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She's coming close to her 100 days in SNF and they think she needs more time. I've never seen the place because she was placed during Covid-19.


This place doesn't have phone for residents to call home.

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So, if she exhausts her 100 days and doesn't apply for Medicaid, what is your/her plan for her care?

Does she have the funds to pay privately, either for the SNF or for full time care at home?

What are her care needs?

Does she have a cell phone, and can you provide her with one? Can she use it?
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Its a shame you can't see her. You say in ur profile she has Dementia/ALZ. How far along? Has this stay caused a decline? Is her Dementia causing her not to progress like she should have. She needs to understand what the therapist needs her to do and remember it from day to day. The last time Mom was in rehab the Therapist said "she can't follow instructions". I said "she has Dementia". Then she said "she doesn't remember the exercises". I said "She has Dementia."

You don't mention the surgeries she had? That really would determine how long she needs to be in and why in 3 months it has not been enough time. Unless Medicare's 50% and her suppliment paid for the full 80days, then she owes maybe about 12k at $160 a day.

As Mom's Dementia progresses its going to be harder to care for her. I would wonder how the surgeries and now this lockdown has effected her. How much has she declined. She maybe ready for LTC and it would be just transferring her to another section if rehab and the NH are one and the same. Though, I would think after 3 months they would know if she has plateaued or not. They are having you make a decision based on their input only. Without u seeing her. I would be sort of leary. A hard decision.

Realize that once on Medicaid they are going to require that her SS and any pension go for her care. Medicaid paying their share.

Can you bring Mom home to care for her. Ask if homecare is available with this virus going on.
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I think it is common. When Medicare stops covering, the facility still needs to be paid.

Do you know anything about applying for Medicaid? You may want to ask a Medicaid office or an estate planning lawyer for a general overview of what it will entail.

Even with CoVid, you can sometimes take a virtual tour of another facility and ask if they have any beds available. I found this site helpful.

https://www.medicare.gov/nursinghomecompare/search.html?

If she is entering as a Medicaid patient, you will find you have less options but there still may be beds available in other facilities. If she has any money to offer as "private pay" you will find more beds available to you.

When we needed to place people, we found it helpful to buy an hour or so of time from a local Aging Care Specialist. They know which facilities are well run and they know which ones have long waiting lists for the Medicaid beds. It cost a couple hundred dollars to deal with them but I felt a lot better having someone on "our side" in the placement choice.

aginglifecare.org

Sometimes, you won't really get many choices. She may have to stay where she is. When you enter as a Medicaid bed, they can put you anywhere within a certain mile radius- and sometimes that is far away for the family. So if she is somewhere close by now, that might be the best you can do.

Best of luck. We've done this three times and it is always anxiety producing because you have to do it fast and you don't have a lot of information or choice.
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Yes it’s typical. Unless you have already decided she will come home when her 200’days are up, they need to know they will paid if she stays there. Do you know how much LTC costs? Once her 100 days are up, her out of pocket expense for the facility is going to be $10k-$12k a month! Can she afford that? It takes Medicaid on average 2-3 months to process and application and determine eligibility. So now is the time for you & mom to decide what she’s going to do. Either she comes home or she stays and transitions to Medicaid if she cannot afford to pay.
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Sam, what is your mom's financial situation? It does take about 3 months for a Medicaid app to be processed, and, depending on how much or little in assets and the complexity, it may take you a while to fill out the app and provide everything that is required. Also, every state has its own Medicaid "look-back" period...in my state it's 5 years, so hopefully she hasn't been gifting money or property to people, as this will all come under scrutiny. If you know of this sort of activity, it may be best to consult with an elder law attorney who has experience with Medicaid applications. Filling out the app is not hard if she doesn't have more than ss and a bank account, owns a house and a car, all by herself. Anything more than that may require some advice. Others on this forum have had Social Services help them fill it out, for free, but they can't give advice or consult on the wisdom of doing certain things prior.

Having her in a facility that you didn't get to tour is a difficult situation. Is it possible to arrange a video walk-through with them via FaceTime or Zoom? I don't know if I'd have her someplace where the communication was absent, but I understand you can only do so much under the current circumstances. Let us know how it goes!
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