My mother is a long term patient in a Tennessee State nursing home facility. She has been periodically leaving the facility for overnight family visits. Will Medicare still continue to pay and hold her room while she is away from the facility?
MediCARE is not paying for custodial costs at the NH. She is likely on LTC Medicaid as it’s Medicaid that will pay for the room&board and other custodial costs.
Medicare’s payments once an elder goes into a NH get more limited to paying for billable costs to vendors….. like will pay for physical therapy for her to do gait training 2-3 times a week, for the MD who is the medical director of the NH or the NP who is the nurse practitioner at the Nh to see mom bedside; pay for nursing staff to do flu shot.
But back to your ?, imo you need to clearly ask the DON (director of nursing) at the NH if it at all feasible to have mom go away on an overnite. In my experience a lot of this will depend on the medications she is on and how realistically ambulatory she is AND how dedicated of a support group you actually truly have. Are you getting the vibe from the NH that they would rather you did NOT do this? If this is what the situation is, I’d ask to have a care plan meeting to spec discuss this. It could be that her level of confusion on her return is problematic or that the meals and medications schedule while away pose problems for her to be back on track.
It was a different story for us & taking my mom out of the NH: I took my mom out of her NH on a Fri late afternoon to go to a Saturday family wedding in another city and back to the NH by midday Sunday. Under a 48 hr period, it was totally ok for a “bed hold” length of time for the NH and for LTC Medicaid rules, Moms meds were all easily taken pills or capsules, she was ambulatory with a 4 Footed cane & still nicely social and ok on wearing Tena underwear. She was tiny petite and I could easily dress and lift her if needed. She was fine, but for us it was beyond stressful as she basically needed a spotter watching her the whole time. Little things like glassware had stems and she could not grab/hold them; she tried to open car door before we were completely stopped & it didn’t occur to me to move latch back to “kid safe” side!; food was too rich for her… it was a long drive back & I told nursing staff abt it when we returned so got Imodium & all ok. Now prior to this, I would take her periodically to see her old beautician & she’d stay there couple of hours chatting and we hit a restaurant in her old neighborhood, so used to getting out of the NH, going for a drive and walking into places. Sounds like your mom is totally good on this part, right? If so and yiur getting issues from the NH it’s imo cause she is coming back way way too confused and emotionally unsettled.
Fwiw that wedding was it for us; had there been another event I would have hired and paid for 2 of the aides from the Nh to go with us for the weekend and stay in their own rooms at the hotel & be there to basically attend to the whatevers for mom as they would know how she rolled.
Regarding taking a LO from their LTC facility... We had to stop bringing my MIL to our home for the holidays because the only bathroom on that floor was tiny and it couldn't accommodate her walker, let alone another person, but there wasn't any other solution. Even using a commode in a private (carpeted!) room was out since she weighed 185 lbs at the time and could barely support herself when transferring. She would freak out because she didn't want to have a BM in her Depends (and I don't blame her). It would have been just me helping her since she has only sons. My back couldn't take it. Now we bring the holidays to her and it's just fine.
Your point is so well taken. I think it all depends on the circumstances, so, in the end, only our OP can guess from history what might happen on the Holiday.
If your mother has dementia or other cognitive impairment, taking her out of her routine is detrimental to her. They need total routine and even if she is still familiar with your (I assume) home, it's very disorienting for them to go back and forth.
If she's spending nights elsewhere, maybe she doesn't need to be in the nursing home at all? Such facilities are for 24/7 care.
Ir depends on the person, close loved ones know it’s not all the same, for some seniors it wouldn’t work well and others there isn’t a problem w having some special outing or overnight visit
As others have said, Medicaid NOT Medicare is paying for your mom's long term care coverage in the nursing home as Medicare does NOT pay for "custodial" or long term nursing home care in a skilled nursing or any other facility beyond a limited time and generally only after a inpatient hospital stay or following a rehab hospital stay where the patient still needs skilled nursing care (such as IV antibiotics, PT, OP, or other medical/nursing services) but it is nevertheless limited to a set number of days NOT long term.
You should check with the business office staff at your mom's facility about this question. Each state Medicaid program is slightly different. The business office folks will know; they have to deal with the State Medicaid program, rules and staff all the time.
One over night may be allowed OR as is the case where we live -- my mom is a Medicaid-covered long term care nursing home residents, has been for over 2 years -- we can pay for a "bed hold." NOT THAT we have done that, as I have no intention of having my mom stay overnight with me or any family member (no one could manage it, frankly -- dementia, various behavioral issues, incontinent, not able to walk, etc.)
My mom's facility has a maximum "bed hold" option (I believe it is 28 days). But the bed hold price, is the full daily rate which is about $500.00. So at my mom's facility, if someone really wanted their LO to sleep overnight for Christmas eve and Christmas day and was willing to pay the facility the required $1K, then so be it.
For the people in here bringing up confusion and other nuances; this person said nothing about that in the question. All they want to know is can they take their mom out for visits and Medicare pay, that's it. Medicaid is most likely what your mom is on. Medicare typically does not pay for LTC. The short answer is yes she is ok to do that. Just get with the nursing home to find out their parameters. People go out on pass all the time at LTC facilities
Call MediCare and ask them. Get everything in writing. As stated below "You should check with the business office staff at your mom's facility about this question. Each state Medicaid program is slightly different. The business office folks will know; they have to deal with the State Medicaid program, rules and staff all the time."
FoxyNana9238: Perhaps you should go to the Medicaid.gov website for your query since, more likely than not, Medicaid is paying for your mother's LTC. Also, you may want to ask the staff of the facility. To make it easier on yourself, there may be a simple phone number to call for Medicaid. I located the Medicaid phone number in Tennessee for you and it is as follows: 800-342-3145. Good luck.
It is your state's Medicaid program paying for Mom's long term stay in the nursing home;Medicare does not pay for custodial care. Please contact your Medicaid office as your nursing home business office. Rules vary from state to state. In New Jersey we were required to hold a Medicaid bed for up to 10 days when a resident was out of facility for any reason (other than death or transfer to a different facility) and Medicaid paid the facility. Somewhere around 2012, the state regulations changed.... the facility is still required to hold the bed for 10 days but Medicaid no longer pays for the hold. So it is really best to check with your state's Medicaid office.
The way I’m reading this your mom has been in this facility for a while and has been doing these overnight visits without a problem so while others warnings are good ones in general you seem to have a handle on her reactions and will know if and when the overnights should stop for that reason. I’m assuming your mom was private pay up until this point and has transitioned now to Medicaid paying and you are concerned that the process may be different for doing these overnights. While I don’t actually know the rules and suspect that as someone mentioned it’s probably different from state to state, it seems unlikely to me that the nursing home is going to curtail these overnights which they have enabled right along. The caveat to this of course would be if they are finding it’s becoming disruptive to her but that discussion would have been the same and not based on who is paying. Again as others have suggested I would ask the appropriate person at the NH to get a solid answer on how it works with them and if Medicaid makes any difference when it comes to these family overnights. I would venture to guess that longer stays away from the NH would make a bigger difference than one night here and there. Good for you for being proactive I’m not sure it would have occurred to me to ask in this situation.
Medicare’s payments once an elder goes into a NH get more limited to paying for billable costs to vendors….. like will pay for physical therapy for her to do gait training 2-3 times a week, for the MD who is the medical director of the NH or the NP who is the nurse practitioner at the Nh to see mom bedside; pay for nursing staff to do flu shot.
But back to your ?, imo you need to clearly ask the DON (director of nursing) at the NH if it at all feasible to have mom go away on an overnite. In my experience a lot of this will depend on the medications she is on and how realistically ambulatory she is AND how dedicated of a support group you actually truly have.
Are you getting the vibe from the NH that they would rather you did NOT do this? If this is what the situation is, I’d ask to have a care plan meeting to spec discuss this. It could be that her level of confusion on her return is problematic or that the meals and medications schedule while away pose problems for her to be back on track.
It was a different story for us & taking my mom out of the NH: I took my mom out of her NH on a Fri late afternoon to go to a Saturday family wedding in another city and back to the NH by midday Sunday. Under a 48 hr period, it was totally ok for a “bed hold” length of time for the NH and for LTC Medicaid rules, Moms meds were all easily taken pills or capsules, she was ambulatory with a 4 Footed cane & still nicely social and ok on wearing Tena underwear. She was tiny petite and I could easily dress and lift her if needed. She was fine, but for us it was beyond stressful as she basically needed a spotter watching her the whole time. Little things like glassware had stems and she could not grab/hold them; she tried to open car door before we were completely stopped & it didn’t occur to me to move latch back to “kid safe” side!; food was too rich for her… it was a long drive back & I told nursing staff abt it when we returned so got Imodium & all ok.
Now prior to this, I would take her periodically to see her old beautician & she’d stay there couple of hours chatting and we hit a restaurant in her old neighborhood, so used to getting out of the NH, going for a drive and walking into places. Sounds like your mom is totally good on this part, right? If so and yiur getting issues from the NH it’s imo cause she is coming back way way too confused and emotionally unsettled.
Fwiw that wedding was it for us; had there been another event I would have hired and paid for 2 of the aides from the Nh to go with us for the weekend and stay in their own rooms at the hotel & be there to basically attend to the whatevers for mom as they would know how she rolled.
If your mother has dementia or other cognitive impairment, taking her out of her routine is detrimental to her. They need total routine and even if she is still familiar with your (I assume) home, it's very disorienting for them to go back and forth.
If she's spending nights elsewhere, maybe she doesn't need to be in the nursing home at all? Such facilities are for 24/7 care.
You should check with the business office staff at your mom's facility about this question. Each state Medicaid program is slightly different. The business office folks will know; they have to deal with the State Medicaid program, rules and staff all the time.
One over night may be allowed OR as is the case where we live -- my mom is a Medicaid-covered long term care nursing home residents, has been for over 2 years -- we can pay for a "bed hold." NOT THAT we have done that, as I have no intention of having my mom stay overnight with me or any family member (no one could manage it, frankly -- dementia, various behavioral issues, incontinent, not able to walk, etc.)
My mom's facility has a maximum "bed hold" option (I believe it is 28 days). But the bed hold price, is the full daily rate which is about $500.00. So at my mom's facility, if someone really wanted their LO to sleep overnight for Christmas eve and Christmas day and was willing to pay the facility the required $1K, then so be it.
Medicaid is most likely what your mom is on. Medicare typically does not pay for LTC. The short answer is yes she is ok to do that. Just get with the nursing home to find out their parameters. People go out on pass all the time at LTC facilities
As stated below "You should check with the business office staff at your mom's facility about this question. Each state Medicaid program is slightly different. The business office folks will know; they have to deal with the State Medicaid program, rules and staff all the time."
Please contact your Medicaid office as your nursing home business office. Rules vary from state to state. In New Jersey we were required to hold a Medicaid bed for up to 10 days when a resident was out of facility for any reason (other than death or transfer to a different facility) and Medicaid paid the facility. Somewhere around 2012, the state regulations changed.... the facility is still required to hold the bed for 10 days but Medicaid no longer pays for the hold. So it is really best to check with your state's Medicaid office.
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