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ocgirl9301 Asked September 2020

Long term care question in related to cancer...

My mom has stage 4 lung cancer and is 80 years old. She fell and broke her hip and two ribs. She is in pain and doesn't want PT currently after two weeks of hip surgery. They are moving her from hospital PT to nursing rehab. We asked about long term care in case she goes longer than 20 days and they said she has to have cognitive issues to qualify. If she can't get her cancer treatments due to a broken hip can we file Medicaid and keep her in long term as she is refusing to try PT at this time due to pain? She sold her home little over three years ago in Texas and gave that money to her family as she knew she had enough for assisted living. Plus she wanted it put away to pay for her funeral cost. She only has enough to cover her assisted living but understand its very expensive if she doesn't qualify. Very confused if cancer qualifies for long term care under Medicaid.

worriedinCali Sep 2020
Your mother is not going to qualify for Medicaid for another 2 years since she sold her house & gave all the money away. If she doesn’t qualify for long term care than getting her on Medicaid won’t change that, she won’t go to LTC unless she qualifies medically. With stage 4 lung cancer and not wanting to rehab, is she wanting palliative care? She can go back to her assisted living & have palliative care which would include rehab if she wants it. However I am surprised you’ve been told she doesn’t qualify for LTC unless she has cognitive issues.

GardenArtist Sep 2020
I'm not able to follow everything you wrote, but my first thought is to get one of her physicians involved, i.e., the ortho surgeon, to write a letter indicating that b/c of her hip and rib pain, she's not able to participate in PT, AT THIS TIME.   

I would think that hospital PT wouldn't be adequate for a broken hip anyway.  My father experienced 2 broken hips, at 2 separate times, and although he got nominal PT in the hospital, the best PT was in rehab.  

How does PT interact with cancer treatments?  Is there consideration for both, or one or the other?  I would think that chemo, and specifically the treatment, would be a real challenge while also trying to heal from a broken hip.

I'm sorry to read your mother is experiencing these challenges, but hope that one of her doctors will step up, get involved, and tell the appropriate people that they need to recognize the challenges of chemo and rehab simultaneously.

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AlvaDeer Sep 2020
She will not be in both Long Term Care in nursing and in Assisted Living at the same time. Her assets will pay for her care wherever they are. When her assets are gone she either will or will not qualify for medicaid, dependent on how long ago she "gifted" all of that money, and how long the lookback is in years in the state where she lives. Is there a reason she cannot return to her assisted living? Is her care too much for that now? Would she accept hospice care? She can accept that at her assisted living if they can accommodate that. If she requires move to skilled Nursing Facility I am uncertain how coverage works for that.

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