My moms long term care Medicaid was denied because they say she doesn't meet the medical level of care to get nursing home care. Has anyone gone through the appeal process that could give me some advice? I'll explain my moms and my background a bit.
My mom is 68 years old with Multiple sclerosis. She cannot walk or stand. She needs assistance with all transfers, to toilet, bed and her mobility scooter. She is cognitively alert and can feed herself, but cannot prepare meals. She also needs someone to dress her and wash her and her hair. She broke her hip in February of 2015, before then she could transfer herself so I was able to help with meals and shopping and anything else really. Now that she cannot transfer herself she needs someone around always incase she needs to use the bathroom. She can hold both urine and fecal for 5-10 minutes, after then she goes in her pull-ups or pad and needs someone to change her.
We just moved to Tennessee and I was sure that she would be accepted for ltc Medicaid because she was without question in our last state. I guess Tennessee has harder rules. They write that she can receive 8 hours of help at home a day and she will need to use free help from friends or family members. I'm the only family around and I cannot take care of her for those other 16 hours of the day. I have three young children, 5 year old, 3 year old and 10 month old and my husband is going overseas for the next 9 months. My mom gets up 2-3 times every night. I cannot mentally or physically handle the demands of her plus my children.
Is there anything in particular I should write in my appeal to Medicaid? I don't know what we would do if she is denied it fully. :/