I would like some input from members from CA that have filed for MediCal for parent

Igloo, it is my understanding that these days one can be admitted to a nursing home with a doctors order/authorization so long as it’s medically necessary that they be in a nursing home. There doesn’t have to be a hospitalization and rehab stint first, but I could be wrong. Now at present time, at least in my county, facilities are only taking COVID-19 patients. I know that when my husbands grandfather went to a nursing home back in 2015, he went from the hospital to a SNF, no post-hospitalization rehab. Just LTC for his dementia and immobility. His grandmother on the other hand went to rehab first and was supposed to go home but wasn’t able to rehab so she transitioned first LTC.

Worried, what type of insight do you have on IF for LTC in CA, if it is that CA is taking the approach that the applicant needs to be either
- already in a NH in order to file
or
- if a new admission into the NH it’s they are coming in a post hospitalization stay. So they are in the facility as a rehab patient / post hospitalization care, with stay paid as a Medicare benefit and then once MediCARE coverage ends then can file for LTC Medi-Cal to remain there as a LTC resident.

That they can’t just enter a NH directly on their own and apply for LTC Medi-Cal on Day 1. They need the records from hospital to NH and for rehab so there’s fat health chart from the hospital and rehab to clearly establish “at need” medically. Or have been at the NH for a while and again there’s a fat health chart from the NH to show their “at need”.

Couple of posts in the past read that they couldn’t just move mom out of her house and into a NH directly for CA medi-cal anymore. That the needs assessment required hospital chart or facility chart to be used to establish need along with the on site assessment. And the on site assessment could be waived if hospital records were there - so less time & costs for the state. Done so totally cuts down on having elders kinda grey area for needing skilled not to be able to be pass eligibility and then facility has to deal with getting them moved out.

NH would like this as they are getting 20/21 rehab days paid at Medicare higher rate too, instead of starting out with Medicaid pending period and that uncertainty.
Insight?

I think they want an original document. In my dealings with medi-cal, just like the DMV they don’t accept copies of anything. Disclaimer: it may have changed in the years since, and I am sure the fact my MIL was an eligibility worker worked in her favor but.....she was able to get both her parents on Medi-cal and IHSS as their POA. So yes your sister should be able to do it with the original POA document.

Bumping up for more answers.

Does that mean that they want the original document sent with the application? Or that they will not accept an application filed by the POA?

We have a very knowledgeable California member who may be able to answer this.