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billstumpf Asked December 2014

Any advice on fighting observation care status for my Mom (96)?

She's at Yale New Haven Hospital with left and right pelvic fractures tailbone fracture. She is a resident at the Hearth in Brandford, ct in the keepsake unit - assisted care. She has dementia. She fell on 12/22 and was taken to Yale and released. She fell again the next day, 12/23, was taken to Yale and found to have the fractures. Yale said she would be admitted. this morning they are saying she will not be admitted. they want to discharge her and have us pay for skilled nursing care. We need guidance navigating her care and Medicare rules for coverage. I am the POA for my mother: william S.

Eyerishlass Dec 2014
Have you spoken with a social worker at the hospital? Are you supposed to take her home with her injuries while you find a place for her? You can refuse to bring her home, that will bring in a social worker and the social worker can help you find someplace for your mom.

Once you find a place for her Medicare will only pay for so many days (I can't remember now how many). In that interim you'll have to apply for Medicaid on her behalf. Medicaid will be the one paying for the facility once your mom is approved but it takes a long time to get approved so start the process immediately. The nursing home should allow your mom to stay as long as she is in the process of being approved by Medicaid. You'll need to turn over all of her income to the nursing home as well.

Good luck.

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