How do you find out if LO qualifies medically for Medicaid nursing home care?

She will have to do a spendown when she applies for Medicaid as she only allowed to possess $2K in countable assets.

She was diagnosed by a neurologist 5 years ago. I'm thinking he isn't much help at all. I told him how scared she was and he was the one who prescribed Seroquel which she refuses to take. He asked if somebody could stay with her or she could stay with somebody but there's no one available every night. She's getting worse and is starting to get anxiety during the day as well, but hears things at night. She needs to be somewhere so she isn't alone, lonely and scared. I put in a call to her primary doctor but haven't heard back. I'm hoping he'll know which direction to point us in. We do let her sleep on our couch some(only space available)but that won't work long term. She also goes to stay with another family member once, sometimes twice a week.

I totally understand your befuddlement. I was able to get my mom to go from being in IL to a NH and totally bypassing the AL phase. What we did was to go visit several NH and narrowed it down to a couple. The medical director of the NH also all had their own private practices as gerontologists. Two of them were also affiliated with the Health Science Center that Mom was already going to but not her gerontologist. Mom switched MD to the one affiliated with NH that was the likeliest to have an open bed. It took about 5 mos to get mom’s chart built out to show to be “at need”. Doctors office every 3 -4 weeks with active lab work. The appointment she had a bad H&H and 10% weight loss, he wrote orders for skilled nursing care needed. Got her moved into the NH within 5 weeks post.

MD who are medical director of NH know what needs to be in the chart to show at need for skilled for the assessment that the state caseworker will look at either as an on site review 1-on-1 with your mom or online reading of her health history.

For those living at home or in IL, they usually flat don’t have the fat health chart that say someone recently hospitalized & in rehab would. And these are what most NH admissions come from.... like 70%-80%, you know the scenario....they fall, go to ER, get surgery then discharge to rehab which is at a NH. Then after the first 20/21 days it’s determined they cannot return home do stay in the NH. The paperwork pipeline is in place for a Medicaid review. Plus everybody is happy as Medicare had paid for all till the point that they leave rehab. And rehab had pretty precisely tell you when they are going to stop “progressing “ so you can start finding the paperwork for LTC Medicaid admissions.

But for those with folks still at home or IL going about with dementia (mom had Lewy) kinda ok on ADLs but not at all ok on medication management & realistically not able to live on their own and not exactly solid enough for AL, your just going to have to work with a MD to get her chart to show need for NH level of care. good luck.

I would begin with family doc. My daughter's dr. sent a referral to our local agency and it has changed my life. Because my daughter had taken a walk and gotten lost (911 call and the police and 60 minutes of terror later) we were in contact with the right people. Because she was already on Medicaid it helped so check and see if your LO is eligible for it. A call to the state or local Senior Services. Good Luck and be sure to take time out for yourself. Retired Nurse

Take her to a neurologist specializing in AD, if she has not already established a relationship and treatment from one.
Only a medical doctor running tests can diagnose and treat AD, or other dementias. With the assistance of the medical professional, you and the practice can apply for Medicaid for your MIL. Then, you can find a memory care live in facility that accepts Medicaid and can place her in the facility. Get started asap as this process may take months or years. Good Luck.

You would need to talk with her doctor. A case worker in a nursing home would also help with the paperwork for Medicaid. There are 2 different types of Medicaid: one for the community and one for institutions. Both are different in what programs are offered but similar in medical requirements. A person is deemed medically necessary if they cannot perform tasks of daily living such as bathing, feeding, toileting or clothing themselves. Each state has their own set of requirements for Medicaid. Here in Texas we use 2-1-1 to find out more info. Hope this helps, good luck.

You would have to apply for it. A caseworker, not a doctor, will make the determination of what she’s eligible for through Medicaid . The programs vary from state to state.

You need to discuss this with her Doctor. She may need to be evaluated by a Neurologist. Dementia/ALZ is a reason for longterm care.