Follow
Share

About a month ago my father was hospitalized and our doctor told us that with all he had going on and the toll that it was taking on our health 24/7/365, we were all going down hill quickly if we didn't do something. We agreed and placed him a facility that he has been in and really enjoyed. The staff and everything about the place is wonderful!
The nursing home recently told me, that all though my father has a list of ailments as long as my arm, more than 33 Rx's, insulin shots 4 times a day, vascular as well as Lewy Body dementia, cannot drive, has to searched down for his medication, can get list a one way hallway and another list as long as my arm; that he is higher functioning than most of the permanent residents.
My real fear is that the state of GA will turn him down for medicare and try to send him back home to us.
I have my grand daughter daily, her mother that had to undergo a double mastectomy last year (has another surgery on Monday!) and my husband that is 80% disabled as well as taking care of my mother long distance.
With all that my father has going on, could there be a possible reason for medicare to decline him that anyone is aware of?

This question has been closed for answers. Ask a New Question.
I don't think there is much chance of your father getting turned down.

Somebody has to be the highest functioning in any care center, just as somebody has to be the lowest. It doesn't mean they don't belong there.
Helpful Answer (3)
Report

Jeanne - wonderfully said! highest/lowest.

Mamo - geez it's his having Lewy Body Dementia. The NH doesn't understand how this type of dementia is different and although Lewy can appear high functioning, do their ADL's, etc. they are in fact just as in need of skilled nursing as those with Alzheimer's.

My mom has Lewy and her MD is part of a medical school gerontology program and is the director of the NH, so this NH understands what Lewy is about. It could be that this NH is not the right "fit" for him.

Once they are on Medicaid, if you want to, you can move him to another Medicaid NH. I did it with my mom and it was actually pretty easy (the NH #1 changed affiliation after she moved in and then there was massive billing issues). Medicaid pays the NH on a day rate basis, so you can move them with no issues on paying. If you do this, you do want to make sure you get all their medications. Most NH do these in a 30 day supply blister pack and they are usually in a hanging bag in a secure area of the nurses station. You have to get all the meds - don't leave without all meds. Medicaid is pretty strict on only paying once every 30 days. So the new NH will have to bill you private pay for the lapse time in medications should you not bring the rest of the month with you. This could be very expensive and you are stuck with having to pay it.
Helpful Answer (1)
Report

To put your mind at rest, as Jeanne said, I don't think your father will be turned down. It can take months to be approved; but , it is retroactive and Medicaid will pay. The nursing home reps don't always give the correct opinions - could be they are just being conservative. I would try to just think positively and try not to worry. Just make sure the NH home has provided all necessary info. The social worker at my mothers NH was wonderful and knowledgeable. I also kept in close contact with the Medicaid office to ensure that they had received everything required.. You need to take care of yourself and your family. From my experience with my mother - she was approved - and your father appears to be in worse shape - blessings to you and take care.
Helpful Answer (1)
Report

Medicaid requires two qualifying elements: the need for the kind of care being received, and meeting the financial criteria.

Is your father's current stay being covered by Medicare, as rehab after the hospitalization? That only lasts a certain length of time. If he needs to be in a care center permanently, that is when Medicaid kicks in.

Have you already applied for Medicaid?

It really sounds to me like he should qualify medically, especially since his doctor says he needs 24/7/365 care. And if he doesn't qualify financially now, there are usually ways to spend down assets until he does qualify.

Good luck!
Helpful Answer (0)
Report

He definitely qualifies financially. He has no $ other than SS. His doctor states he meets the criteria. The only reason that I can figure that they look at me rather strange when I placed him in their, was he appears high functioning, but he can't do anything for himself other than dress and toilet.
he cannot drive, take care of his own meds, shop for himself (again he gets lost), he does not know when to chance clothes or take a bath/shower; even though he really smells.
I just pray all goes well.
I saw my doctor today and she says my health is not the greatest anymore either. i've been caring for my mother since I was 21 and then my own family and then my father. my doctor said I just couldn't take any more.
Helpful Answer (0)
Report

Thank you to everyone for answering my question. It certainly makes me feel more at ease.
Suzanne
Helpful Answer (0)
Report

Why does the Social Security award letter state one amount, after deductions, but the amount received each month is over $200 short of that amount?
Helpful Answer (0)
Report

My fathers SS award letter states that he will he receive a certain amount each month after deductions. I went on line to set up an account, because I could not find the award letter when submitting all information to the NH for Medicaid.
I looked at the amount that is to be paid, compared with the amount to be deposited (as far back as it would go) and noticed that there is approximately $237 difference each month. No, he does not have any taxes withheld. The only two things are part A and part B.
Helpful Answer (0)
Report

This question has been closed for answers. Ask a New Question.
Ask a Question
Subscribe to
Our Newsletter