Mom's insurance authorized long term care but the facility wants to discharge her. Has anyone else experienced this? - AgingCare.com

Mom's insurance authorized long term care but the facility wants to discharge her. Has anyone else experienced this?

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So a month ago my mom was told insurance would no longer cover nursing home care. I talked to the ombudsman and days later I got a letter from her insurance authorizing a year of long term care. The authorization started from 8/1/17-7/31/18. Come to find today that the facility is pushing for discharge. I've already called the ombudsman again. But has anyone else experienced a battle between insurance and a nursing facility where one says yes and the other doesn't? Mom is limited physically, needs help with daily activities and is becoming partially blind. That isn't safe for someone alone 12 hours a day. Not to mention the weekends I have to travel for work conferences. I'm not saying this because she's a burden. But she herself has said she would feel scared and she has diagnosed anxiety. So you can imagine my apprehension to putting her into an anxious environment.

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Sorry I realized I forgot to add an important part. When I had originally talked to the ombudsman that mom didn't feel ready to come home he talked to her, the social worker and the doctor. The facility doctor is the one who put in a request to insurance for long term care. They've been getting paid for long term care since August 1st. Then the social worker tells mom she's going home with in home support for 4 hours a day.
She has improved but not to the point of being able to only need 4 hours of supervision a day.
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Most skilled nursing homes have a wait list to get into long term care. Some have two sections; short term care ( rehab after a hospital stay) and a long term care section. Once they are no longer improving and rehab has ended they expect you to leave the short term care. You are then expected to find a long term facility or take them home.
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I guess ur talking about Insurance for longterm care. Maybe the facility Mom is in won't except this insurance. If th facility is privately owned, the insurance doesn't pay the full amount. Have you talked to the administrator? Maybe they have not received anything from the insurance company. Don't assume the right hand knows what the left is doing.
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It all depends on your insurance. Mine will pay for 5 years. I moved into Assisted Living a year ago with my husband (because I needed help caring for him at home.) Now, every time he falls, I push a button and someone comes to help me get him up. See if you can read the policy. Perhaps it only pays a year of nursing home, but will pay more for Assisted Living.
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Some "long term care" includes a care-giver to move in and live with the person.

I know a man who had a live-in caregiver for about 10 years and it was covered by his insurance. He had had a stroke that incapacitated him (some kind of neurological stroke) and with assistance he was still able to function. So his insurance supplied the live-in caregiver. His wife was also still alive and that made no difference in the insurance.
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Perhaps a memory care apartment in an assisted living facility would be a more appropriate placement. The one I found for my two friends for whom I am their POA worked perfectly right up to the wife's passing and now is working perfectly for the husband. They were guided and watched over and the nursing staff gave me advice as their needs changed about what they needed that I was responsible for providing--like when it was time for a wheel chair, when hospice care should begin for the wife, etc. I was told they would never have to leave once they got there and after 18 months of regular payment, they would accept public financing. It's now passed two years for the husband and he's not out of money yet, so we are in good shape.
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Just refuse to pick her up and take her home. Tell them she cannot care for herself and there is no one there to care for her. I have heard that is the only way to force them to do what is right. Stick to it, you are right to fight to protect your mom.
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