My husband and I have my 95 year old MIL in assisted living in a Houston residential home healthcare place. She is not happy because she can't have everything she wants. We want her to give the place a chance but she has pulled on my grown son's (her golden grandchild's) heart strings and now he wants to see if he can find a place for her where he lives, in New Orleans area. I understand it is easier to get Medicaid assistance for nursing care even if a person does not qualify for Medicaid assistance for assisted living. My MIL does not need nursing care at this point in time but will likely need it in the future. She can only contribute her SSI toward any costs. Does anyone know what the availability and quality is for Medicaid funded nursing care in New Orleans?
Realize Medicaid programs have to get $ from state coffers to pay the state % share for programs. There are programs that the federal government have by law dedicated (required) funding from the state, which skilled nursing care is, in order for state to get federal matching funds. LA had a crisis last year for Medicaid funding & a special session had to be called to deal with it. From that the criteria for eligibility was seriously tighten up. Legislators didn’t care about increasing funding. It was only cause a big NH group in Lafayette said they would close all if funding wasn’t changed AND Governors office sending letters to over half of the residents or their dpoa that state support would stop in 90 days, that made the special session happen and deal with funding. It was a bold but smart move by Gov. Edwards (D) to do this as totally got media on it. He’s up for re-election, if he looses, I’d expect the new R Gov to walk back most of the funding.
NH care is expensive as it’s 1-on-1 24/7.
What LA is doing, like other states are too, is really tightening up the criteria that qualifies for being eligible & “at need” medically for skilled nursing care. If she’s currently in AL and pretty good on her ADLs and doesn’t have a fat medical chart that show truly needing 24/7 skilled nursing care, she’s not gonna pass a review for eligibility. Even if she’s 95......
most NH admits come via a post hospitalization discharge to a NH / rehabilitation center for rehab. The classic scenario is mom broke a hip, EMS called, get sent to ER, then admitted to hospital, has surgery then discharged for post hospitalization rehab. These are all covered by MediCARE. MediCARE rehab benefit pays 100% of her first 20/21 days, then pays 80%. The first 20 tends to be the period of time needed to determine that she cannot return to old life so she stays in the NH but transitions from being a rehab patient (MediCARE) to NH resident (private pay, LTC insurance or Medicaid). She has the nice fat medical chart that shows current “need for skilled care”. And she either spends down assets & private pay till able to apply for Medicaid or is poor enough to apply Day 1 of the transition.
Moving them into a NH not via hospitalization route can be done. I did it for my mom. From IL to NH bypassing AL phase. It basically meant every 3-5 weeks visits to her gerontologist with mini mental’s & labs done for abt 5 mos. The visit she had a bad H&H, 10%+ weight loss and some other issues is when her doc wrote orders for skilled nursing needed. On retrospect, I now realize just how very unusual this was to do successfully. I don’t think if I was attempting this now it would fly.
Nola is a pretty small city under 500k and still pretty poor. It’s 60-70% African American and the Medicaid accepting places reflect that. For those 80 & 90s, living in that diversity may not work out. My mil old NH (closed after Katrina) had issues in keeping staff due to continually racial comments by residents. It reflects a different era for most elderly.
What seems to happen is families look outside of NOLA for a place that takes Medicaid. Like over in Houma / Thibodeaux. I have a friend who has his auntie in New Iberia area. It is a drive but easily managed for a day trip. Northshore imo is pretty centered around Christwood, it’s huge & very successful but pricey. There’s Medicaid accepting facilities over in St Tammany, but I think you’ll find them close to full or with waiting lists as St Bernard Parish kinda moved to St Tammany Parish (“Tammanard’s) post Katrina & St T has still a population boom from post Katrina.
LA does in theory have Medicaid AL. But waiting list is years long & the # of participating vendors basically nonexistent. What state is doing is shifting $ to PACE. In NOLA, 2 PACE centers. Google the Benson Center to see what it’s about. Catholic Charities is the big player for elder programs; they run the 2 PACE here. CC also have large affordable housing systems.... there’s one on Carrollton by Maple, another Royal in FM, 1 kinda behind Touro, a new big complex in 7th ward. Their mainly all old big Catholic schools, convents, rectories that are converted to IL to almost AL units. Personally I’d put her on the list for all the CC run places if she is to move to NOLA, so she can eventually get a unit and then age out on the CC care system as their residents feed into the PACE program & when finally truly needing 24/7 facility go into a CC run NH. She does not need to be Catholic, just like don’t need to be Jewish to move into Woldenberg.
If she’s truly not at the level of clearly showing a medical history for needing skilled nursing care, she likely won’t get into a NH. Like if she’s good living in her AL, she’s not gonna have the medical chart to show “skilled nursing care needed” that can pass Medicaid review. My late mil place was kinda 50% not needing “skilled” &back then it was allowed if occupancy was low. As better than having the place close. But not now, as demand for NH beds surpasses availability.
Also keep in mind, NOLA has development boom. There’s “opportunity zone” tax shelter for developers in lots of census tracts. Some older NH are more valuable to turn into condos. It’s what happened to Maison Hospitalere and old St Anna’s location. Both now 500k - 1M+ condos. Rents in old property in more desirable area 2k+ mo. Every year abt this time I get a call from old friend or friends of friends who have kid @ Tulane or Loyola or doing their Teach for America in NOLA & astounded that kids need $1500 - 2k a mo for shared rent in an old double. Property taxes & water bills here are crazy high.
Really get your research down before you move her. Also should she have any property in TX (land, house) they need to be sold or placed on MLS listing with a Realtor to ever get her LA Medicaid application to move forward. Their in TX so nonexempt assets. Good luck.