If elderly person enters hospital, and needs nursing care after

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:How can he not have his own residence? Is he homeless?

If he is homeless and indigent, then a social worker will have to make an assessment of what his needs are and what the local resources are that can meet those needs.

The assumption is he would be Medicaid eligible and in need of full-time nursing care. Which would actually be best in the short-term as he would have a roof over his head and a bed.

If Medicaid eligible then they will find a facility that has a Medicaid bed available.

If he is not in bad physical shape and does not need full-time nursing care, then it would be up to the local elderly services to find a room/lodging that is available to meet his needs. But there would still be a cost involved with that so it might be dependent upon what he gets for Social Security.

In many, many communities there is NO housing available for the elderly. Add into that all the competition for rental properties and rent increases, there are very few places which are vacant.

It is not unheard of for the elderly without significant medical needs (necessitating nursing care) to find themselves on the street.

You will see them on the streets and along the roads in Florida since there are usually no housing vouchers for elderly as families with minor children come first. Florida is the bellwether for how it goes elsewhere.

If the elderly have a car they may live in them. Or else you see them pushing carts with their belongings. Many of them do not have mental health or substance abuse issues, they are simply old and poor and have nowhere to go.

He is currently staying with a relative but that relative’s house is not set up for a disabled person, nor does the relative have the means (time, skill, money) to care for a person who is not independent. That relative does not want the person back because it would be too much.

Yes, the hospital has someone that will coordinate their care and find nursing home that has room to take him. It sounds like after dischargee, they will need to go to an assisted living facility and I believe Medicaid for that expense but they will have to go the a place that takes that.

Medicaid does NOT cover assisted living. OP, if your relative does not want this elderly man back in their home then the first and most important thing is to make sure that he knows it. Have you and/or relative point-blank said to him that he is no longer welcome to live with them? If not, then relative needs to sit him down, look him in the eye and tell him. He should be fully aware that he does not have the option of living with family anymore.

The sooner he knows he is on his own/alone the better. He can make choices based on the fact that he can no longer expect his family to care for him. Hopefully, he will wind up with a good social service person who can aid him in (also hopefully) finding a place to live and a support system. There are many people in volunteer organizations who will help fill in the voids in his life, such as activities, companionship, adopt-a-grandparent program, donation of clothing, rides to appointments, etc.

Medicaid in some states covers assisted living, in other states it does not. There are also programs for assisted living that are lower cost. However, in MD, they only pay for nursing home care. But, in other sates its different as each state runs their own long term care medicaid program.

If he is staying at a friend's house, someone needs to locate a bed and apply for long term medicaid for him.

That's true, but MOST of the states require that individual has "nursing home level of care needs" AND will need a waiver AND will have to be put on a looooong waiting list. In summation, people should never expect to get Assisted Living benefits from Medicaid.

It varies by state and some assisted living have sliding fee scales.

[Anonymous]

In many states patient is released into a rehab facility that is paid for by medicare. Up to 90 days. After that, it becomes paid. The hospital has to coordinate with the nursing home to take him. But if he has no means, then it is harder to find a bed. If he is in a bed and continues to need nursing care, then the nursing home will attempt to find him a medicaid bed.

[Anonymous]

The MOST important thing is that neither you nor the relative accept him into your home now. Then the hospital will have to find a bed for him in a place that will care for him, no matter what insurance he has, or doesn't have.

Once someone accepts him into their home, it is it is over, and on you, rather than the hospital, to solve the problem.

[Anonymous]

^ this

[Anonymous]

Anonymous wrote:The MOST important thing is that neither you nor the relative accept him into your home now. Then the hospital will have to find a bed for him in a place that will care for him, no matter what insurance he has, or doesn't have.

Once someone accepts him into their home, it is it is over, and on you, rather than the hospital, to solve the problem.

This is why it is important for OP/relative to sit the man down and tell him point-blank that he is not welcome to return "home," the system will have to figure out a way to support him, and OP/relative will be hands off from now on.

I doubt that OP/relative will be willing to do this, though.

I'm also not sure if the man would have any rights if the house he's living in has been his primary residence for some time. In other words, he would essentially be evicted. While the relative can kick any adult out of their home for any reason there may be consequences to do so. For example, has the man been paying "rent" (or contributing his social security) to the household? He may have rights as a renter.

[Anonymous]

Anonymous wrote:The hospital will discharge to a nursing home but usually they pick the first bed who will take that person vs. the best fit. If this is your loved one you can call around, visit and pick one.

And this is difficult even when a person does have supportive family, especially if the medical situation is at all iffy. Currently helping an elderly relative who has no children with this and they are calling 45 places per day looking for placement. It is really difficult.

[Anonymous]

Anonymous wrote:In many states patient is released into a rehab facility that is paid for by medicare. Up to 90 days. After that, it becomes paid. The hospital has to coordinate with the nursing home to take him. But if he has no means, then it is harder to find a bed. If he is in a bed and continues to need nursing care, then the nursing home will attempt to find him a medicaid bed.

My mom is in a post-hospital rehab facility now. Medicare pays 100% for 20 days. After that, medicare pays 80% and you either have to pay the copay or have another insurance plan to cover it.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Where will the hospital discharge the patient to? Do they have people to handle it? This elderly person does not have his own residence or anyone capable of caring for him.

End up going to a low cost hell hole.

Do you have personal experience with this?

I do. Yes, this is what happens. The social worker tries desperately to guilt family members into more then they can do, and when that doesn’t work, they find placement in not-so-nice places because that’s what happens if there’s no $$

[Anonymous]

I know from family members in a range of financial circumstances that many facilities take Medicaid in their skilled nursing facilities and when you get to that level of care there is little difference between the good places and the bad places.

[Anonymous]

Anonymous wrote:The MOST important thing is that neither you nor the relative accept him into your home now. Then the hospital will have to find a bed for him in a place that will care for him, no matter what insurance he has, or doesn't have.

Once someone accepts him into their home, it is it is over, and on you, rather than the hospital, to solve the problem.

This!!! Just had to deal with this with my mother. To make a long story short, severe alcoholic who lived with her boyfriend for the last 18 years. Boyfriend went into hospital, mom couldn't take care of herself and ended up in hospital also. Boyfriend died and hospital kept mom until court ordered guardian could be appointed. Hospital and guardian found rehab facility (not for alcohol) to discharge to and then rehab found memory care facility for long term care. It takes time but if no one will take the elderly person the hospital is required to find next facility. Then that facility has to find the next. Sort of like passing the buck. For my mom, she does have money so she ended up in a good location but they had to handle it rather than me stepping in.

[Anonymous]

When my MIL needed to go to rehab after a hospital stay, the hospital social worker helped arrange it. My SIL is a nurse at a nursing home and we were able to get her sent there. Not sure what the mechanics of that were behind the scenes. I'm sure we had to choose a place with a Medicare bed but it's not like we had no choice in where she went.

MIL needed to stay because we could not care for her at home. Medicare paid for the rehab part. She had little assets and needed to apply for Medicaid, which she is now on. She had to spend down a month or two of assets paying the nursing home as a private pay patient before she qualified for Medicaid.

It was relatively straightforward, but my husband had POA and did the work of applying. I'm not sure how this would work if there wasn't someone who could gain access to the elderly person's financial statements and apply for Medicaid for them.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:How can he not have his own residence? Is he homeless?

If he is homeless and indigent, then a social worker will have to make an assessment of what his needs are and what the local resources are that can meet those needs.

The assumption is he would be Medicaid eligible and in need of full-time nursing care. Which would actually be best in the short-term as he would have a roof over his head and a bed.

If Medicaid eligible then they will find a facility that has a Medicaid bed available.

If he is not in bad physical shape and does not need full-time nursing care, then it would be up to the local elderly services to find a room/lodging that is available to meet his needs. But there would still be a cost involved with that so it might be dependent upon what he gets for Social Security.

In many, many communities there is NO housing available for the elderly. Add into that all the competition for rental properties and rent increases, there are very few places which are vacant.

It is not unheard of for the elderly without significant medical needs (necessitating nursing care) to find themselves on the street.

You will see them on the streets and along the roads in Florida since there are usually no housing vouchers for elderly as families with minor children come first. Florida is the bellwether for how it goes elsewhere.

If the elderly have a car they may live in them. Or else you see them pushing carts with their belongings. Many of them do not have mental health or substance abuse issues, they are simply old and poor and have nowhere to go.

He is currently staying with a relative but that relative’s house is not set up for a disabled person, nor does the relative have the means (time, skill, money) to care for a person who is not independent. That relative does not want the person back because it would be too much.

Yes, the hospital has someone that will coordinate their care and find nursing home that has room to take him. It sounds like after dischargee, they will need to go to an assisted living facility and I believe Medicaid for that expense but they will have to go the a place that takes that.

Medicaid absolutely will not cover ALF's

[Anonymous]

Anonymous wrote:

Anonymous wrote:The MOST important thing is that neither you nor the relative accept him into your home now. Then the hospital will have to find a bed for him in a place that will care for him, no matter what insurance he has, or doesn't have.

Once someone accepts him into their home, it is it is over, and on you, rather than the hospital, to solve the problem.

This!!! Just had to deal with this with my mother. To make a long story short, severe alcoholic who lived with her boyfriend for the last 18 years. Boyfriend went into hospital, mom couldn't take care of herself and ended up in hospital also. Boyfriend died and hospital kept mom until court ordered guardian could be appointed. Hospital and guardian found rehab facility (not for alcohol) to discharge to and then rehab found memory care facility for long term care. It takes time but if no one will take the elderly person the hospital is required to find next facility. Then that facility has to find the next. Sort of like passing the buck. For my mom, she does have money so she ended up in a good location but they had to handle it rather than me stepping in.

Yup. Once you touch it, you own it. If a facility accepts a resident and then discovers that the hospital wasn't entirely truthful upon discharge (I'm an RN, this happens every day in order to get someone out of a hospital bed and into a facility), the accepting facility must now find placement for that resident. Which means embellishing/lying about why the resident needs a new placement

[Anonymous]

Anonymous wrote:

Anonymous wrote:The hospital will discharge to a nursing home but usually they pick the first bed who will take that person vs. the best fit. If this is your loved one you can call around, visit and pick one.

And this is difficult even when a person does have supportive family, especially if the medical situation is at all iffy. Currently helping an elderly relative who has no children with this and they are calling 45 places per day looking for placement. It is really difficult.

Very difficult, especially on medicaid. It took me months to find a bed. Many would claim they don't have a bed but when I called full pay, they'd have a bed so they were clearly lying.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:How can he not have his own residence? Is he homeless?

If he is homeless and indigent, then a social worker will have to make an assessment of what his needs are and what the local resources are that can meet those needs.

The assumption is he would be Medicaid eligible and in need of full-time nursing care. Which would actually be best in the short-term as he would have a roof over his head and a bed.

If Medicaid eligible then they will find a facility that has a Medicaid bed available.

If he is not in bad physical shape and does not need full-time nursing care, then it would be up to the local elderly services to find a room/lodging that is available to meet his needs. But there would still be a cost involved with that so it might be dependent upon what he gets for Social Security.

In many, many communities there is NO housing available for the elderly. Add into that all the competition for rental properties and rent increases, there are very few places which are vacant.

It is not unheard of for the elderly without significant medical needs (necessitating nursing care) to find themselves on the street.

You will see them on the streets and along the roads in Florida since there are usually no housing vouchers for elderly as families with minor children come first. Florida is the bellwether for how it goes elsewhere.

If the elderly have a car they may live in them. Or else you see them pushing carts with their belongings. Many of them do not have mental health or substance abuse issues, they are simply old and poor and have nowhere to go.

He is currently staying with a relative but that relative’s house is not set up for a disabled person, nor does the relative have the means (time, skill, money) to care for a person who is not independent. That relative does not want the person back because it would be too much.

Yes, the hospital has someone that will coordinate their care and find nursing home that has room to take him. It sounds like after dischargee, they will need to go to an assisted living facility and I believe Medicaid for that expense but they will have to go the a place that takes that.

Medicaid absolutely will not cover ALF's

It depends on the state. Some states do pay for it.