Medicaid application finally in; now there's more to do?

Her primary MD should have any previous test records. Look there first, then ask for the records or updated testing. The actual testing is pretty benign, dealing with memory, problem solving and ADL's such as eating, bathing, dressing.

Xina - so much of what's in articles on medicaid is on financially being "at need" for eligibility.... The 5 year look back.... Doing a spend-down, etc . All emphasis is about $$. Family is often blindsided that the elder has to show medical "need" as well.

If your moms discharge paperwork when she left the NH and what is in her current health chart, her doctors orders for care & medication management show "need", she should be ok.

What are you hoping that medicaid will provide? There will be a limited # of hours of care per week. Medicaid will not provide for 24/7 care at home

Barb - omg NYS medicaid will pay for 24/7 in-the-home caregivers?!
Not payment to family living there as caregivers like what California's IHHS program does? But paying a caregiving agency for 24/7 care? Is there a cap on rate?

Wreck NYS state budget? If $ 25 hr a mo, then $ 18K mo / $ 216k yr w/out equipment, transporation, or speciality like PT, OT, ST..... Add those, HUGE cost.
Is it a very narrow limited program? Most states place a limit on at home to around 28 -32 hrs as over that it's not cost effective as they can get 24/7 in a facility with skilled nursing & on site staffed ancillary services for less. Even then states are looking to PACE type of larger community based long day elder programs to have them go into rather than 1-on-1in home or a NH for those ambulatory with family having to pick up all care outside of PACE time.

Do you know what NYS has as medicaids daily reinbursement Room & board rate for NH?

I just cannot see how the costs are sustainable for NYS or any state once the tsunami of baby boomers start hitting medicaid eligibility.

Barb - copy that! so I'm guessing there basically are so few medicaid beds in NYC so in-home has to happen. A unique situation. All boroughs?

I was overjoyed to find out that NYC Medicaid covers 24/7 home care, though I'm holding my breath until the actual application goes through, hopefully soon. We are paying out of pocket until then. I'm not sure if there's coverage because of a nursing home shortage or what.

Igloo, in NYC, you CAN get 24/7 inhome care through Medicaid.

I agree Igloo. I don't see how in the world that kind of expenditure would be sustainable. It may be a great benefit, but, man. So, I suppose that the state of NY picks up that cost for around the clock in-home care. Do you think they think it's less than paying a Medicaid rate to a NH? In my state, NC, the Medicaid rate to a NH is considerably less than a private pay rate?  Of course, here, there is no provision for in-home around the clock nursing care.

When my mom went into a NH in TX back in 2011, daily medicaid R&B was about $145 a day, 53k a year. To me it was really amazing just how much basic & skilled services could be provided & provided across the board equally for all residents for such a low amount. The private pay residents - other than having a solo room - had the same meals, social services, nursing care, whatever. I flat couldn't figure out the math, I mean jeezlouise hotel rooms run over $ 150 a nite & with drab free breakfast & no skilled nursing on call. So I asked. Apparently key is for NH to have about 25% of beds at all times with MediCARE rehab residents as payment triple or more. Guaranteed 21 days /100% and then possibly another couple of months at 80%. So Medicare is kinda underwriting a NH ability to have Medicaid R&B beds.

Barb - is some of the billing for 24/7 at home being heavily shifted to Medicare?

If Medicare gets changed to be more limited under this new administration, the NH aren't going to be able to stay open imo. The future is not gonna be pretty on Aging in America.

This is only NYC we're talking about, not the whole State of NY.

Igloo, I think it was due to a lawsuit several years ago. Not sure about the number of Medicaid NH beds. My mom is in a nh in Connecticut, near one of my brothers, and I've never really investigated nhs here in the city.