A newer NH in DH aunts area offered to bring aunt into their facility on Medicare. We all know Medicare doesn’t pay for long term care. They suggested she come off of hospice and come in on rehab for up to 100 days. Since aunt is bedfast for four months while being in an ALF I was not expecting this offer.
I’m thinking she would be lucky to make it the first week much less the 20 days that Medicare will pay 100% on. Aunt does have a great supplement that would pay the remaining days if they worked some miracle on getting her moving or getting it approved. Historically she has done well with home therapy and it might actually get her going again or at least sitting up or in a wheelchair which would be better than being bedfast regardless of where she is.
So I asked what they would do after the rehab was discontinued due to not being able to do the therapy. They said they would find her a bed. I asked if it would be In the same facility.
If we don’t have a bed here, then somewhere in the area she assured me.
So, at that point I lost interest thinking I should find her a facility where she didn’t have to move. But that was before I looked at the other places. Now I think I should see if I could negotiate her staying at the same place as the rehab.
It seems a slick move for the NH to use their beautiful new facility to get patients in and then fill up the less desirable locations (also owned by parent company) with these patients when they come out of rehab. Maybe I’m being too critical? Of course they haven’t met her so they may change their mind after doing the evaluation.
Has anyone done this? I know in some ways it seems no different from being in the hospital and being discharged for rehab and then instead of going home, going into care.
Home health and hospice have kept her out of the hospital and at home for a long time. She has been on hospice for her dementia. She has been In an ALF for the past 4 months due to a problem with her home.
Hope all works out for you.
Thanks for the replies and good advice.
I had to move her. Her property owners insurance (from the water damage) footing the bill was over. 5 months they paid for the ALF. Plus she really wasn’t at the right place as an ALF patient. She needed more care than they could provide.
In her area and everywhere else I suppose, staffing is pitiful. I was paying for her long time caregivers to come in to help with breakfast and dinner plus her hospice cna was coming everyday. In spite of all that she was staying wet, sometimes soaked and as a two person transfer, not enough help to get her out of her hospital bed.
She only has limited funds to private pay, so I had to get her where it would matter in order to secure a Medicaid bed.
I spoke with her old pt and hospice nurse and got their recommendation on a place that I had marked off the list earlier. Not the one I wrote my original post about.
This place also wanted to try rehab.
So we dropped hospice in favor of rehab. I was very afraid to do this because the first place was upfront that they used their own hospice. I was assured she could go back on her hospice with the same company when the rehab was over at this second place.
I will say the therapy has done her a world of good. Her appetite is great. Her private aide said she hasn't found her wet even once. The place is spotless.
Of course, almost immediately, as in the next day, I was advised over the phone that the Medicare Part B would be picking up the rehab but the R&B would be private pay.
I commented to the admissions person that it seemed a bit of bait and switch. She said all the things we already know about how to get into Medicare paid rehab. 3 nights in the hospital, yada, yada. That she had really tried. I wasn’t buying it and she knew it. Of course, I knew it when she offered it but decided to see how far it would go.
Since then, I have heard zero from the staff except for accounting calling last week saying I “should” have prepaid for the prorated month?! I didn’t go into how Medicare was supposed to be picking up the tab for 100 days. 🙄
I requested she send a bill.
I still haven’t received the bill but I expect it any day.
I called yesterday (as I am frantically working on the medicaid app) to speak with the “new” administrator. In a meeting… along with everyone else I asked for.
HR was manning the phones. Seems, almost everyone is new. Not a good sign. When I’ve been at the facility the two nurses I’ve spoken to are new. The SW is out. The admin office is dark. Have not heard one word from her.
I have to make sure I have a medicaid bed before I pay a month in advance private pay. I was promised that by the missing admissions person. I will see what I can get in writing before going forward with the checkbook. Aunt is helpless but not feeble and has a great attitude. Just the right amount of dementia these days. She’s been the easiest part of the whole ordeal.
To date, I have not signed anything nor been offered anything to sign. I’m hoping the new administrator will work with me on the Medicaid bed when he comes up for air.
Thanks again for the replies. I thought this post had floated off to the cloud. 🤗
It’s a wild ride out here in Facility land.
oh, I’m sure some doctor or their staff signed it at some point.
Edit
To be fair, the admissions person said they would use the files from hospice and ALF to make a decision. they have several doctors on staff.
Igloo always warns those files must be thick to get on Medicaid. Her files aren’t thick. She has been well taken care of for years by Home Health, private aides and hospice and by my family. So they didn’t turn down therapy. Said part b would cover. Just turned down R&B being paid by Medicare. Probably have the rehab portion set up separate from the NH or some such arrangement that made it fly under the radar for a moment or two. I have no doubt she will be paying full private pay rate when they get around to it.