Follow
Share
This question has been closed for answers. Ask a New Question.
Find Care & Housing
Josephine - you kinda have 2 diffferent issues going on: first mom running out of $ to pay for AL and second - finding a AL that will take Medicaid.

Medicaid was designed to pay for skilled nursing long-term care. By & Large that means care provided in a NH. Some state have waiver programs to divert NH Medicaid $$ to community based programs like an AL or other delivered at home programs. So you need to find out just what the situation is in your state as to a Medicaid waiver for AL. My mom is in TX and the waiver program is small and with a long waiting list.....it is easier to get them into a NH in TX rather than into AL paid for by a waiver. Understand? If you state just flat doesn't do AL waivers, then you have to figure out how to get mom qualified both medically & financially needing a NH and the skilled level of care a NH provides.

My suggestion if for you to call the social worker at the AL mom is at now. You want to take the time to have a meeting with the SW. What I have found is that since social workers are required to be on staff...they often have the ability to be more frank in what they say. A good social worker will have on hand a listing of other facilities and know what they are like often. They could have even worked at one of them before too. I'd do that first and only contact those that take residents "Medicaid Pending" .

Now if mom's state is one that it is a NH placement for Medicaid to work you willneed to do whatever to get her at that point. So also you want them to look at mom's chart with you to see if it looks like mom will meet the state standards for needing "skilled nursing care".

Now if she doesn't then you have to be creative. I moved my mom from IL to a NH and totally bypassed her ever living in AL. What worked for us, was for mom to become a patient of the MD who also was the medical director of a NH. My mom saw gerontologists in practice in which all the doc's were also medical directors of several NH's. Now they know how to run a chart to show the documented need for skilled nursing care. For my mom, it meant every 4 - 6 weeks she would go for an office visit and have a work-up done. The visit that she had a 10% weight loss and a critical H & H lab, was the day the doc wrote the order for 'skilled nursing care needed" and she got into a NH within 30 days. Just because they are old, or have dementia, or can't live on their own, isn't enough to qualify them for needing a NH. They need to have a fat medical file to show the need for NH level of care.

All this takes time, so start looking now & getting mom's documents together for her Medicaid application. The documents Medicaid requires are pretty specific and you have to provide all that is on the list. Mom's insurance policies, any funeral or burial policies, bank statements for several months or possibly years, citizenship documentation, etc. One good thing for you all, is that mom clearly shows a pattern of spending by her paying for AL, so she should be a pretty straightforward review by the Medicaid caseworker of where her assets have gone. Good luck and keep a sense of humor in all this.
Helpful Answer (1)
Report

The time to move her to a new facility is now. Often times, it is difficult to find a Medicaid bed when the resident is already out of money. Those beds go to residents that have been self paying first.
Helpful Answer (0)
Report

Unfortunately the facility she is in does NOT accept Medicaid, but I will find out if they can guide me. Thank you.
Helpful Answer (0)
Report

hopefully she is in a facility that accepts Medicaid which will cover the cost. The facility may be able to help get this going. She must be getting social security? She will be allowed to keep a relatively small allowance each month, the remainder will go to the facility. If they do not accept Medicaid, you will be looking for a new facility, and it will be a difficult move.
Helpful Answer (0)
Report

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