My mother has no assets and very little money. What is the next step if family can't afford to pay the facility at the time of her release from rehab?

Dear Charlie,

I'm so sorry, I know this is a very stressful situation. Have you tried talking to social worker about your mom's options? Given her age surely they can escalate her application. I hope the social worker will be able to give you all your options.

Charlie, are you in the US? If so, if a patient does not have a safe place to return to (i.e. with adequate care) then the rehab facility needs to find them a place. I thought that was the standard across the country but maybe someone will correct me.

Cdnreader is right; talk to the social worker (and the physician probably too) at rehab. Tell them you are concerned that your mom needs more care than she will get at home and that you need help with the next step. Be firm with them.

Nursing homes say they don't accept "Medicaid Pending" but will usually waive that for rehab patients. If you haven't already done so, research and/or visit nursing homes in your area that accept Medicaid, just in case your rehab facility does not have a long term care Medicaid bed available. They may need to transfer her to a different facility. It helps to know which facilities are ok and which you'd rather avoid.

Medicaid can reimburse up to 90 days back, but it seems like approval for nursing home Medicaid happens much faster, especially if the person's finances are straight-forward. The person in the business office should be able to advise you about that.

Good luck -- I hope your mom finds a spot at a place with caring staff!

Don't take her home. It's easier to get her placed from rehab and once home it can be impossible. I had my mother in law apply (with my help) for SSI which helped pay for her assisted living. I walked the paperwork through to speed things up.

Call your local Elder Services. They will have a local agency come in the home and care for her-on a limited amount of hours-for free, depending on her income. Since she is low income, she will qualify. My father is having Bayada Nurses come in a few hours a week b/c he is low income. But call soon as it takes a couple of weeks to get going.

Don't most states have state run Nursing Homes? I know Texas does. Granted, they aren't the best, but with continued monitoring they might be the answer.

Don't most states have state run Nursing Homes? I known Texas does. Granted, they aren't the best but with continued monitoring they might be the answer.

Hello! I was in this pickle with my mother as well...but she is much younger. She suffered a stroke in March at age 59. She is simply not able to live by herself and already on Social Security so she can't afford the full time care she requires.

My advice is find a social worker, compliment him/her often, and follow their every word!

There are places that will accept Medicaid Pending, that's what we are able to do with my mom. The social worker will know where those places are and which one is the best.

In the past three months I've come to learn that if I try to do the leg work I stress myself out turning in 1,000 directions. But when I go to the social worker they say, "oh, you need to do this and this." And it works perfectly!

Take a deep breath, and find a social worker ASAP!!!

She was living (self-pay) somewhere before rehab? Communicate the situation to the social worker at the rehab facility and convey there is nowhere for her to go. Under no circumstances let them talk you or anyone else into taking mom home until this gets sorted out. The sooner the better.

In NY, Medicaid can be retroactive for up to 3 months as long as you provide the bills and paperwork required. So, you may be able to get money back that is spent prior to Medicaid approval.

There are Medicaid Ombudsmen  that are there to help with big problems .look for those phone numbers on your state Medicaid site. Also can try calling some of your political Representativesand escalate the issue toget the Medicaid issue squared away -she sounds entirely like she qualifies for Medicaid and should be placed in a facility with Medicaid beds

What do we do ? where will she go ?
Family ? Bring her home, 98 ? How much time do you have left to love her ? Rehab will take payments.

Would she qualify for hospice care? I imagine this has already been determined but it might be beneficial to get a hospice company in mind in order to move her to hospice as soon as she qualifies in order to get her the best care possible as soon as possible.

I don't mean to sound unkind, but, it there a reason why you don't want to bring your Mom home for her final days? This can be a really special time, even in those few moments when you're both tired and almost whipped out, that special bond between mother and child cannot be shared with anyone else. I remember caring for my mother before her surgery while living with me. It was hard. But I would not trade those special moments for anything. It was, at times magical, very spiritual, and those moments shaped the person I am today. I hope my experience may give you pause, and perhaps even, a different pathway option. I hope you and your family find your way, God Bless......

Charliekobe1234,
Your best source of information is the Social Worker. They will guide you to choices that you may not even know you have. Check in with the rehab Social Worker and then contact the Social Worker that is assigned to her through Medicaid. Senior Services will give you information too.

Yes, talk with the social worker and emphasize she can't come home with you. She's 98, they will have to put her somewhere. Don't let them bully you or talk you out of it. My mother had dementia and fell and split her head open, it looked like! We were in the ER for 11 hours and she got one stitch and I hesitantly asked the doctor if she could be admitted for a day or so. NO. He said she was ready to go home, and if she was admitted to the hospital she would be charged $2000 a day, or something like that. Took her home, but got her in a nursing home Medicaid pending within a couple of months, no thanks to that doctor! Talk to social services. The doctors don't care.

If she absolutely needs placement and you know you can no longer take care of her, just don't pick her up
from the hospital to take her home. If they call, just don't come to the hospital. This will put them in a position of having to place her in alternate emergency placement and get the ball rolling right then

If you think about it - it's sort of insane that we as family/lay-people find ourselves in a position to figure out the most complicated of situations when at one the most vulnerable, overwhelming crossroads...Some people are thrown into this with no preparation - we're lucky to have each other to bounce ideas off of, but the discharging process can't expect that a family member, possibly the least experienced player, figure out a strategy that covers all the bases when they don't even know what they don't/can't know!?!? And you know what? This is going to be a growing/recurring catastrophe as the wave of boomers hit their golden years.

I have just come home from a visit to my 93 yr old mother. I have to share that my experience is close to what you are going through. After several falls in a 2 hour period in which I was forced to call 911 for help getting her back in her chair. After the 3rd time I had her taken to the hospital where she stayed for a week and then moved into Rehab. The Social Workers in the hospital, in the Rehab, and the Social Worker that has been with us since mom qualified for Medicaid. While in Rehab it became apparent to me that I needed to place Mom since I can't lift her or transfer her. I not only care for her but also my disabled husband so my plate is full. I felt guilty at first but through the help of all of the Social Workers and wonderful staff at the nursing home I have come to realize she in the safest place. She is still unable to use her legs so my choices were limited and my guilty feelings huge about not being superwoman. With the staff, my husband, and my daughters telling me to "Let the professionals handle it and just enjoy being the daughter again"! I'm in a much healthier place now and mom is doing wonderful after the adjustment period which is another topic on here that this website helped me through. Don't let anyone make you feel guilty for knowing your limitations and acting in you mother's best interests. You can have a wonderful, loving relationship with her in a facility too!