How hard is it to find a nursing home/assisted living facility for a person who will need to go on Medicaid?

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Mom is 92, uses a walker, has early dementia and is starting to have bathroom issues. She lives with her son and daughter-in-law and often is very nasty to her son, accusing him of stealing. They work all day so she is home alone for long periods of time and with everything going on the dr. Feels this will have to change before too long. She has no assets and very little money. Has anyone dealt with this situation?

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Wow igloo 572! Thank you! I spoke with Senior Planning Services today. They will do the Medicaid application and all the research required as well as help with placement whenever or if ever it is needed. Fee is not cheap but can be part of spend down. I will keep all your suggestions/advice in mind! Good luck districtgal with your parents. My mother-in-law doesn't have enough money for a facility to start with so no surprises....it's Medicaid or no facility!
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One item that gets overlooked in the mice maze that is Medicaid is that they have to qualify medically for skilled nursing care. So much of Medicaid concerns is focused on the financial / spend -down / transfer penalty concerns. But for Medicaid, both "at need" financial & medical is required to be eligible. How your state does this varies.

If they are a private pay admit, the facility can be lots more flexible on the need for skilled nursing. This is a factor as to why some places just do not participate in Medicaid.

Majority of NH admits are via rehab from a hospitalization so medically at need clearly in fat medical file. For those trying to admit coming from home or IL, that is not there. When I moved my mom from IL to NH (totally bypassed the whole AL phase), the state sent out a nursing team to NH to evaluate whether she qualified for skilled. Yes she had MD orders for skilled but still state did review. She was denied so an medical necessity appeal needed to be done. The issue was the NH CNA intake did not put down all of moms medications, now RX were done but did not make it into her chart. (btw this was the start of the issues with NH #1....) When state came to do their once over of mom 2 days after her admission, only 1 RX in file (she had 5). It took about 4 mos to resolve the medical necessity appeal, which the NH has to do (as they control the chart) although I as my moms MPOA had to request. So for my mom 4 mos to clear medical & almost 6 mos to clear financial eligibility for Medicaid. Now NH took residents as"Medicaid Pending" but only for a 6 mo initial period.

When looking at facilities, having them at one that does "Medicaid Pending" is mucho importante. It seems that facility can take Medicaid but not do " pending" or can limit pending period. You need to be very clearly understanding of just how the NH does this and what is expected if it goes amiss. Whatever you do, sign only as "Jane Smith Jones in her capacity as DPOA for Mary Smith" on every document and do not pay anything till you get a copy of all documents. Over & over on AC there are posts from family who sign mom in as DPOA but don't get a copy of the stack of paperwork. If it goes bad, it's a $ 100,000.00 debt.....get the paperwork!

You know there will be a NH with an open Medicaid bed somewhere. It may not be your first choice, but you can get your elder in; get through the Medicaid maze; then move them to the better/closer NH that you have your elders name on their waiting list. Once their eligible for Medicaid, transferring from 1 Medicaid NH to another is pretty straightforward paperwork. If you go this route, couple of helpfuls: get all of their medications & go prepared to do this; do NOT have the NH get their SS, retirement or any other income as its tough to stop or change direct deposit at will; you need extra hands on the morning of the switch to the new NH; be sure to zero out or have it at $5 or $10 in their personal needs trust fund at the old NH. (for MIL her NH held the personal needs $ for a year before mailing a check to BIL). For my mom, NH #2 allowed me to go in the afternoon before and set up moms room with photos, TV, linens, clothing, chest of drawers, etc - mom just needed to be there by 10:30 AM the next day. If mom had needed an ambulance to transfer, they would have arranged for it too but mom was totally ambulatory. If they are on Medicaid, the state pays facility by day rate, so no repercussions on not a full month at a facility or need to do a 30 day notice. I did a 2 week notice as I only paid NH #1 for moms copay for only those days there & paid NH #2 for her days there. NH #1 was peeved abt the move but not my problem.

In looking back at all this (I'm going through stuff & jettisoning as mom has died), being organized is the key to your sanity. Invariably paperwork goes amiss and whatever it is needs to be faxed/sent within 72 hrs. Get a list of the required Medicaid documents; start a binder on financial (bank statements for at least 3 years, their awards letters; insurance policy; funeral stuff); one on legal & medical (like all those mailings from CMS); if they have a home then one for house items. These binders you update regularly. For my mom, Medicaid did an annual renewal in which many many items submitted with the initial application had to be resubmitted along with the current mo bank statement & 3 prior months and within 14 days of date of letter. And every year letter was either received after due date or a day before due. I wouldn't be surprised if 30% of renewals get denied for lack of on-time submission; it makes state resting look good in finding ineligibly
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I am also going through the same thing for both of my parents. Both have dementia. Moms name came up for Medicaid but not dads. I have not heard the progression of moms application. That was from April. I have them in a assisted living facility that accepts Medicaid when the time comes. I am getting very nervous what to do because their money is almost gone. They also have no provision for funeral expenses. It's unfortunate that things are so stressful and difficult when trying to help your parents. The advice to start early is great advice. This may lessen your stress in the future. The sooner the better. God bless. You are not alone.
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I live in KS and my Mom moved to NH from independent living with a short stay in the hospital. The doctors would not release her to anything else and the NH helped get her on Medicaid, filling out the application, telling me what I needed, and filing it for me. She didn't have to wait here either.
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Pamstegma: Here's the thing-if the patient goes from the hospital to the NH rehab bed, they don't always get to stay in the NH (be transferred to the long-term care section). My mother, who was in the NH, was told "you're too well to stay here." INCORRECT!!!!!!!! Less than 48 hours later, she suffered an ischemic stroke there and died!
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What you wrote 126cher does seem to be true! Once Medicaid comes into the conversation they no longer can help. My husband and I got LTC insurance last year and going thru this for my mother-in-law makes me glad we did. We may not ever use it but if one or both of us do need this kind of care it will save my kids some distress...at least I hope so!
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mean sad and said----sorry
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The good AL and Nursing Homes want 2 years at least private pay before people go on Medicaid. Once you are on Medicaid they tell you there is no room. Than a person comes along that is paying on their own and magically there is room. Get Book " Bitter Sweet Season" by Jane Gross. Book tells said truth.
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It's not that they don't accept it...they just have a limited amount of beds for Medicaid patients. So her name can go on a waiting list which is better than nothing (I was told by one facility a 2-3 year wait) but we still would like to see what the place is like! However, because there is such a limited amount of beds as soon as Medicaid is mentioned they are not very helpful...at least so far in my search!
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Kathy, what would be the point in even visiting a place that doesn't accept Mediciad?
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