My mother, with the help of my sister and brother, left her nursing home against medical advice. Now she wants to return to nursing home. Advice?

Well I have done nurse aid work most of my life and med aide so have experience and have a great friend here yo help me iut

The last time the poster posted was Nov. 21st. Really would love to know if she saw a lawyer and got this all straightened out.

Its Medicaid. And it was the Title Company that probably did the research. I would hope if she received any Medicaid a lien would have been put on the house years ago.

My mother died 18 years ago. When dad wanted to sell the house recently, the state still looked to see if she had received any monies from medicare before he could sell. After 18 years they still looked.

I am still unclear about what happens with the condo. Who is living there? Your mother's name is on it, so won't Medicaid put a lien on it for your mother's ownership part?

Does anyone have DPOA and MEDPOA on your mom?

I ask because if you do, you can not allow your mom to leave the facility with your siblings to avoid this happening again. If the POA said no leaving the facility with these people and they took her, they would be criminally prosecuted and their actions would not be held against your mom.

Can I suggest that if one of the siblings that took her out of the original facility is POA, that you ask them to resign if the doctor says it will get her moved and ask the doctor if he would accept her if the person that instigated the prior situation resigning would help.

I think that one challenge with leaving against medical advice is that the insurance company can not pay for services related to the 1st stay for a specific amount of time. This could be why the doctor says no, because they won't get paid for treatment. I would also enquire if she is eligible for hospice, this moves her from treatment to comfort care. Just some thoughts to get her in a facility that you feel will give her better care. She can graduate from hospice, so it doesn't necessarily mean the end.

I am so sorry for you having to now handle this mess and try to fix. Your sis/bro need to fix it.. You struck a chord with me, because my I have been arguing with my mother for MONTHS not to take my father out of a wonderful VA LTC and move him closer so she does not have to travel 60 miles to see him (and I do the driving). I have told her she will regret this decision as they cannot afford private pay as there would be nothing left for her... and that he is getting world class care, why would she be so selfish to not recognize this. Finally I gave her ultimatum...if she did it, I would NOT help with anything. Not finding a home, not taking him to any appointments, not anything and she was on her own. It was all I had left to use...it worked but she still agitates over it. My brother backs me up, but I have told her she can do what she wants..just don’t expect me to pick up all the pieces again. WHO in their right mind would leave a wonderful VA care facility where there are NO costs to the family and he has 24-7 care and access to all medical needs? He has neuropathy, had 2 strokes already, vascular dementia, very diseased gall bladder that can leak into his stomach at any time, AND a aneurysm in the stomach that we can only pray outlives him. Surgery is not an option due to his fragile condition. I am so annoyed with her for being so selfish... because I had to go through this for 2 years and I’m the one that managed to get him into the VA home. It sometimes occurs to me that while old age is not for the faint of heart, the stubbornness and selfish of some elderly make it much more difficult than it has to be.

I would let your sister and brother deal with this situation. They should have never encourage this. Let them deal with this mess!!

Sounds like your sister and brother have a problem. I would let them handle it and back out of the entire mess.

Well your siblings will have to reap what they sowed

We had a version of this, when difficult MIL fell out with the doctor who visited her nursing home, encouraged by Brother and SIL. DH, basically responsible, then found that it was virtually impossible to find another visiting GP, even for med scripts, because the fees for nursing home visits weren’t financially viable unless the GP did virtually all the residents. It took months of taking MIL in car (very much not easy) to a GP surgery, plus letters to Members of Parliament, medical associations etc, before we found another GP who would see her on her own way home so that travel costs weren't an issue.

It’s well worthwhile to investigate this stuff before anyone spits the dummy and backs off from the system. Also a good idea to put the responsibility back onto the family members who thought it was all a good idea.

Just to add some information about my own experience, I took my mother out of a SNF & it was still called a “discharge “ to home w daughter. The nursing home did not encourage me to take her home since she was immobile & had dementia...which they warned will get worse... & I was private paying after insurance stopped paying ...due to my mother not making progress in physical therapy...I did renovations & ran into all kinds of unforeseen problems like needing to upgrade plumbing & electric...I made dining room into my mother’s bedroom & took out carpet & put floor...bought stand assist lift & reclining wheelchair w seat cushion to prevent skin breakdown same as nursing home had ...nursing home & I worked together to make it “safe discharge “ as I went along with their recommendations. What I want to bring out is that I was still sent home w papers of a recommended care plan . Amongst those papers was a paper saying if I disagree...I have 90 days....so in other words, if maybe I had sibling who shared poa & Health proxy...& they disagreed w my decision...which would never happen because my sibling always said whatever I decide is good...I also had a Home Health Agency do assessment at nursing home & they examined my mother’s records . Social Worker told me when I left with my mother & her private pay Aide that if I change my mind & find it’s too difficult, I can’t just drop her back with Access a Ride...that she’ll need another 3 day hospital stay....because she’s no longer a resident of the nursing home.... That was almost 3 years ago & she’s still home . Anyway, I hope I was helpful to you! Hugs 🤗

AMA for doctors is a big deal. Lawsuits can arise from AMA situations. Doctors almost always win, but it’s time consuming and expensive. Doctors, like nursing home can cherry pick who they want, and being on Medicaid doesn’t help. Everyone wants the higher paying residents/patients.

AMA= high risk.  Like someone else noted, these facilities are a business.  I wonder if getting a power of attorney would help at all?  I'm just trying to brainstorm and somehow make someone else "responsible" for her.  But that may be impossible if she is not mentally incapacitated.  I'm so sorry this has happened. 

You may just have to look at what you have and see if there is a way to improve the nursing home she is in.  You say it's a nightmare, but how so?  Are there things you can do to mitigate problems there?

Have you asked the nursing home that backed out why and how this can be corrected?

I would notify Medicaid that your siblings have financially exploited your mom. Since they screwed up her good placement and are basically stealing taxpayers money by their shady real estate deal I think that they should pay the piper. Your mom is by being in a sh!thole facility.

This is what it looks like when you try to cheat.

If you disagree with the discharge, I believe that you have 90 days to contest discharge decision. Can you go to Social Worker at Nursing Home she was in & talk to her/him that you disagreed with discharge & you’re contesting it?

You can also try to take her back to hospital & say you have nobody to care for her ....or get PRI from Nurse & pay about $100 & take it to any Nursing home administration office.

We all make mistakes..this is a big one your siblings made. Hopefully it will be corrected soon. Hugs 🤗

I think you may have a problem with Medicaid. When they sold her condo, that money should have gone to her care. Not sure if Medicaid would allow her to buy another condo. Once ur in LTC with Medicaid, its usually for life. Whose name is the new Condo in? If not Moms, the share she contributed may be considered a gift. It will either have to be paid back or Mom will be penalized until the amount is met.

I am just giving you how I feel things may go based on my experience with Medicaid. How did ur siblings think they were going to pay for the new condo? All Moms income has to go towards her care.

So sorry you have to deal with this. Like I said, you may just have to sit down with Moms Medicaid caseworker and see what can be done.

Most (but not all) NHs only dedicate a few rooms to Medicaid recipients because they don't get compensated enough for them by the govt. These rooms are shared and the existing internal residents get first dibs on them. It is extremely unfortunate that your mom left. But, put her name on waiting lists for as many good, reputable NHs as you can. Not sure what state she lives in, but wait times can vary. Here in MN I was blown away when a very desirable NH had an open room when I called them. Her name was on the waiting list of AL and that took 3 years. Now my MIL is in this awesome place. SO...it is not hopeless but it may take a while.

No one is going to take your Mom if they think fraud is being committed, by buying family a condo when she was receiving medicaid.

How much of this hot mess did your mother initiate?

In addition to what has been said, I think her Medicaid status is the reason only one nursing home will take her. They may be the only facility with a Medicaid bed available. If your mother could afford to self pay for 6+ months then you’d probably be able to place her in a better facility. So Medicaid + a past history of leaving ama is not good.

What are your brother and sister doing to repair their mistake?

In what circumstances did she leave the last NH against medical advice? If it was messy and/or expensive, other facilities may decide they don't want to take the risk of admitting her.

What did the NH she left say when you approached them, and how long ago was it that she left?

Meanwhile, I think brother and sister had better take it in turns to support your mother at home until an acceptable place can be found for her - don't you?

Nursing homes and all elder care facilities are businesses. They "cherry pick" the best and easiest patients they can get, and those who can pay the most. So they are in the driver seat. It is so unfortunate this happened. Your brother and sister are responsible for this. I would wish them all good luck in trying to repair it.

Have brother or sister take her into their homes until THEY figure it out! They have caused one heck of a mess and they should immediately sell mom's condo, if it is actually hers, to pay for her care.

Have you checked the assessor records online to see who the condo owner is? After I went through the experience with my twisted sissies, I have a very suspicious mind and trust absolutely no one.

Just my 2 cents ... that would be brother and sister's problem since they felt she was well enough to take her out AMA. Would not be my problem. The only way u get into LTC is if 24/7 care is needed. There may not be a bed to go back to. When one is empty they make sure its filled quickly. And do u blame the facility for not taking her back?

First, ur probably going to have to reapply to Medicaid again to cover her longterm care. So, yes, it would be private pay until the application is approved. It may not be.

If she is on Medicaid for her healthcare (which I would confirm if she got it because she was in LTC) she may be able to get homecare.

I think what you may want to do is call Medicaid and see what needs to be done to get Mom back into LTC. Make sure they know that ur not the one that created this problem your just trying to find out ur options.

Boy, I would have killed my siblings. I would help but not give up anything. They made this mess they should clean it up. :)

I think I would let brother and sister handle this. There should be some consequences for their foolish actions, don't you think?

Anyway....

There is a process by which one gets into a NH; the easiest route is if a patient is in the hospital and gets placed by the discharge department. That lets you skip the waiting list.

Most likely, the only place with available beds is the least desirable one in your area. You CAN move mom once she's placed; the best scenario would be for mom to he hospitalized for 3 days and be eligible for a brief stint in rehab which would then turn into a long term care stay.

Has she been approved for long term care Medicaid or Community Medicaid? Those are two very different things.

PS I am pretty sure my brother and sister will not sell the condo, which will allow my mom to private pay for a few months.