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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.

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I don't know why you want to skip the community Medicaid part. Once she actually has Medicaid, the managed care company that has her case can smooth the transition to a nursing home. Why fight it?
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I would suggest speaking to an Elder Law attorney. They can be very helpful in situation such as this. My MIL was admitted to a SNF as Medicaid-pending. We have to pay for the first month's charges up front and then were reimbursed once she was approved for Medicaid. Perhaps this would be an option for one or more of the facilities in your area?
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If she is this challenged, then have her doctor order her home care and Medicare will pay (but it has to be medically necessary - which sounds like it is). You could spend money consulting an attorney, but recognize your mother has a terminal illness and no amount of care will help her recover. There are so many people who have dementia the nursing homes are overwhelmed and they do need to know they will be paid. Keep asking for help, stay on waiting lists, and do as much as you can for your mother if you are near. In past times, children took care of their parents and we didn't have such a backlog waiting to get into nursing homes. Hang in there!
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Just curious....if you have applied for medicaid...how is she paying for her current residence? Is it family pay or subsidized? Based on her condition would she qualify for hospice? Eating,incontinence,dressing,falling,meds....no sign of possible improvement? Medicare /hospice care does not mean you are 2 weeks away from death. Also, any VA eligibility? ( yes I know that is a nightmare) Feeling like a ping pong ball is tough...and many times one of the players holding the paddle does not have all the correct answers.
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I think an elder law attorney would help. I feel bad for you, the Medicaid process takes months anyway. When my aunt needed to be placed in a nursing home, the hospital that was discharging her wanted a list of 5 nursing homes in 24 hours. 4 out of the 5 rejected her because we as nieces didn't know the status of her financial affairs, i.e. did she have enough money to pay for a nursing home. I think the nursing home that took her figured she had a house and she'd have to sell it so they figured they'd get something. Eventually when I did file for Medicaid for her, I had an elder attorney do it. It was costly but it saved me from having problems in the end.
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Where I live thr Social Services at the hospital try to find a place, but then I livein a small area with a few NH. I was up for a job at a NH. My job would have been calling around to hospitals and telling them a bed was available. I was under the impression it works both ways. I know when my MIL was being transferred from Fla to Atlanta that the SS t the rehab sshe was in were very helpful. My SIL did the footwork because it was another state but the SS worker did her best to help. In the end, we found it was her supplimental that was causing the problem.
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If no family can take care of her full time and she's living on her own until the system keeps in, I'd probably ask an attorney/other if living at a personal care home is an option while she waits. The rent might be the same and at least there'd be someone who could give her her Meds and watch after her.
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Not to experienced with Medicaid, my dad was and my wife is private pay. But, if she is can qualify for some type of short term nursing home stay for rehab to "improve her mobility" or something else, medicare will pay for 27 days I think. Once she is admitted would that meet the medicaid requirement that she be in a nursing home before she can be approved?. Might get the doctor to play along with this.
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I understand why you are balking at Community Medicaid because that means she stays home on her own, with only a visit by a caseworker daily or 3 X a week. At least that's how it was for my parent in Louisiana. You need to get her
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?
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Monica - if you really don't see community based Medicaid as being able to deal effectively with the level of care mom needs, then imho you need to think about the problem differently.
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.
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I see that many people are recommending seeing an elder care attorney. That is always best, but most people use this website because they can't afford the $400/hr that such an attorney. I am a disabled paralegal and I offer free assistance to those who have no money to pay an attorney. I used to do PI law and know how to get people care after an accident and I know the issues with Medicaid, Medicare, Hospice, etc. There is always a solution with the proper negotiation. If you want my help, please email me the details of Medicaid problem and tell me who is DPOA for your Mom, if it is someone other than you.
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Is it not an option for her to live with someone she loves who can take care of her?
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We just get community medicaid "approved" for both our folks AND that was ALL our local NH needed to admit them BOTH in the same room, no less. Now we are submitting docs for the "medicaid" for NH care! AND it was fast and fairly simple for the community care process too (less than 2 months). Wishing you all the BEST in your process. They are both doing so much better than they were at home even with extra helpers coming in......both have dementia too.
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My dil's grandmother was admitted to nursing home for skilled nursing care paid for my Medicare, after being in the hospital, but then was needing to be transitioned to long-term care, Medicaid pending, with her having been on Medicaid before, but not sure the same type as "community" because hers was because she was drawing a disability check, but she wasn't careful about her money before, so now she's running into problems with her Medicaid pending status
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I believe her check was going directly into her bank account but since she wasn't having to pay the nursing home at first, because Medicare was, 2 or her daughters, 1 of whom had her checkbook, were coming to see her and having her write checks to them - without the amount filled in, they were doing that later or at least one of them was and not the one with the checkbook but apparently that one was at least letting the other have checks to do this with - so when she was endeavoring to transition to Medicaid they caught all this, charged grandmother with fraud, wouldn't pay the nursing home - which, not quite sure what the deal is there, if, like according to igloo, they'd normally take 6 mos. to approve anyway, but maybe because of this, they're concerned they're not going to get paid or maybe in order to, they've issued charges on the two daughters; they were supposed to have had court this week
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deb daughter -- A skilled and patient negotiator could solve this problem. If grandma gave blank checks to her daughters, she made herself ineligible for Medicaid (although she probably had no idea how the law works). Unless the money can be repaid she will be ineligible until she spends down her assets. Good Luck. Perhaps the daughters who took the money should let her move in with them and hire a CNA to take care of her while they are at work.
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oh, yea, right, Beverly, like that's going to happen; well, maybe, actually with one of the daughters, that does work and actually at least did have a good job, at least I hope this doesn't cause her to lose it; she actually, as I understand, did take only one check and that was to pick up a check her mom had previously written out to - yes, get this - one of those payday loan places, so since, presumably, she could prove that, she was hoping to get her charge dismissed, have her contact reinstated, and then I could possibly see her doing that, if it comes to that; from what I understood, if the nh pressed these charges, Medicaid would reinstate her, at least, pending status; of course, considering the "giveaways", whether they would ultimately approved her would still remain to be seen, but at least I think the nursing home would allow her to stay but then's where maybe the check would need to be more supervised to ensure, that if Medicaid doesn't retroactive and they want funds for her stay, they would be there - and yes, grandmother had no idea how the law worked, they just thought since while Medicare was paying and she wasn't having to, she could do what she wanted to with her money and if she was going to, had better while she could.
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i admitted my mother to a Geriatric Psychiatric Facility for evaluation. After 3 days, the attending psychiatrist determined that she required Skilled Nursing in an Alzheimer's lock down unit. Medicare will pay for the 1st 100 days of skilled nursing when a patient is transferred from a Psychiatric Facility. You still need to speak to an elder attorney. I hope this helps. It's so overwhelming.
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Yes, retain an elder care atty.
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Sorry about your mom. As far as getting her admitted to a NH, you must get durable POA, you should have a copy of the 1st mcaid application completed in August. How much money, or liquidable assets does she have. Frankly, mom must be absolutely broke, except $2000 in assets, or a ppd burial plan is acceptable. In my state, Mass., she should be in the state computer system by now as having applied. And the above poster is correct, 100% or all of moms monthly income, SS, pension, retirement is used to pay for NH care, minus $72.80 that mom can keep per month. Mom has to spend all her money. And liquidate any assets in case mom has to begin her NH stay as a self pay resident until she is out of funds. If I were you, my first step would be to call on the status of your moms medicaid application. Why isnt she approved yet? Too much money? Missing bank stmts? Is there a life insurance policy? Medicaid needs everything. 6 months is way too long, she should have already had a medicaid caseworker assigned by now. It sounds to me like medicaid ia missing some info. You, as the next of kin, are going to be doing all the legwork for medicaid, (even if you chose to hire a lawyer) so DPOA os imperative. What is holding up her mcaid application? I think that is the 1st question. Good luck, stay strong. I lost my mom in december, 2015.
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Sometimes if someone is admitted to the hospital, they become responsible for finding placement for her. She may get 30 days in the NH paid by Medicare for rehab while the Medicaid goes through. They will move her to where there is a Medicaid bed available. It has to be from inpatient to NH vs personal residence to NH.
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By applying for and getting approved for Community Medicaid you are essentially showing the Nursing Home that she is Medicaid Eligible.
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.
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I applied for my Mother in October for a home based medicaid waiver and she just got approved last week. I have searched for anyone knowing about this and see some might on here. Does anyone have this, how many hours did you receive? I cannot wait to see if this really comes true!
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.
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not too sure about the actual home based Medicaid waiver but the other program the state has they just called me about couple weeks ago re hub's aunt and/or uncle - or both - and said they could pay for 20 hrs./month - the Medicaid waiver might have been more but they don't qualify for that based on income and/or assets
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Why won't Medicaid pay for the first 100 days or until Medicaid kicks in? We put my MIL in a nursing home and Medicare paid then we sold her home and used this money until we got her assests down to 2k or less then she was approved for Medicaid. The process as I remember it took a few months to get all the paperwork filled out then about a month later she was approved. Yes an Elder Care Attorney is a blessing. I would definitely consult with one. We did and found it very helpful.
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Sorry I meant to say why won't Medicare pay for the first 100 days.
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get with an Elder Attorney asap. Than goodness I heard of that "on here" and we got one when working with my dad's issues. of course he fell, went to ER, was told "by me" that he couldn't go home because my mother could no longer care for him properly, he stayed in hospital 3 days and was placed into NH, he paid privately for one or 2 months but then qualified for Medicaid. While Medicaid was pending, the NH could NOT put him out. they knew they were going to get paid, but it takes them about 9 or 10 months to get things in gear. and working with an Elder attorney was SOOO helpful to our family.
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You were told the right thing. My mom went into nursing home with community Medicaid. Once you're actually there, they convert it to institutional medicaid. Community medicaid paid for my mom to have 24/7 home care before she went into a nursing home.
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Christine, they paid for 24/7? wow
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Lizdevine offers excellent advice. It is important to determine why the Medicaid hold up. Then, I could determine whether or not she needs an elder care attorney or a paralegal to call and get them to work faster by politely nagging. It is always better to keep dementia patients at home if it is possible to do so. Medicaid should be the last resort. All she will have is $72.80 per month. That will not cover her needs -- medicine, snacks, kleenex (not provided by nursing homes), perhaps a hair cut. If Mom is poor and has no assets, Medicaid is the answer. If Mom has assets, use the assets to hire people to take care of Mom and do some of the work yourself. Whatever the problem, love (and money) are always the answer.
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