She is qualified for medicaid and has been receiving nursing and caregiving help at home. But she has worsened and it may not be feasible to care for her at home.But everywhere we have looked says although they accept medicaid, they have waiting lists. What do you do if you cant wait??

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That's a common and frustrating problem in some states. Many skilled nursing homes limit the number of Medicaid beds. It's easier if a person can go in as private pay for awhile, but since your mother qualified for Medicaid, she likely doesn't have the money for that.
She may be forced to go home with Medicaid home care until a bed opens up. I'd contact your local long-term care ombudsman at (type in the Zip Code of her rehab center), or find the ombudsman on your state website. These people are trained to help in these situations. Good luck,
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You say specifically it's a rehab center. My father stayed in one after his stroke for about 6 weeks (in Tennessee). Because there are always people waiting, the patients are evaluated not just on how much or whether they have improved, but their potential for further improvement. If they have reached a plateau and it looks like that is either as good as it can get, or that in-home therapy would be just as effective, they are often released.On one hand, it makes sense, especially if you are on the waiting list during a crucial period when you would benefit from treatment. But I know it's hard on patient and family when being in a facility was good and it's time to go...
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PD - both great insight from Carol and Mary.
You can push it so that they have to find her a place. The facility knows or is betting that most family won't do this. However if you do this (allow the facility to place her), you may find that mom is moved to a NH in another area or even another county who is desperate to fill their beds w/revenue.

I'd like to add that you speak with the social workers at the rehab facility. They seem to really know what's out there facility wise and how to deal with getting in.

My mom was in IL and moved from IL to a NH without hospitalization or rehab facility or being in AL prior, what worked for us was for her to become a patient of the medical director of a NH. They are going to know just how to write up or tweak your mom's medical chart to show the imminent need for NH that will pass Medicaid review and also by being the medical directors patient your mom is likely to move to the front of the list and ahead of others on the waiting list @ the NH. Also it cannot hurt to contact the NH who have your mom on a list every other day just to see where she is on their list.

My mom was on 4 IL waiting lists at the same time so there is alot of duplications, the same thing happens for NH and your mom may actually be higher on a list as the others have found a place or realistically have passed away but haven't told the facility to take them off their list. Good luck and keep a sense of humor.
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No facility can legally "throw a patient out in the street", because that would be "patient abandonment".
The suggestions above are very good ones!
Priorities can be changed to goal: facility, easier, if the management et al, of the place a patient is in, knows clearly that the patient going home with family, even with home health care workers, is not an option.
Just make sure they know that incontrovertibly, and something will be found--but as mentioned, it might be out and away from your area.
AND, it may be a facility that is less than decently ranked in quality of care.
IF that happens, you can put the person back on waiting list for a facility you prefer, and be prepared to wait.

IF the facility that gets your family member is less than you like in quality, family is generally very welcome to come do some of the care load for that person--just make that known to the staff and those in charge.
[[the actual workers would be thrilled to have family come help wit patient care! I know it was a wonderful relief from patient loads when I worked in those places, but it was very rare. ]]
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Chi - you are so right!
Facility knows 99.99% of family is going to take mom home even if they cannot provide the level of care that mom really truly needs.
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My friend has Medicaid at home care 40 hours a week, I would ask for that. I heard Medicaid beds are of lesser quality private nursing home beds. Goodluck
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Facilities tend to play the scare-you-to-pieces games
--they try to make families think their elder would get put into the streets,
or have families believe there is no other choice but to accept the elder into their home.
That is bullying.
That is insurance-driven, more often than not.

Further, once the system manages to get an elder moved into someone's home, or back to their own home, the system makes it harder to get the elder back into the system
...they will require an emergency room visit,
and some in-patient hospitalization in an acute hospital,
as an actual admitted inpatient,
in order to get the elder back into the system.
make sure the elder gets "admitted for treatment",
NOT "for observation"!!!
Putting someone on Medicare into a hospital bed for "observation"
immediately excludes that person from getting adequate coverage fro Medicare, and,
can prevent them getting placed into a skilled facility for even necessary rehab, unless that person can pay for all that out of pocket.

If the person has to go into the hospital, try to make it the ER first, then admitted to the hospital for treatment.
Do your best to avoid signing any paper that says the patient is responsible to pay whatever insurance fails to pay.
Sign authorization for treatment, though.
By not signing that the patient is responsible for paying the hospital bills,
IF the facility converts the patient to the "for observation" category part way thru the stay, the facility is then responsible for the leftover bills.

Kinda confusing--not entirely sure I got it totally right, about that "for observation" category, but just be on your guard!
There is some more about this on one of the other pages in AgingCare.

One of the easier ways to get an elder moved out of your home, if there is trouble getting that done with them at home, is to leave them in the hospital, and make the hosp. find a place for the elder.
To do that, one must really be prepared to stand their ground, in some circumstances.

Patient's rights rules can make it very hard, too--since even those who cannot think straight, still have rights--finding a way thru everything is really tough. .
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