They want to be assured they will get paid. I applied her for medicaid last August. Before that, we had a PRI done which concluded that she should be in a SNF. I submitted applications to 4 different NH's & she was put on waiting lists for all. She has dementia, has a serious balance problem, can only walk short distances with a walker, can no longer manage taking her medications correctly, & cannot take care of herself. Now she is getting more forgetful, most of the time can't follow a conversation, & isn't eating nutritious food. She is currently living in an over 55 apartment complex, not assisted living or any kind of help. The medicaid caseworker now tells me they can't approve her for NH medicaid unless she is currently in a NH, they tell me she should apply for community medicaid. The NH director of admissions tells me they can't admit her without medicaid 1st being approved. I feel like a ping pong ball getting bounced back & forth. She is falling through the cracks because nobody will go a little extra to steer me in the right direction. She needs to be in the care of a NH but, at the NH director of admissions urging, I told the medicaid caseworker to go ahead & change the application to community medicaid. I don't feel comfortable with that because she can't do so many things for herself. Since the NH won't work with medicaid pending, how can I get her admitted without waiting for something to happen to her? She is willing & ready to go, she knows she needs to be there.
doctor involved in this. With an official diagnosis the doctor, she may be able to be admitted on a short term basis to an SNF with Medicare coverage. You don't say how old she is - I assume she is Medicare eligible?
Doing an admission as Medicaid Pending is discretionary by the facility. You don't mention where you all live but I'd bet that it's a competive marketplace for facilities, so they basically do not have to be accommodating and can still have waiting lists. So for where you live, NH don't need Medicaid or medicaid pending to fill their beds. Where I live (new orleans) the better places closest to us in Uptown (poydras home, st annas) with the exception of 1 do NOT take Medicaid at all & they have 90% occupancy. The joke is that in order to get into this place (Hainkel Home) you would have to marry one of the current residents. Families who cannot afford private pay end up finding a NH in an outlying parish (LA version of a county) to get mom into an available medicaid bed & admission as medicaid pending. You just may need to "cast a wider net" to get mom into a medicad bed that is a hour or two drive away. Once she is approved for Medicaid, you get her moved back to one of the places closer to you.
There will be a medicaid pending bed somewhere. It may not be your first choice, or ideal, but gets her into skilled nursing care & into the Medicaid system.
I moved my mom from NH1 to eons better NH#2 at about month 10 of her first year in skilled. It took Medicaid not quite 6 mos to get her approved, so she was totally within the medicaid system when she moved. Getting them moved is pretty straightforward....if you do this you want to keep control of moms monthly income so that it goes into moms bank account and then you or whomever is DPOA write the NH a check each month for moms required by medicaid co-pay (also called the SOC -share of cost). So that the month you move her, you are able to divide out her income the month of the move so that each facility gets the copay to the penny for each day she is there. This is really really important to do as its required by Medicaid to be paid each month no matter what.
Good luck in your search.
That way they can admit her knowing she will just switch her Medicaid from "Community" to "Institutional". Many people enter a NH following a hospital stay but in this case, Community Medicaid could provide her with in home services or go with her to an Assisted Living depending on what your state provides. In our state you must apply for Community Medicaid if you are living in your own home. The program provides, case management, meals, cleaning, transportation, laundry, medication management and administration and a Life Alert.
And to Monica, the squeaky wheel gets the grease, get on the phone and stay on it until you get an answer. Your moms application is more than likely sitting in a pile and worked on here and there, if at all, still.