What are the limits and regulations for Medicaid for nursing home? - AgingCare.com

What are the limits and regulations for Medicaid for nursing home?

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My mother-in-law falls a lot and no one can take care of her anymore and shes ready to go the nursing home.

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I worked as a secretary for a local Visiting nurse facility. The easiest way we found in getting a person in a NH was being in the hospital or rehab and transferring from there. Harder to go from a personnal home and Doctor recommendation. You have patient evaluated while in hospital or rehab and more likely to get onto the nursing section if connectedto the rehab.
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Dogtired - first, does this AL take Medicaid waivers? If so, you need to get mom on the list and find out where she is on it for getting a waiver bed, if it's realistically 6 mos, then you have lucked out!. But if this AL is only private pay, then you need to work with mom's doctors to get them to write orders for her that "skilled nursing care is needed". Skilled means nursing home and start looking for NH that have Medicaid beds and take residents "Medicaid Pending".

The AL medical director or affiliated MD is likely not going to be helpful in doing this as the AL being private pay is pretty profitable. They want mom to stay in AL & have you all private pay. For my mom, I was able to move her from IL to NH and totally bypassed the AL stage. What I did was find a couple of NH that had room and took Medicaid; and had mom become a patient of the medical director of one. He was also one of the doc's who had been within my mom's gerontology group, so there was overlap in medical history. Basicially he saw mom every 3 - 5 weeks or so and did a spate of tests and monitoring. Lots more lab work oriented than the regular gerontology visits which where more about dementia & cognitive testing. Anyway about mo. # 5 mom got a bad H&H lab report, a 10%+ weight loss and some other issues so doc wrote orders for skilled nursing care needed. A medical director of a NH will have their own private practice and will know just how a chart should to read to show the need for skilled nursing care. When they are coming from their home or IL or AL, they often just do not have the fat medical file to show that. So some creativity is needed. Also maybe some medication changes - like from Exelon pill to Exelon patch which requires more "skill" to apply; or a medication needs to be compounded which the AL isn't set up to do but a NH does as that is "skilled".

Most NH admits come from a post hospitalization discharge to the NH for "rehab" and they have this nice fat medical chart so all OK and existing to show the need for skilled nursing. But if you're at IL or AL or home, that chart is too slim and needs to get built up to show need.

Do you have a copy of mom's AL admission agreement? You want to find out what # of days or weeks you need to provide written notice in advance to have her move out without penalty. Most have it at 30 days. If so, you need to try to move her so that there is no penalty from the old AL and still have her move into the NH within the doctors orders prescription time frame. If mom paid a AL deposit, you might find the new NH and get admission paperwork done and filed for mom to be Medicaid Pending the day she moves in - oh on this ask the NH for the list of the documents they want to review to do the application, it could be simple to find or not, but it will take some time. Then you move mom a couple of days over the 30 days and let the AL take the extra days stay out of the deposit. May just be simpler and not increase any of mom's assets for Medicaid.

Once mom is on Medicaid in the NH, she will have no $ to ever pay for anything anymore basically. If mom does not have a prepaid no cash value funeral & burial done, please think about using some of her existing $ to pay for this. Once on Medicaid, she will have to do a co-pay of all her income to the NH except for a small $ 35 - 90 a mo personal needs allowance which basically covers beauty shop and phone or cable. Good luck.
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The social service at the facility should be able to help.
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We live in California. My mothers funds are running low. She has been in assistant living for the last wo years and has enough money left for about five months. I and my sisters are unable to have her move in with any of us for many reasons. What are the options to get financial aid for her.
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What if we can't afford a "nice" one? Isn't it better to sacrifice for a while and keep her at home? I am sure I can find ways to survive and not lose my life completely.

At home with Dad is now at home with Mom as Dad is now gone. Mom is 90 and not nearly as difficult as Dad was although I do get tired of the routine sometimes..
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I was told the best thing is to find a place you are interested in. Talk to the director about how things work. Then make an appointment at the Medicaid office to get their info.
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Some nursing homes, nice ones, will take her if she can private pay for two years before converting to Medicaid. To go into a NH with just Medicaid limits you to county run or non-profit facilities that can be pretty depressing.
The limits vary from state to state. See your state's rules.
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