I'm having issues with the nursing facilities being understaffed at night. Residents wandering in and out of her room. I'm afraid this is hinders her ability to sleep. She is a recent admit and this is a big adjustment for both of us. I need to have the peace of mind when I'm not there that she is being taken care of at night. I have made them aware of my concerns but we all know that unless someone is monitoring this its sometimes unavoidable. I want to hire a companion for the evenings and partial night times. Will VA spousal benefits apply? I am now paying out of pocket for min. daytime companionship when I can't be there.

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And once they are eligible for Medicaid, the VA will change to $ 90 a mo.
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I probably should have stated this differently, thanks!
VA A&A doesn't work for paying for skilled nursing services in a NH as A&A doesn't cover the costs of a nh. NH run $ 5K - 12K. VA pays like $1400. Medicaid once they qualify will pay for the NH in full. For a NH stay, Medicaid works but A&A doesn't.

If they have something to settle or sell & face a spend down to qualify for Medicaid, A&A can make sense to do during the limited time for getting spend down over. They use the A&A during "bridging" and private pay the difference to the NH. But usually you want the spend down done & over with ASAP and not carried out forever. So A&A gone so Medicaid can pay.
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Aid and Attendance CAN be used to help pay for a nursing home. It does NOT stop once you're there. This is the correct info:
What are the Disability Requirements for Aid and Attendance?
Veterans, spouses of veterans or surviving spouses can be eligible for Aid and Attendance benefits if they meet the following disability requirements:

The aid of another person is needed in order to perform personal functions required in everyday living, such as bathing, feeding, dressing, toileting, adjusting prosthetic devices, or protecting himself/herself from the hazards of his/her daily environment; or
The claimant is bedridden, in that his/her disability or disabilities require that he/she remain in bed apart from any prescribed course of convalescence or treatment; or
The claimant is in a nursing home due to mental or physical incapacity; or
The claimant is blind, or so nearly blind as to have corrected visual acuity of 5/200 or less, in both eyes, or concentric contraction of the visual field to 5 degrees or le
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If you are wanting the VA Aid & Attendance program to pay for an outside aide for your mom who is in a skilled nursing facility, probably not an option.

A&A pays a stipend (about $1,400) to covered veterans or their spouses to enable them to pay for caregiving at their home or another community based setting. So can be used to pay a home health agency that comes to their house or towards the cost of living in an assisted living facility. But once they go into a NH, that means they are now in skilled nursing care so A&A stops. They instead get a VA stipend of $ 90 for personal care needs. If they are on medicaid, the VA $ 90 is extra $ and not a factor in the asset or income limits that Medicaid has. Also the VA $ 90 gets paid in addition to whatever Medicaid allows them to keep as their personal care allowance (varies by state from $ 35 - 105).

Suzi - at some point soon, there should be a care plan meeting regarding your mom. It is important that you plan for this initial meeting with whatever specific & detailed concerns you have. CPM - under Medicare rules - are done within the first 30 & then every 90 days & they can be really great to establish what works for mom as each dept will send someone to it. Like nursing, dietary, activities, etc. The medical director will not attend & neither will the DON unless there is a significant issue. You will be asked to sign off that the meeting happend AND you can write in at this point something succinctly that is a concern on this page. Comprende?

You may find that the facility has issues (liability, insurance, etc) with outside vendors coming in to assist residents. Neither of the 2 NH my mom was in would allow for overnight sitters. These were NH who took medicaid.. Having a sitter come in during the day for a couple of hours is like having a "visitor" & management look the other way on these. But more than that is likely to be a problem.

Often for new residents, a NH will encourage family to let them adjust on their own without family or sitters at their side for the first two weeks. NH needs to be able to evaluate their abilities & cognition, & if you or sitters are there to constantly "do" for mom, this can't be done.

It sounds like both you & mom have adjustments to be made regarding what living in the communal living situation that a NH is.
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Is mom self pay or medicaid at nursing home?
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