What to do when my mom's primary physician won't admit her to the hospital, so she can go to a nursing home?

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My mom is 93 1/2, weighs 87 lbs. She has Alzheimer's with daily sundowners. She cannot see and cannot walk, due to a foot deformity. Needless to say, she needs 24hr care and then some! Medicare regulations stipulate that she would must have a 3 day hospital stay, in order for them to approve her transfer to a skilled nursing facility.
Her primary doctor will not admit her, because she "does not have an acute medical condition that grants 3 days in a hospital". She does have a pacemaker (coronary artery disease), low blood pressure, chronic constipation, osteoarthritis, osteoporosis and ---dementia!!!!!! (By the way, he has seen her only once and that appointment, didn't even touch her; only ordered an EKG).
Can anyone give me some advise on what to do here???? In a nursing home she would have absolutely everything she needs. In our home, it's from her wheelchair to another chair, or to her bed. She's wilting, like a flower, without any stimulus.
Her Medicaid is pending, contingent upon her placement, which, evidently will not happen soon. I did make an appointment with a different doctor, who perhaps will be more sympathetic and will find something with her that grants an admission to the hospital.
Your thoughts, please????!!!!

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Yes, Jeanne is right. It's really sad that there are so many hoops to jump through so our elders get the care they truly need. Here's hoping your Mom qualifies for Medicaid sooner, rather than later.
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Thanks, jeannegibbs. My mom is pending Medicaid, indeed, but as recently as yesterday I was told by an Admissions person that she must be admitted to a hospital first. I was also told in a different home, what you're telling me, however, they didn't have any MCaid beds available at the time.
After that, the admission issue has been the only thing I've heard from anyone. I'll be trying again the MCaid avenue and see what happens. Thanks so much for enlightening my thoughts!
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Jeanne, that sounds right. I have no experience with Medicaid (only Medicare) so I should have been quiet :) Good thing we have people here, like you, who do know.
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Medicare does not cover long term nursing home stays. They cover a short period for rehabilitation after being in a hospital. For example, if Mom is in the hospital after a fall and the hospital has done all they can for her, they may recommend that she go to a rehab center (also called transitional care unit) for therapy to get her strength back before she returns home. Medicare pays for that, as long as she is making progress toward the goal of going home.

The program you want for your mother is Medicaid. It pays for skilled nursing home care for persons who need it and are financially eligible. There is no requirement for a hospital stay, and there is not expectation that the person will make progress toward the goal of going home.

I don't know who has been giving you your information, but there is definitely some confusion somewhere. Go to the nursing home you have selected and talk to an administrator. They can help you. They will probably admit Mom Medicaid Pending.

The doctor is right. He cannot in good conscience admit someone to a hospital who does not need the kind of care a hospital provides. And then to send her to the rehab unit of a nursing home after 3 days would not make any sense, because she does not have conditions that therapy is going to help.

You want admission to permanent skilled nursing care, not to a rehab unit. And I think you need to talk to someone who works with Medicaid rules (like the NH administrator) and not another doctor.
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Another doctor, definitely. What a sad situation when 'government rules' get in our way of helping those in the sunset of their lives, like your Mom. I'm so sorry. Doctors are so afraid of the government and insurance companies. I truly believe the government and insurance companies are 'practicing medicine without a license' and I don't think it's right at all. Do you have any friends who have placed their parents in skilled nursing care? If so, perhaps you can ask for doctor recommendations? Good luck.
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