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Hi, I’m James with Parkinson disease. i have had Parkinson for 20 years, but now it is getting worse and i need 24 hour care. i thought i could get in the nursing home, but found out its nearly impossible. you can’t get in the nursing home on Medicare unless you’ve been in the hospital the 3 days prior, and you can’t get in the hospital because your doctor says you don’t have any visible injury or broken bones. and you can’t get in on Medicaid because you have to have been in the nursing home for 30 days. this is unreal. I’m unable to care for myself and have no one that can. Does anyone know how to get through this classic government stumbling block?....THANKS

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There are some amazing answers on here - thanks all of you!
Medicaid will be possible once you assets run out - Medicaid help for the poor so you need to qualify financially. Medicare doesn't pay for nursing homes, long-term, though as has been pointed out, states vary with what they pay for.
If your doctor says you need nursing home care, you likely can get it, but it will probably be private pay until you no longer have assets, then you will qualify for Medicaid.
I agree that you may need another doctor to help you jump through the hoops. I also agree you may need to get on a nursing home list, as the best ones often have waiting lists. However, that can change fast when many of their residents are in the 80s and 90s. So, don't let a list discourage you.
The suggestion that you go to www.medicare.gov is excellent. If you spend time on the site you can get some good information. Do some of the footwork yourself (or get a friend or family member to do it), and see if a different doctor is necessary. Maybe being more insistent about your need for better care is what is needed with this doctor. Good luck - it's often a longer and more complicated journey to get care than it should be, but that is the reality we face at this time.
Carol
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As a former nursing home social worker, I can give you some ideas to consider. First, go to www.medicare.gov.....to get the nursing home surveys. You will find out information on all nursing homes throughout the country. When you find a nursing home in your area that appeals to you, see if they are strictly private pay or if they also accept medicaid. When you pick the nursing homes that fit the bill, tour them. See if they use their own staff, or contracted staff. Much more oversite with inhouse staff, trust me! You may want to apply for a bed, however, there may be a waiting list. One tip-it's oftentimes easier to get into a nursing home after a hospitalization....there are reasons, but I'll just leave it at that. Once you are in the skilled part of the nursing home, it is usually easier to go into the intermediate care side, when the medicare is exhausted. If your doctor refuses to help, find another doctor. Hope that helps!!!
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Why are there so many rules and regulations, that sometimes seem to contraditct each other, and sometimes run in circles like catch 22? Probably because they were enacted by different bodies at different times and for different reasons, and nobody has ever taken on the daunting and politically thankless task of coordinating them and trying to achieve some consistency. As an elder law attorney pointed out to me, many of the older laws are aimed at keeping people from cheating the government out of taxes or getting benefits through fraud. They are meant to protect taxpayers. Many newer laws recognize the vulnerability of elders and aim at protecting them from exploitation and providing benefits for them. The whole mishmash of laws doesn't work together very well because it is not designed as a cohesive whole, protecting both vulnerable adults and taxpayers. And as a psychiatrist I respect explained it, medical science is leaps and bounds ahead of social science. We have figured out how to enable people to live much, much longer. We haven't spend much quality time trying to figure out how to deal with the problems and challenges that face us with an greatly increased elderly population.
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You might want to try another doctor. If your disease is truly debilitating and you explain it well enough you may be able to receive the care you need.
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You are correct, those are the rules, it is very frustrating at times to get placed and have it covered by insurance. The three day stay in the hospital used to be much easier to convince the doctor however with the new rules the doctors have to follow w Medicare and Medicaid they are not admitting people anymore for the three day stay. I would hope and Expert will jump on and answer here for you as well as try to locate a new doctor if your current doctor will not help you. Also if you’re current doctor has a social worker, try to speak to them for help as well.
Blessings,

Bridget
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Try your local VNA. They have ways to expedite things and jump through some of the loopholes.
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