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Medicare ended Friday, May 27. My father had a stroke and was placed at SNF in February for rehab. Monday May 30 the SNF stopped rehab. He's unable to take care of himself and I'm afraid that since he can't afford to pay out of pocket he will be sent home. He applied for medicaid in February but I'm told it could take up to a year before it is approved. He has improved a lot since he's been there but with no rehab I'm afraid this will set him back and if I don't come up with a solution soon I'm sure they will release. I need financial assistance so he can get the help he needs and stay at the facility or find a facility that can give him the help he needs. What other resources are available beside medicare and medicaid for the elderly? He's totally disabled now but his goal is to be able to take care of himself and go home. Now that the rehab has ended he'll never be able to do that and if he's sent home now how will he get the care that he needs. He's on a feeding tube, he can't walk and if he sent home on such a short notice his home is not equiped for a handicap individual and none of the caregivers have any training on how to care for him. I'm at the end of my rope. What do I do now? Where do I go for help?

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Where is the nursing home social services/administrator? They are able to assist in your situation. And, no, your Dad will not be released from the nursing home unless I do not know all the facts. Medicaid will pick up reimbursement to the nursing home for each month your Dad is there and not able to pay privately. Contact your state Ombudsman to assist you. Be sure you have all your Dad's finances in order to prove your case.
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Speak to the social workers at the SNF. They are experienced in advising what to do in situations such as this. Also check with your County, there is usually a "Council on Aging" or "Senior Advisor" that can assist you in this situation (no fee). Hope this helps. I'll keep thinking. Good luck!
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I had a similar experience, but mom went into assisted living after medicare's extra 20 days of rehab expired, not a SNF. If your father still needs daily nursing care (feeding tube, etc), then sounds like he should still be in a skilled nursing facility. The SNF should take him now, care for him now, and medicaid will pay for his care retroactively to date of admission when his application is approved. If immediate admission to a SNF is not an option, there should be several home health services available. Medicare will pay for home health services -- limited, but at least it is something. The social worker at the rehab facility should be able to put you in touch with reliable home health agencies who will evaluate your dad's daily needs and schedule visits. Also, Medicare will pay for durable medical equipment and you must GET A RECOMMENDATION / PRESCRIPTION in your dad's medical discharge records for this equipment from the nursing supervisor at the rehab facility. Ask for a Wheelchair, rolling walker, toilet grab bars, and a hospital bed. You must request that these items be prescribed in his records! Medicare will also pay for enteric supplies for his feeding tube, etc. The nursing /rehab supervisor at the rehab facility should tell you about all of this stuff, give you home health agency recommendations. I only learned about these things from my mom's recent experiences. You have to be constantly overseeing your dad's care, and I know how stressful this is. Call your local Area Council on Aging and get some recommendations for a Geriatric Care Manager, who can help coordinate all of these circumstances for you.
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Follow-up to previous answer: If you dad is a military veteran, he can also tap into assistance from the Veteran's Administration, in the form of a pension for assisted living or nursing facility care. This application also takes a long time to process, but it pays retroactive to date of admission to an ALF or SNF. Check out the Department of Veterans Affairs website, look for EXAMINATION FOR HOUSEBOUND STATUS OR PERMANENT NEED FOR REGULAR AID AND ATTENDANCE forms and instructions. see http://www.va.gov/vaforms/search_action.asp?FormNo=21-2680
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Caution! If your father has resources above Medicaid limits (assets and/or income) his application will be denied! Before you approach the SNF to handle the application find out what the Medicaid limits are in your state (virtually all states have an asset limit of $2,000 with income limits varying). The SNF will want private pay to any degree they can receive it and will NOT counsel you on preserving assets for your father's benefit which CAN and SHOULD be done since Medicaid allows only $35 per month in personal needs allowance and, moreover, if Dad is discharged to the community you are going to need every penny. If your father is indeed over the limit(s) consult a professional immediately. Keep in mind that even if the application is filed the last day of the month, benefits will be retroactive to the first of the month. Do not feel pressured by the SNF to do anything until you figure this out. Most importantly, DO NOT sign anything that will make you financially responsible. Good luck!
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With respect to the VA Pension suggestion above...this pension may also be used to pay home health aides. Some agencies will "front" care while the application is being processed. If you need professional counsel be sure to use someone who is familiar with BOTH Medicaid and VA benefits since qualification and eligibility requirements are separate and distinct. You do not want to disqualify him from one benefit set while attempting to qualify for another (if he is over resourced for either).
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Relax and take a deep breath. It isn't all doom and gloom. I have never heard of any application taking a year to get approved unless someone is trying to hide assets. If you are not comfortable with the Medicaid application process, comsult an elder law attorney. This is their specialty and might even be able to save some of the assets your Dad worked a lifetime for.
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Have your physician prescribe Home Health Services. It isn't as good as daily physical therapy, but it is something. I have had non-stop Home Health Services for the last 3 years after a hospitalization left my mom weak and hardly able to walk. A home health agency can come into your home and give physical and occupational therapy plus a nurse and an aid to bathe the person. Their criterion for continuing services is that the patient must show improvement.. I've found that all agencies work with this because they want the patient to show improvement so they will get paid. Their services are time limited. My current agency has provided my mother (and me) with a physical therapist who has come 3 times a week for 2 months, an aid that bathes my mom 3 times a week for 2 months, a nurse who provides bandages if needed. My mom doesn't need occupational therapy at this time. But that is about 5 or 6 hours of work that I don't need to do every week. After 2 months they will drop down to 2 times a week for about 6 weeks. If there is a fall, the services will increase to 3 X a week again. If not, we will be discharged at the end of the last 6 weeks.

Then I call my doctor who prescribes home health again. And another agency comes on board and starts all over. There is no relationship between the care she has received for 3 months and the next agency.

It is great in many ways. It takes some of the burden off of me and it also gives my mother the stimulation of these relationships. I have cycled through most of the agencies in my city. I have a few favorites that I have had 4 and 5 times.

it helps.
Best of luck to you.
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Interesting caregiverdiary, is this medicare or medicaid? From my trials of this, dementia patients dont qualify as they dont improve and it never worked for me. It worked for 6 weeks after a broken leg, then it all stopped . Also on the Veterans applications, 1 year + is normal, it took us 20 months to get approved and several I know at the daycare we were using, also took well over a year. I would love someone to help me without us paying a fortune weekly, I need to know the tricks here i guess. Goodluck 946, I went thru this and was on my own, had to sell my parents home to pay for private care, no one helped me and wont until all the moula is gone. Hang in there!!
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luvmom, you are so right that the system fails to provide any real help to stressed out caregivers until all the money is gone, as you have said. Hang in there! The advice given by Mr. Robbins is important because nursing homes have the right to discharge residents with proper notice and there is little recourse when that happens other than to start over - yet again. Lots of wisdom shared in everyone's replies to your post, re946. You're between a rock and a hard place like many of us who are caregivers. I wonder if Centers for Medicare and Medicaid Services even cares about the plight of caregivers?
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Thanks CaraMia, appreciate the good comments. When I first read this posting I said under my breath "welcome to aging parents" no one cares, its all on our shoulders unless you parents are poor and/or not until they are poor.And, even then, do they get the true care they deserve when they are covered? Few have had an irrevocable trust in place 5 years prior and thats they only way out that I know of. Cheers to all of us caregivers!! I am pretty sure I now have to leave my job to care for my Mother, as there isnt enough money for me to work and pay a caregiver, yet its over by $300 a month to not receive medicaid.
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If does not receive a VA Aid and Attendance Improved Pension Award with 90 business days from the date of application there is something wrong with the application. If information is not provided on the proper form, in the proper form and without corroborating evidence undue delays will occur. It takes paperwork thirty days to cycle through the system, so each time the VA has a question or additional information is required, you are looking at another 60 day delay. My experience has been (with the Philadelphia center, anyway) that properly completed and documented applications are processed within 30 to 72 business days. The VA actually does a heck of a job if you give them what they need to do it!
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Yes they did write a couple of times for additionl info but it went on so long I called congress like someone else at the daycare did.
It was then approved in 3 more weeks !!! Its how it has been around here so the daycare owner tells me, she said plan on a year but its retroactive. There are companies now that charge to fill out the forms and claim to get answers in 3 months time.
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Mr.Robbins is correct. Your father cannot come "home" to living quarters that is not equipped to handle a person with a feeding tube.
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Yup. You have to be destitute to get help. But once you are destitute, it's not equal care for low to no income people vs wealthy folks that have long term care benefits they paid into. Or should I say, the long term care benefits they could afford to pay into? This country isn't doing well for its poor elderly and disabled. I doubt the good 'ole USA will ever take notice of this minority group because it's members die off or run out of steam (exhausted caregivers eventually fall prey to their own illness/age related problems and require care themselves.) But, maybe one day somethings gotta give...
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If you apply for VA benefits it shouldn't take very long to get through the process as long as the forms are filled out correctly. Once submitted, if the VA finds they need something additional they will request it, and when the paperwork comes back, the application is at the bottom of the pile - so it's IMPERATIVE that the forms are filled out CORRECTLY the first time. There are companies/organizations that claim they will help you with the paperwork for free - but I've talked to many who went that route only to find out they were talking to an investment company who did help with the paperwork, but also was trying to make money on investments. Go directly to a local VA office - they have people that will help you get the application correct the first time (this is what they do) - they actually will help you fill it out and have all the paperwork in order so that it gets through the first time - they know exactly whats needed - and the wait may only be 3-6 months, but if approved the payments are retroactive to the day you applied. Also check with your County government for a VA rep. Here in Florida, our County has a dept. that is County run by veteran's who know the process of filling out the forms. They will assist you for free, just like the VA offices will. You should never have to pay someone to help you apply to the VA. Good luck!
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The services I described are covered by Medicare.
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Thank you all for your comments. Being new at this I was in the dark. I went to my local Council on Aging and they are now doing an investgation and I now have an obudsman to assist me. I've learned a lot in last few days and I now see how the nursing home will not do their jobs if someone doesn't follow-up. Again thank you.
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Glad to hear you are progressing in the right direction and now have the proper assistance to help you through the process. It's always a new and hard road for caregivers, but I've found this site invaluable when I needed answers and help when I went through the process with my mom last year. I learned so much when I had to go through the journey with my mom and am glad there's a site where I can share my experiences and suggestions. You're involved with your dad and looking out for his best interests - give yourself a pat on the back, as you certainly deserve it. Good luck. Thoughts and prayers that all work out for you.
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You have to be dirt poor ( relatively speaking) to get Aid and Attendance from the VA.
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Thats not true at all, a person can have $80k and more, in the bank and still get it! I think you are confusing it with medicaid. As long as the person was a veteran or spouse of a veteran, and has enough medical issues, you can get it. It covers daycare, or you for care taking, etc.
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No one will be sent home with a feeding tube in place. Check out all options with Eldercare or an elder attorney in your state.
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I cannot imagine trying to fill out the paperwork for the VA aid and attendance alone...it's not that the forms are too hard to understand, but companies, who do this on a regular basis, know what the VA is looking for and can save you a LOT of time, especially when it comes to gathering documentation from doctors and hospitals, etc. My Mom's ALF had a company that does it for no charge for their residents.
Like everything else, there are good and not so good companies. I would recommend calling your local ALF and ask who they use for their residents. I have been really pleased with the service I received and how quickly they compiled the application. Of course, you do all the foot work of gathering documentation. Be relentless on following up on paperwork from your parent's docs. Eveyone has their own system, so it takes awile and I had to call medical records depts. 2 - 3 times to get what I needed. You will need records for the last 12 months.
Early on, I did try to call the VA directly and got terrible advice. They said Mom's income was too high. What they failed to tell me is that certain types of care can be deducted from her income, and thus she now qualifies.
Also, if you need to qualify for Medicaid at some point, the VA benefit can be discontinued.
It is such a game and that is exactly why I come here for the BEST advice from folks who have "been there, done that."
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There are many companies that will assist you with filling out paperwork for VA and not charge for their services - but be very careful - some of them are investment counselors also, and are trying to get you to invest in their company and have been successful - which may not be a bad thing - just don't let them force you to do anything or feel pressured to invest because they are assisting you. Here in Florida, our County government has a VA rep who will prepare the application for you - for free - and assist you in getting all the documentation you need. This is what they are experienced in (they do it every day) and can really get the process accomplished in a short period of time, even though it does take months to get the VA to approve or disapprove your application. But if approved, payment from them will be retroactive back to the first day of the application. If you do the application yourself and miss one thing on it, or the VA needs to send it back to you for a clearer explanation, your application then starts again at the bottom of the pile and you can be waiting so much longer. Check with your local County government, Council on Aging or call local assisted living facilities for assistance. Good luck!
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caregiverdiary: excellent advice about "rotating" in home care agencies. Too bad we have to go through the hassle of starting with a new company each time. But as you said, it gives your mother someone else to interact with.
The only issue I have with these agencies is that they want all their people (PTs, OTs, aides, and nurses) to come in 3 times a week each! Mom gets overwhelmed and cannot keep their schedules straight. I had to finally ask them to commit to the same day and time each week. I, too, removed the OT...she really didn't need that type of help...and reduced the nurses to one time a week. The PT and aide is what she needs right now.
Thanks for the great suggestion.

If you are thinking about applying for VA benefits, start collecting records now. They also ask for financial and bank statements...so do not make any odd transfers or deposits until the statement has been submitted.
The aid and assitance benefits seem to lean toward mobility care. So document everything your parent needs to maneuver in his or her environment. (ie: crutches, canes, walkers, scooters, lift chairs, bathroom aids, help with bathing, eating, or walking, etc. Or even if they have to take your arm in order to walk. I even listed adaptive tools and clothing that I have bought for Mom.) Some companies may even ask you to submit a picture. I made a list of things for Mom's doctor because he does not see her every day and needs to know about the limits to her mobility.
If you find a company that has a good reputation and record for getting benefits, it is worth it even if you have to pay some out of pocket. For example, let's say they charge $800. to file. If you receive the benefit, it can be up to $1056 per month. currently.
I have no experience with the "freebie" companies....sounds too good to be true and should most likely be avoided.
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Whoever you use to help you with the paperwork, you can get a head start in collecting the necessary documentation by going to http://www.veteranaid.org.
There is a list of documents needed and some other valuable information.
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My father was 80 yr old and was complete drop from medicare services. He just came out of hospital and is needing assistance. He had a follow up with his cardiologist but they wanted full payment. Due to him being drop from medicare he was turned away. I called five different places and each one could not provide me with a answer on how to get back his medicare. My father is born american that paid his taxes when he strong to do so. Now medicare is failling him when he needs it the most. Live in the state of Texas. I dont know what else to do or where else to call. Please help.
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Why was your father dropped from Medicare? This does not make sense. Call the Social Security line 1-800-772-1213 and ask why your father was dropped. You must provide his S.S. number , his full name and his date of birth. I assume that you have his POA or you are his Guardian. They will direct you to another number and get some answers. I have never heard of someone being "dropped", after having received benefits.
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