I cannot handle her recovery at home! They told me at her 2 days after they filled their bed at rehab that because her orthopedist sed she should never bear wieght on that leg again they cannot show medicare any progress therefore cannot justify her stay there. If I put her in a home for recovery we cannot pay our mortage and bills...i dont know what to do but am furious that money will dictate her quality of care.
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A broken hip is one of the worst injuries an elderly person can sustain. I hope she can at least be kept comfortable.
Take care,
Carol
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do an internet search for the words "how to appeal a rehab nursing home decision to discharge medicare" and you will find an article which includes this info.
They must give your parent a written Notice of Medicare Provider Non-Coverage (NOMPNC) form at least two days before the anticipated discharge date. On that form there will be information about how to contact the relevant "Quality Improvement Organization" (QIO). The QIO is the group that reviews these cases and makes determinations about whether care should continue.
If you haven't received a NOMPNC at least 2 days before the discharge date, the facility has to keep your parent until at least two days after you do receive
i see you live in Oregon. I thought Oregon was known for providing some of the best resouces and funding for elder care. have you called
have you check this oregon site for contact. her dr can be your best help b/c if he orders something, ususally it will be covered.
I'd like to add my experience in dealing with the elder having a home, it's expenses and MERP (estate recovery after death). Yes, their home and a (1) car is an exempt asset for Medicaid. However, the $ the elder has after they get into a NH is usually limited to whatever your state has set as their "personal needs allowance". The $ varies by state - just as the Medicaid rules vary by state.
My mom is in TX in a NH on Medicaid and still owns her home. Her PNA is $ 60 a month and is totally spend on stuff she needs to live at the NH like cosmetics, clothing replacement, hair salon. The reality is that the PNA is designed for doing just that and no more. Some states have a PNA as low as $ 35.00 a month. All expenses for her home (taxes, insurance, utilities, yard stuff, etc) is paid for by myself & another family member, there is no mortgage and the property is modest and we are fortunate to be able to do this. BUT if there had been a mortgage (traditional or reverse), then the house probably would have been sold as the monthly mortgage costs would have probably become an issue eventually. Now when she dies, we will let MERP know within 30 days that we will file a claim against her estate for all our expenses related to the empty house. This has to be done in our state within 30 - 45 days in order for the MERP expense exemption to be done.
As you live in the house and have been a caregiver for more than 2 years, you qualify for the caregiver exemption, but you will need to properly file for the exemption with your state's MERP program so there is not a problem with a MERP claim or lein against the house later on. My mom's state (TX) has all this stuff on-line so it's easy to find. You need to remember to do whatever your state's MERP program wants after mom dies and within the timeframe set by the state.
Now once they are in a NH on Medicaid, all their monthly income less PNA must be paid to the NH. If they get $ 1200 a month, then the NH get's paid $ 1,040.00
if they live in TX. So if you want to keep the house or live in the NH, the state expects you to pay on your own whatever to do that. If the house has a current Realtor listing, then you can apply for a waiver to divert some of the monthly money to pay for whatever needed to have it market ready. This usually is limited to a couple of hundred $$ to pay for yard, utilities and seems to be limited to a few months as it is expected that the house will be sold. But if it's the situation, that you are living in the home, the state expects you to pay for all without ever coming back for a claim for expenses. The expense claim seems to only be able to be used if the home is considered empty.
The cost of the mortgage is the big issue here. Can you on your own continue to pay the mortgage? Or do you really truly need mom's income to do this? How much is owed and is there anyway to pay it off completely? Go through the mortgage paperwork to see how to do an early payoff and what it might cost you.I'm assuming this is a traditional mortgage or a HELOC and she has owned the house for quite a while and there is alot of equity in the house and most of it has been paid off. If the amount owed is just for a few years more and you can possible pay more on the mortgage each month, look into doing that. Even if it is just like an extra $ 75.00 a month added to pay down the mortgage. You need to do whatever you can so that you don't find yourself homeless. Good luck.
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