Anonymous wrote:Ultimately, the idea is that she spends everything she has until she does qualify for Medicaid. So you need to work with the social worker and figure out how to protect the spouse during that process.

You don't get to just say "assisted living she can't afford" because basically, she can afford it until she's out of money and then it's medicaid.

Social workers are generally not experts in spending things down. That would be an elder care attorney, or the business office of the nursing home.

^the group home is private pay.

Anonymous wrote:Doesn't Medicare cover home visits for elderly people who need assistance?

No, not a caregiver. Only short-term PT/OT and a weekly visiting nurse, if necessary to monitor vitals, etc.

The only real option is for her to pay out of pocket until she eventually qualifies for Medicaid - that’s if the rehab is attached to a nursing home and has a long-term care bed. They might need to consult with an elder care attorney to figure things out. But if someone is bed bound and has gotten as far as they can in rehab, Medicare won’t continue to pay.

They can also look for a cheaper assisted living, like a group home. It’s not in a facility - they’re in regular houses in residential areas, and they usually have a small number of residents. But if she requires two people to assist her, it might be tricky to find a place that can take her. I’d reach out to a placement agency like Owl Be There (I know A Place for Mom isn’t popular here).

There really aren’t many other resources that don’t involve paying out of pocket, or transitioning to Medicaid (which means sending down all assets. Hence the need to talk to an elder care attorney).

And medicaid will only cover skilled nursing not assisted living.

Anonymous wrote:Ultimately, the idea is that she spends everything she has until she does qualify for Medicaid. So you need to work with the social worker and figure out how to protect the spouse during that process.

You don't get to just say "assisted living she can't afford" because basically, she can afford it until she's out of money and then it's medicaid.

You can spend down fir funeral expenses, clothing, home furnishings for the nursing home, eyeglasses, etc.

Anonymous wrote:This is going to sound heartless, but I don't mean it that way. If she is not safe to be discharged to her home, do NOT take her into yours unless you want her there the rest of her life. At the rehab hospital, if you tell them she is not safe to be discharged to home and you cannot take her, they will find a bed for her elsewhere.

No, they’ll only find a bed for her elsewhere if a healthcare provider determines she needs it. What family thinks doesn’t matter, it’s what the providers are willing to document that matters. If they determine she “can” go home, that’s where they’ll transport her. Since she doesn’t live alone and her husband is independent, they’ll almost certainly push discharge to home.

Where is her husband in all of this?

Ultimately, the idea is that she spends everything she has until she does qualify for Medicaid. So you need to work with the social worker and figure out how to protect the spouse during that process.

You don't get to just say "assisted living she can't afford" because basically, she can afford it until she's out of money and then it's medicaid.

Anonymous wrote:This is going to sound heartless, but I don't mean it that way. If she is not safe to be discharged to her home, do NOT take her into yours unless you want her there the rest of her life. At the rehab hospital, if you tell them she is not safe to be discharged to home and you cannot take her, they will find a bed for her elsewhere.

+1

If she leaves the facility, then they no longer have to help her. Don’t let them trick you.

If she is not walking, can she use a wheelchair?

My mother was told she is not safe to walk anymore. The assisted living moved her to a wheelchair.

I’m trying to understand why a wheelchair is not being suggested to her.

This is going to sound heartless, but I don't mean it that way. If she is not safe to be discharged to her home, do NOT take her into yours unless you want her there the rest of her life. At the rehab hospital, if you tell them she is not safe to be discharged to home and you cannot take her, they will find a bed for her elsewhere.

Doesn't Medicare cover home visits for elderly people who need assistance?

I don't have specifics about how to pay for things but word to the wise - make sure she is getting turned ever hour or two if she is in bed. If not, then she will get bed sores and those are awful and super expensive to pay for because the bandages often need to be changed every day and medicare will only pay for twice a week. You can do stuff like get foam bed wages to prop her up in different ways.

OP I agree that you should should talk to and work with the social worker hopefully available to you at this nursing home.

Do let us know what happens next. I expect alot of elders are going to find themselves in this position.

If she doesn’t have a safe discharge plan then the social worker or discharge planner should be working on this. This really is their specialty and they know what’s available.

Do your edification, Medicare gives you up to 100 days only. And you have to be progressing in order for them to certify the stay. Whatever isnt covered is the patient’s responsibility. After that, patient t status dictates the level of care. To me this sounds like a SNF issue not assisted living. But there might be assisted livings that can manage that level of care.

Assisted living is almost always private pay. SNF is covered by Medicare for up to 100 days with a three day qualifying hospital stay and if they meet criteria such as progress requirements. Not likely to be covered after a rehab stay due to lack of a three day qualifying hospital stay, lack of progress and use of some of the allowable days. SNF is covered by Medicaid after the resident is destitute.

This should give you some information so you can start formulating questions for the social worker.

Hi all,
My aunt is at a rehab facility in Virginia. Prior to the hospitalization that led to rehab, she was walking some. However, since the hospitalization she has stopped walking and is effectively bed bound unless there are two strong people to move her. Rehab is ready to discharge her soon (I guess because Medicare has said they will stop paying at some point). However, she has no place to discharge to. Her finances make her too wealthy for Medicaid but she does not have finances that can support assisted living (she is also married and her husband is still in their apartment and can still live alone.)

They have appealed to Medicare, but even if the appeal is approved then it doesn’t forever solve the problem. If my aunt stays past the Medicare date she will incur charges that she can’t afford

I am trying to support my mom and other family members who are trying to manage this by seeing what resources or ideas are out there. Please let me know if you have any suggestions.