How hard is it to get Mom into a nursing home?

LadySugarBug · Jun 21, 2006

Do you mean MediCAID or MediCARE? We are looking for a NH for my grandmother - she has no $, and suffers from severe Osteoporosis so we have to look for a nursing home vs. Assisted Living (they are usually For Profit and do not coordinate benefits). We are in GA. I am not sure how other states are. To look at the ratings for Nursing Homes in your state go to www.medicare.gov I have been on ALL DAY looking at the ratings of various NH's in our area. Good luck to you, and I hope you are able to keep your mom with you. That being said, for your own benefit, ASK for outside help to give you a break! It can be too much to do on your own, as much as you love them! (Neighbors can be very benefitial!!)

RB

Antikigirl, ASN, RN · Jun 21, 2006

My grandmother was living in a wonderful 5 person adult nursing home about a 2 month ago (she passed away early this month:( ). However, the group home would no longer take medicaid or medicare...so she had to move to a nursing home (and I mean nursing home...that building is older than dirt and reminds you of the facility of "One Flew Over the Cookoos nest".). But we had NO CHOICE!

We hoped to have it temp, and move her there in the mean time and find a better place but where having an uphill battle. No places wanted to deal with medicare/aid at all anymore...it was all too complicated, the facilites made no money...in fact they lost money and had harder times paying staff or providing services...and hi ya...paperwork paperwork paperwork and no guarentee anything was covered!!!

Then we got a bigger probelm..not only did grandma's doctor then discharge her from care because he would no longer accept medicare/aid....(and her cardiologist too!), but same with my very ill mother in law! OUCH!!!!!!!! We were really in a pickle to put it very lightly.

The battle over finding a place for grandma was cut short. The move was too much for grandma (she was a cardiac nightmare, had severe CHF, and the stress of change got her...and for this 93 year old woman with teflon bands in her heart, all valves replaced, two hip replacements in a year, and frequent UTI's and URD's was a ticking time bomb to begin with...wouldn't take much to send her into pneumonia or cardiac failure as is). She died of CHF a week after moving to the home.

It makes me very scared about the future, and of our patients now. If MD's and facilities won't let people in...where can they go? What can we do to stop this from happening?

I pray for your grandmothers well being and safe and happy placement where her needs can be met with having the dignity and individuality she so deserves!

catlady, BSN, RN · Jun 21, 2006

What nursing homes love the best is for the resident to come initially on Medicare and then convert to Medicaid or private pay when the Medicare runs out. But for that to happen, the resident has to have a three-day qualifying stay in the hospital, or Medicare doesn't kick in at all.

They're not averse to having Medicaid as a payor source, although hopefully your mother also has Medicare so that if she needs therapy, it can be covered under Medicare Part B. What they *don't* like is someone who only has Medicare, because it's so limited in what it will cover.

What you need to be doing when you think your mother is going to need a nursing home is going out to tour facilities of interest and talking to their admissions people. Every facility has its own quirks and preferences, and you want to make sure it's a perfect fit for your mom. You don't want to wait until the last minute, or when she does end up in the hospital and you have to make a quick decision because the hospital discharge planner is under pressure to get her out of the hospital.

Blackcat99 · Jun 21, 2006

Thanks so much Lady Sugar Bug, Triage RN34 and cat lady. Mom is on medicare at this exact moment but has just now applied for medicaid. Right now, things are great. I have a live-in caregiver helping me take care of Mom. Mom has alzheimers and congestive heart failure and is 84 years old. Yes it's so important to get a break. Thank you for telling me that the small 5 person group homes don't accept medicaid or medicare. I didn't know that. That is a shame. I sure hope Mom's doctor will keep her when she goes on medicaid. Yes, I think maybe I should start touring facilities and talking to admission people now. That way, I will know ahead of time which facility to call if Mom is unable to stay in her own home.

Nascar nurse, ASN, RN · Jun 22, 2006

Food for thought.. The http://www.medicare.com nursing home compare site is a good place to get an IDEA of a nursing home, but in only shows "one little picture in time". This information is also nearly 6 months old and a lot can change in a NH in 6 months - good and bad! Also need to consider and ask the facility what types of residents are being admitted. For example, we do a lot of hip and knee replacements, therefore when you view our buidling it LOOKS like we've got a pretty high pain issue going, but in fact we are ACCEPTING residents that are just gonna have pain issues related to whats going on with them. Some NH are known for their wound care and as a result, their site may LOOK like they have to many wounds. Always best to go visit a place, look at residents (hair combed/shaved/clean clothes), look at staff interaction with residents, smell, taste a meal, etc. Then you've go a CURRENT picture of what's going on.

Home Health Columnist / Guide · Jun 22, 2006

please look in your community for area office on aging...info found in blue pages of phone book.

there is a medicaid waiver program available in many states that is meant to keep elderly at home and out of nursing homes.

in pa ours is called: hcbs waiver for individuals age 60 and over

to provide personal care, respite, adult day daily living centers, environ modifications, spec med equip & supplies, transportation, pers, companion, physician services, home support, home health care, counseling, home delivered meals and attendant care to individuals age 60 and over. this waiver was recently amended to increase slots and add community transition services and remove the 80% individual cost cap from the waiver

centers for medicare/medicaid link: http://www.cms.hhs.gov/medicaidstwaivprogdemopgi/05_hcbswaivers-section1915©.asp

to find program, click on your state:

waivers and demonstrations through map of states

p.s.: you do not need to have medicaid, but be medicaid eligible.

i've cared for many in this program to keep em out of snf. for those that cant get to doctors, philadelphia's program has rn's make monthly visit to eval home safety, med compliance, assess for illness and instruct disease management, med prefills if needed--service my homecare agency provides. also pt performs bathroom safety eval, provide shower chair and bath grab bars all in name of safety. cheeper to keep your loved one at home.

Blackcat99 · Jun 22, 2006

Thanks Nascar Nurse and NRSKarenRN. Yes I am sure hoping to keep Mom home. I will definately check out the medicaid waiver program. Thanks so much.

milky · Jun 22, 2006

http://www.medicare.gov , is a great site, not only does it explain medicare and medicaid benefits, but you can go in to the section that says "Nursing Home compare" you can look up nursing homes in your area and it gives you info on each facility including latest state inspection results and each individual tag and plan of correction etc..

CoffeeRTC, BSN, RN · Jun 22, 2006

Nascar and Catlady are right on. When considering the nursing homes and seeing the reports online...that is only a glimps of the picture. Vistit them at least once. Yes the numbers on paper mean something, but they aren't always showing you the big picture. Our pressure sore numbers are high, but that is because we get alot of res admitted with them also are pain numbers and cath numbers are high because we have a lot of hospice pts.

Blackcat99 · Jun 22, 2006

Thanks milky and michelle126. I am praying that my live-in CNA will stay here with Mom and me till the very end.

CapeCodMermaid, RN · Jun 22, 2006

If your mom owns her own home, I don't think she'll qualify for Medicaid.