It seems that dad needs a whole lot of care. If discharge is saying that he needs SNF (somewhere), it would be really difficult to get him that level of care at home with only home health during the day and family at night.
What home health? People dropping in all day to take care of him, like OT, PT, nurse, or what? That's exhausting for everyone. What kind of care at night? Family takes turns, makes room in their schedules, not enough sleep, and he might need care at night as well as things move along? Also adjusting to changes is really hard for people who are old and sick, no matter what they say they want in the first place.
Make sure what you're going to get, and don't idealize how wonderful home care is going to be. It's best to be careful what you bite off because it might be hard to chew.
Whatever you decide, I hope for the best for all of you.
Raven, what you wrote is only temporary. It has to be doctored ordered. In home is usually ordered after a hospital stay. Mainly for Physical therapy and you get an aide for bathing 3x a week. The hours an aide works depends on the "In home's" ability to provide that aide. Once the person has completed their physical therapy or lets say the were caring for a wound and its healed, in home discharges the client. There is "intermittent" care but again, not enough hours if a person needs 24/7 care.
Is there a reason Dad can't get rehab at home? If he doesn't need 24/7 care, according to its website, Medicare will cover "skilled nursing care and home health aide services up to 8 hours a day, with a maximum of 28 hours per week". Dad must need both.
Home care is a cost-savings to Medicare/Medicaid/VA/other payers but it seems hospitals are prone to route patients to a facility. (It's been 7 years and I'm still waiting for an explanation for a hospital social worker as to why my mom couldn't come home to recover from an accident SMH.)
As others have said, it's possible to transfer a patient across States. If you have a SNF/rehab in mind, the admissions office should be able to help you figure out coverage needs.
Very good points. I appreciate your response. I suppose the next step is to ask the hospital if their purpose in sending him to SNF is due to him needing 24 hour care. Currently, he does not receive any care during the evening unless he specifically needs something trivial (non-medical). So, he could receive that with us, and then during the day he could receive Home health services.
They found that Dad, while in Rehab, is 24/7 care. If he has traditional Medicare, Medicare goes anywhere, the suppliment may not. Medicare is a health insurance and has nothing to do with getting into a SNF. Medicaid, on the other hand, you do need to worry about. That does not go State to State. If Dad is going to need Medicaid to pay for his care, check with your State and find out how long he needs to reside in your State before he can apply.
I see no problem in placing him in a SNF in Fla until u get ur ducks in a row, if he can private pay. But I do not think I would start a Medicaid application in Fla only to end up taking him to MI.
He has Medicare coverage. The reason we want to get him back to MI is because mom also has dementia and we have to be with her 24/7, as well. More of us live in MI to help. Thank you for your help!
I just don't know if he actually has to go to a SNF/rehab in Florida first? I know that Medicare isn't going to pay for a state to state transfer anyway. We plan to pay it, but will Medicare have issues with him now moving to MI?
So overall, he still has a lot of strength. He's just bedridden and after being in a hospital for 4 months. Pneumonia and all sorts of other challenges kept PT from happening on a regular basis. He has really not eaten much in 5-6 days, but he keeps taking his meds and now has moments of delirium. He's weak, and we feel like the Florida health care system is failing him by tossing him around from place to place. He won't accept a feeding tube to "keep him alive", but I feel like if he gets nutrition it will help. We desperately need advice.
Dad lived at home before hospitalization in December. We'd like him to live at home after this, too. He started in a hospital diagnosed with pneumonia and CHF and they gave him antibiotics and discharged him after two weeks. He went to rehab only to need hospitalization after 18 hours. He passed out when trying to stand to use the commode. We wouldn't let them send him back to the same hospital, so he went to a nearby city and they had him in ICU for two weeks. After another week in the hospital they sent him to a long term care facility across the state. After a month and a half, they sent him to a SNF, and after 12 days he needed hospitalization again. So even though we told them not to, they sent him to the first hospital, and they intubated him against ours/his wishes. He was there and came off the vent and stayed until we could transfer him to the other hospital safely. Now, the other hospital has cleaned up the pneumonia again and wants to discharge him back to the SNF. We just want him out of the system, and he has said multiple times he wants to come back to MI. He is a Florida resident, but has a home in MI, too.
He has Medicare A and B and a supplemental high insurance. Thank you!
bsheila263, please first price out what a medical transfer from FL to MI would cost... it could be thousands of dollars, especially if he needs an ambulance, based on what I've seen others post on this forum, and my own experience just getting my non-mobile MIL from one LTC to another it was a few hundred dollars just to go a few miles.
We did do several inter state admissions in my facility but it would be helpful for all of us if you gave us more information. What was the reason Dad was hospitalized? Where did he reside prior to hospitalization? Where does he plan to reside after rehab and/or is the discharge to long term care? What is his discharge diagnosis? He is mentally competent and does he wish to transport to Michigan? Is Dad on traditional medicare with a supplement, on a Medicare Advantage Program or on FL Medicaid?
As I said we did do interstate admissions but I believe the transport from one state to another was private pay by the family. In most cases, the patient being transferred could not travel alone and the family also paid for the traveling caregiver. Transportation was private pay because there were many facilities in the location of the discharging hospital that could supply equivalent care; the families involved wanted the patient to be closer to them.
Might be able to give you more info if you can supply the above information but this involves a lot of coordination on the part of the social worker at the discharging hospital and the admissions director of the accepting facility regardless of the state involved.
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What home health? People dropping in all day to take care of him, like OT, PT, nurse, or what? That's exhausting for everyone. What kind of care at night? Family takes turns, makes room in their schedules, not enough sleep, and he might need care at night as well as things move along? Also adjusting to changes is really hard for people who are old and sick, no matter what they say they want in the first place.
Make sure what you're going to get, and don't idealize how wonderful home care is going to be. It's best to be careful what you bite off because it might be hard to chew.
Whatever you decide, I hope for the best for all of you.
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Home care is a cost-savings to Medicare/Medicaid/VA/other payers but it seems hospitals are prone to route patients to a facility. (It's been 7 years and I'm still waiting for an explanation for a hospital social worker as to why my mom couldn't come home to recover from an accident SMH.)
As others have said, it's possible to transfer a patient across States. If you have a SNF/rehab in mind, the admissions office should be able to help you figure out coverage needs.
I hope Dad gets to go to the home of his heart.
Thank you!
I see no problem in placing him in a SNF in Fla until u get ur ducks in a row, if he can private pay. But I do not think I would start a Medicaid application in Fla only to end up taking him to MI.
So overall, he still has a lot of strength. He's just bedridden and after being in a hospital for 4 months. Pneumonia and all sorts of other challenges kept PT from happening on a regular basis. He has really not eaten much in 5-6 days, but he keeps taking his meds and now has moments of delirium. He's weak, and we feel like the Florida health care system is failing him by tossing him around from place to place. He won't accept a feeding tube to "keep him alive", but I feel like if he gets nutrition it will help. We desperately need advice.
Dad lived at home before hospitalization in December. We'd like him to live at home after this, too. He started in a hospital diagnosed with pneumonia and CHF and they gave him antibiotics and discharged him after two weeks. He went to rehab only to need hospitalization after 18 hours. He passed out when trying to stand to use the commode. We wouldn't let them send him back to the same hospital, so he went to a nearby city and they had him in ICU for two weeks. After another week in the hospital they sent him to a long term care facility across the state. After a month and a half, they sent him to a SNF, and after 12 days he needed hospitalization again. So even though we told them not to, they sent him to the first hospital, and they intubated him against ours/his wishes. He was there and came off the vent and stayed until we could transfer him to the other hospital safely. Now, the other hospital has cleaned up the pneumonia again and wants to discharge him back to the SNF. We just want him out of the system, and he has said multiple times he wants to come back to MI. He is a Florida resident, but has a home in MI, too.
He has Medicare A and B and a supplemental high insurance. Thank you!
As I said we did do interstate admissions but I believe the transport from one state to another was private pay by the family. In most cases, the patient being transferred could not travel alone and the family also paid for the traveling caregiver. Transportation was private pay because there were many facilities in the location of the discharging hospital that could supply equivalent care; the families involved wanted the patient to be closer to them.
Might be able to give you more info if you can supply the above information but this involves a lot of coordination on the part of the social worker at the discharging hospital and the admissions director of the accepting facility regardless of the state involved.