My Mom has a studio apartment in an Assisted Living Facility. Medicaid is paying for her care but she contributes a share as required by the state. She has been in and out of the hospital and rehab facilities for several months. The administrator of the ALF is pressuring me to let her know what's happening. Mom is in no shape to return to the ALF. She needs to be in Memory Care (at the ALF level). The place where she lives has a unit but the administrator won't commit to giving her a place there. We have continued to pay her share for the room and board. Can the facility kick her out...forcing her to stay in a SNF until we can find another place for her?
Bed Holds are the amount of time a custodial care resident leaves the facility and then returns to the same room and their personal stuff continues to stay in the room. It can be divided into 2 categories: hospital stay days and THV / therapeutic home visits. Each State - again EACH STATE- sets the # of days for these as the State will continue to pay the facilty some % of the regular LTC Medicaid day rate to the NH/SNF of AL/MC. Like VT has hospital days max of 10 days and THV to up 24 days. But my State, LA, it’s 7 hospital days max paid at 75% and up to 15 THV days paid at 90%. TX considers any hospitalization to be discharge from LTC Medicaid and THV is a max of 3 sequential days and if over 3 it’s a discharge.
Your mom having her monthly income go to the facilty is an over all required Share of Cost to be on the Medicaid program but it does not necessarily allow her to keep her room as bed hold policy overrides.
Really imo you need to have a reality check on your mom’s situation. If she has an assessment done, that removes some of the emotion in the decision making. If it’s that she is “at need” for care in a NH, then decision is made and you have to find a facility for her. If her assessment is she’s ok for MC, then it’s on you as her POA to find her a facility. Not to be harsh, but thats the reality.
Yes the administrator of her current place is vexed with you & mom as mom is probably past her bed hold and, if so, they are not getting their reimbursement and they have another elder ready to take that room.
If the AL wanted to go all hard ball, they could issue her a non-compliance Notice (for Medicaid regulations) and indicate they will consider her to be private pay unless she clears out within a certain period of time. You don’t want that happening as any other place you look at will be able to see a non-compliance violation as it’s attached to her Medicaid file and they will find a legit reason to roll back a welcome mat.
Because if Mom cannot return to the ALF then Medicaid is NOT going to pay their share.
At that point Mom will have to give up her placement.
You already know that mom needs memory care.
It's time to work with Medicaid and the facility to see if mom can stay where she is, again with some share of cost, and with help from Medicaid, or if Mom will have to be placed by social workers at Hospital or rehab in another place.
This isn't a matter of "kicking someone out". This is a matter of governmental assistance and how long they will contribute to holding a room that almost certainly will not be returned to.
Sorry, this is tough stuff. I realize her "stuff is there".
It's time to find out now what the rules are.
Call and make an appointment with the admins tomorrow and level with them honestly about where you are at.
I sure wish you the best.