Is this normal nursing home care after moving to Medicaid?

Under Federal Law Medicaid residents should receive the same care as a private pay resident! Their rights are the same and the requirements for their care by staff are the same. No one should be able to tell the difference between a resident on Medicaid and a Private Pay resident by the quality of care!

It is common for a resident to be moved to a room (many times smaller) when they apply for Medicaid. Residents have to be in a vendor bed (Medicaid approved bed) before application to Medicaid can be made. However, there should not be a decline in the care the resident receives.

If you are seeing a decline in care talk to the nurse, if you don't get resolution talk to the Director of Nursing. If you still don't see a change contact your local Ombudsman Program. Ombudsman are Federally Mandated Advocates for resident in long-term care facilities. They can help with this and there is never a charge to the resident or family!

Unfortunately, a majority of the skilled nursing facilities (SNF) are under staffed. It truly amounts to greed for the most part.

In turn, the patients do not receive the care they deserve and need. Any patient with cognitive issues, will suffer more, as they cannot advocate for themselves. Also, in SNF the caregivers do not know the patients well, so if they are told no, they take that as the last word. They don’t have the time to spend, to redirect or work with the patients with cognitive issues.

It’s imperative that family and friends get involved, and are diligent in advocating for the proper services that their loved one needs.

The move to a smaller room is normal for most facilities. The decline in care is also common but not acceptable. The staffing ratios are often higher on Rehab floors vs long term units. You have to make you voice heard. In my experience, the squeky wheel works. You can squek nicely though.

Does anyone have suggestions on questions I should ask in our meeting?
I know to ask about medication, daily routine but what specific questions would you guys with experience recommended?

The room and it’s location will change because of Medicaid, BUT Quality of Care should NEVER decline because of the type of insurance coverage. I repeat quality if care should NEVER DECLINE. It sounds like this particular facility is not a good filt for her and I would definitely look for another one immediately. You should take your concerns to the director of nursing and to the administrator and changes in the quality of care should change ASAP. Neglect and abuse should be reported to the state department that regulates the care center. They are required to have this information posted.