers are very, very generalized. But I do think it gives an answer to your question, regardless.

EDIT: It does bring the question to mind - how does this off set the cost of having these 16 million seniors in a nursing home. Although- it’s safe to assume some would be in other settings like Assisted Living as well as still living alone or with relatives. Not all would qualify for NH level of care. Still - I don’t know the answer to that one. But one has to assume that caring in bulk is more cost effective- not to mention the government takes back the seniors entire social security check. Would an in-home senior be willing and/or able to forfeit their check for a minimal amount of government in-home provided care. Would the relative caring for them be able to provide the balance of that care with no SS check from the senior care recipient to help with expenses? All interesting and complicated questions. With no helpful answers from our government- at this time, at least.
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igloo572 Jun 2019
Awesome analogy.
Medicaid does not cover 24\7 care in an individual home because that is very expensive. Some states have waiver programs where they will send in someone for so many hours a day, because that care would be less than cost than a full time nursing home.
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No, Medicaid does not cover 24/7 care in the home.

Why does Mom need to be put to bed "correctly". Why on time? If there is a directive from the doctor than that should be followed. Have you talked to the director of Nursing. Have her explain the procedures and then voice ur concerns.

I see your frustration when it comes to the aides. Like people in general, everyone has there own way of doing things to get the job done. Aides have a number of patients each. They all have to be gotten ready for bed.
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worriedinCali Jun 2019
Medicaid actually does cover 24/7 home care in a few states and the OP happens to be in one of those states :)
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