Medicaid community home care?

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M

Mhillwt Asked December 2019

Medicaid community home care?

Hi my friends mom will be going home in a few weeks after a 6 month hospital rehab stay. She has a rare autoimmune disease that requires her now to be in a vent at night (sometimes during day) and a feeding tube ie peg. I’m assuming she will get 24/7 aides approved but given her medical condition, the family wants a 24/7 nurse. Does Medicaid ever provide 24/7 nursing care vs 24/7 aide? She is only 74 and is fully mentally ok ie no dementia etc.

Care Decisions Home Care Hospital Discharge Medicaid

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score 0 · Answer 1

So sorry to hear that, MH!

Have your friends looked into specialty hospitals? I have a friend with an adult son who is in a similar situation (vent and PEG feeding) who stayed at home as long as his parents (with Medicaid aides) could manage, but they are elderly, though still working.

He seems quite happy in the specialty hospital and has a peer group of folks in their mid 30s who seem to be having a pretty jolly time.

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score 0 · Answer 2

Please note that the aides cannot do this care, but family members can. (Check with the Agency to be sure).

There are many folks in nursing homes who have medical needs only and no dementia.

https://www.health.ny.gov/health_care/medicaid/program/longterm/pdn.htm

There are also chronic care hospitals, like Coler on Roosevelt Island.

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thanks....so medicare and medicaid do provide nursing services ie that i know but they would never provide that 24/7, correct?

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score 1 · Answer 3

No Medicaid nor Medicare will pay for a RN to be there 24/7 (not even in NY). Those procedures aren’t considered to need skilled nursing 24/7.
Family will be taught how to perform her care.
I suggest your friend work with the DC planners at her rehab to get trained now while mom is in rehab. They can teach her/him and then have them perform the care (PEG, vent) under their supervision.
If your friend’s family doesn’t think you can provide care inform the DC coordinator and ask them to assist with finding a NH that takes ventilator patients.

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score 0 · Answer 4

I'm assuming the hospital and the family have the discharge all worked out so friend's Mom will be safely cared for at home. What have they said about the discharge plan?

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score 0 · Answer 5

No. The only way is if she can pay out of pocket. Medicaid may pay for, possibly pay for a few hours a day. Definitely will not pay for a nurse.

A nursing home if prescribed by doc can be paid by Medicaid if she qualifies with less than $2,000.00 remaining in countable assets.

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Actually in NY Medicaid WILL pay for a nurse and she can have a lot more than $2000 in assets. In NY you can have up to $15k in the bank.

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score 0 · Answer 6

The rehab should be helping with getting things set up. She shouldn't be discharged until things are set up for her care. I would say she will be set up with Homecare. Which means a Nurse checking on things and an aide. Most of the care may be the family's responsibility.

Who has been paying for her care for 6 months? If Medicaid, this can all be worked out between them and the Social Worker. Your friends family will not be left high and dry. If they are worried about what is going to happen, then they need to talk to the Social Worker and she/he will take them thru the discharge process.

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