After months of meeting with an elder lawyer, collecting all the documents needed, my mother's application for Medicaid was finally submitted last week. Now the lawyer tells me I must arrange for an evaluation (2 in fact) to prove that she does need 24/7 care. I didn't know about this. And apparently the evaluations take 3 hours! What on earth do they do - does anybody know? This process is never-ending. Fingers tightly crossed that she ends up getting Medicaid after all this.
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Barb - is some of the billing for 24/7 at home being heavily shifted to Medicare?
If Medicare gets changed to be more limited under this new administration, the NH aren't going to be able to stay open imo. The future is not gonna be pretty on Aging in America.
Not payment to family living there as caregivers like what California's IHHS program does? But paying a caregiving agency for 24/7 care? Is there a cap on rate?
Wreck NYS state budget? If $ 25 hr a mo, then $ 18K mo / $ 216k yr w/out equipment, transporation, or speciality like PT, OT, ST..... Add those, HUGE cost.
Is it a very narrow limited program? Most states place a limit on at home to around 28 -32 hrs as over that it's not cost effective as they can get 24/7 in a facility with skilled nursing & on site staffed ancillary services for less. Even then states are looking to PACE type of larger community based long day elder programs to have them go into rather than 1-on-1in home or a NH for those ambulatory with family having to pick up all care outside of PACE time.
Do you know what NYS has as medicaids daily reinbursement Room & board rate for NH?
I just cannot see how the costs are sustainable for NYS or any state once the tsunami of baby boomers start hitting medicaid eligibility.
Just read on one home care agencies website that a person must be evaluated first by a nurse from some sort of independent agency to determine what care she needs, and then again by the home health care agency's own nurse. With supporting documentation from a doctor.
Xinabess the assessment needs to take some time, partly because just *everything* takes forever with older people :) and partly because there's a range of 'activities of daily living' that they'll want to look at. But it shouldn't be too much of a trial for your mother. Do be there to assist, but do try not to butt in, and certainly don't argue or contradict your mother directly - just calmly give the assessor the correct version.
E.g.
Assessor: "have you fallen in the last six months?"
Mother: "Oh no! I'm always careful to hold on, you see."
You to assessor: "You'll want to note: several times, including two serious falls one leading to a fractured wrist."
But your mother may pleasantly surprise you and be actively interested in the process. I remember at the end of my great aunt's, she was asked to write a sentence on the OT's form. She put: "I am beginning to be hungry."
If your moms discharge paperwork when she left the NH and what is in her current health chart, her doctors orders for care & medication management show "need", she should be ok.
What are you hoping that medicaid will provide? There will be a limited # of hours of care per week. Medicaid will not provide for 24/7 care at home
As always, I appreciate all the advice I get here!
Also, in your profile, it appears that you mom was already in a NH. Is that right? The facility should be able to document what level of care that she needs. Be careful that the person who is preparing this form actually knows her needs.