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My Mom lives in a memory care facility and she receives Medicaid for long term care. Yesterday they sent to the ER for a fall to the head. The hospital did a full workup and there was no injury to the head. She hurt her hip, but it was not fractured. All tests came back the Doctor discharged her back to the Nursing Home. They refused her to come back. They dumped her without telling me. I am so lost. I feel betrayed.

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I went through all of this over the past 9 months (I wish I had known). My mother was in an ALF and then upstairs in their Memory Care unit. They called the ambulance on her at the drop of a hat, and she was transported to the hospital at least six times in six months. If she had IV meds, they would insist she go to a nursing facility because "they don't do that." When she got COVID from their facility, she was sent somewhere else for quarantine, and it was an awful place. When she fractured her neck falling in their facility, they wouldn't take her back with a neck brace. The constant transfers were awful for her because she has advanced dementia. I finally had enough and moved her to a skilled nursing facility that will take better care of her and won't send her away for every minor thing.
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What is the reason they give for her not being able to come back?

Are you working with the discharge planning team at the hospital for find another placement?
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The facility should have had various papers (not sure who would have signed them, you if you have a POA or her?) when she went in. That "contract" stipulates what the facilities will or will not do if she goes to the hospital and then is discharged if and under what circumstances they'll take her back. That language in the original signed contract is what is important to have/review as that may tie your hands.

Yes as others have said, get with your state regulators and your area agency on aging. Some law schools have gratis programs to help, some law firms may offer pro bono services too if needed.

The paperwork where my mom is a resident -- now going on 2 years, and Medicaid covers her long term care nursing home expenses now -- had original contract language when she entered as "a private pay" person (and then we "spent her down" to meet our state's Medicaid asset limits) was clear that they'd "hold her bed" only for a few days (72 hours) but we had the option to "pay privately" to hold her bed for longer, but no longer than 25 days their upper limit (not sure if that is a facility or state imposed limit?). My other half and I opted to agree to "pay privately" to hold her bed if she had to be hospitalized for some reason as she is in one of the best Medicaid qualified nursing homes in our state (did the research on that before she went there). That sweeter to the facility (bill us $500 a day -- as that is the cost at her facility -- for up to 25 days the upper allowed limit AND that will hold a bed! This gives the facility assurances that they will NOT have a "vacancy/empty bed. " Medicaid will not pay for the bed hold so the facility only does the bed hold for 72 hours IF family does NOT OPT to pay privately for the bed hold.....If there are other private pay patients waiting to get into the facility, the facility would rather swap out the Medicaid paid patient for the higher private pay patient if they can; so that happens. Then the state has to shift the Medicaid patient to another facility and that may not be as good or perhaps far away.

You might be able to offer a "private pay bed hold" as a sweeter...OR your state regulators/area agency on aging folks might be able to extend the length of the bed hold at her facility.

Sorry, all of this is such a hot mess and most families not aware nor have the resources to control things. And, worse, residents/patients are moved around like deck chairs if the opportunity presents itself to a facility to "move along" a low paying or difficult person. Good luck with this.
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Cover999 Sep 2022
What state is this?

I believe OH is different. Here, NH and I believe even ALs, have to have a valid reason for discharge, and they could start it while the resident is in the hospital, as I mentioned about my mom.

They just need documentation to confer that. By happenstance, the woman from the facility my mom was at happened by the room she was in at LTACH. All she did was say she was from such and such, and went back out the room. I overheard her telling the person she was with "They didn't tell me she was up here", while walking down the hall to leave.

She offered no well wishes or anything like that.
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They either felt mom was too much to handle and caused too much disruption at the facility or they wanted to free up a spot for a more lucrative private pay patient. Sadly, this happens all the time and these facilities get away with it.
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ConnieCaretaker Sep 2022
The behavior can be modified with medications, so it must be to get rid of Medicaid patients; which sounds like a violation of civil rights. Yikes.
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Yes we are. The hospital has been taking care of her untill we find placement. The hospital called Protective Adult Services.
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Any fall including a head strike requires medical investigation.

That's GREAT no head injury was sustained.

I can't believe a NH could refuse a resident back, but reading the comments, it seems this does happen. I am so sorry for it.
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Cover999 Sep 2022
Yes it can if the NH feels they could be liable; here's probably what happened. OP's mom went to hospital; hospital updated NH on Mom's condition, NH started discharge processing; time for mom to return, NH says no. A hospital stay is a good time for NH to discharge a resident if they have a good reason to do so.
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She may need skilled nursing (a higher level of care) than memory care at this point. But the MC facility should have advised and given you information on why they don't think your mother should return to the facility. As suggested, get connected with the hospital's social worker or an ombuds person (or a local social worker) to help find an appropriate place for your mother. All the best to you both and a big hug. You'll get through this - ask for help.
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mdebrosse1 Sep 2022
Thank You
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My Mom has advanced dementia and she cries in french and they told me that her crying was offensive. They gave me no idea that they would do this. I would have found her somewhere else. They treated her like garbage.
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Cover999 Sep 2022
Called Business. They could use this as reason for the discharge, she was a bother to others.
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I'm so glad the hospital is helping and mom is safe!
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mdebrosse1 Sep 2022
Thank You. No family should have to go through this. I was a caregiver for homecare at Nursing facilities. I treated my patients with respect and care. They lost mostly all her clothes and shoes. I just replaced what they lost.
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If they refused her, it's possible her level of care needed now is more than the memory care can handle. Possible she needs to go to NH (with memory care). She has medicaid already, so more than half your battle already completed.

Talk to hospital social worker about the need for her to transfer from hospital to a facility and see if they can offer to help. DO NOT go pick her up. The doctor already indicated she needs facility care. It is much easier to go to facility from hosp instead of your own home. Stress safety, mobility and memory care needs to hospital social worker.

Once talking to them, they will probably offer you a list of facilities in the area so you can go take a look. You can also look on your own. Talk to social workers at facilities, letting them know she already has her Medicaid for facility care. They will tell you if they have a bed available. You will need to be quite busy in the next few days checking facilities out and making your decision. Just get her in one. YOu can move her later if you want to without jumping through hoops

I also suggest that you call the Ombudsman's office to report this 'dump'. They will investigate...facilities do not like to get Ombudsman's inquiries.
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mdebrosse1 Sep 2022
Thank You so much.
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