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while mom was visiting with us we decided that we wanted to remove her from nursing home and bring her home i called the facility and they said that she had to be at the nursing home to be discharged correctly i don't know alot about this discharge thing but that just doesn't sound right i just feel as if there trying to take money from her so there pro longing her stay there the man also said she wouldn't be ready for discharge untill friday. I also thought he medicaid paid for her stay there. the nursing facility gets her whole SSI check too dang i can't catch a break so that leaves me paying her pays on the outside

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Don't forget the follow-up post where you are begging the NH to take her back after she drives you bonkers at your house.
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This is like that part in Titanic where the ship is seconds away from the iceberg.
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MeDolly Oct 2023
Perfect description!
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Today is Tuesday. The nursing home can discharge mom by Friday, which is 3 days away. Do you not have to make your home ready for a disabled and vision impaired woman over the next few days?? What's the huge rush, I don't get it.

How do you plan to care for mom, with all of her issues, while going to school full time and trying to raise a grandchild?

I suggest you spend several whole days with mom at the nursing home BEFORE deciding whether or not to take her home with you. Visiting is one thing. Living with you fulltime is another, especially dealing with UTI, anxiety, stroke and other issues.

Wishing you the best of luck with all of this.
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Sizeash22 Oct 2023
mom can see to do things she just can't see to drive or read mail things like that as far as me going to school i do my schooling online from my home as far as takeing care of mom she needs help with things like preparing meals getting in and out of shower shen walks with a walker and she gets around fairly good it's mainly reminders that she may need like when a doctors appointments is and getting her there I thought that's what home health is for support and helping with some of those things i just don't understand why she should have to be made to go back to a place she isn't being taking of
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NH is required to do a discharge report. Mandated to do this by State licensing & Medicare regulations, copy to health insurance too. Whether she’s there as rehab patient or LTC resident. Done as in person evaluation at the NH & done by its staff.

This is why they want to her back & discharge EOW. If she doesn’t do this, she can b regarded as leaving “AMA” against medical advice. That is the type of discharge report they will file by EOW on her. AMA in her file likely morphs into future issues.

As far as her monthly income, a NH under LTC Medicaid are paid a daily room&board fixed rate by the State for each resident. Required to do a copay of almost all her income (like SS$) to the NH under terms of LTC Medicaid program with sm amt as a needs allowance. Everyone at the NH as a custodial care resident under LTC Medicaid is doing this….. whether income only $900 in Social Security or $2400 a month from multiple income sources. (Fwiw maximum monthly income for most States is $2472 a mo for an individual to be ok for LTC Medicaid).

Going AMA can snowball into serious issues for both her AND you as her POA. Say she is being treated for a skin issue that was staph and being watched on becoming MRSA. That this determination was done by a MD, nursing staff, wound care team will all be included in her current chart at the NH and also into discharge reports. If concerns are significant, NH has to - HAS TO - write in the report that as it was AMA exiting so they recommend that APS / Adult Protective Services be considered to be contacted to do an in person visit to the individual’s new living situation to check appropriate conditions. APS gets a copy. If she’s post stroke, low vision & active wound care, APS can make visits to your home & at will, to see living conditions. This is something you should be aware is highly likely to happen by your doing this. Serious stuff. If your home has not be adapted for her needs, APS can find issues with how she’s living and remove her. It happens.

also by going AMA, it sometimes poses problems for future health insurance claims to be paid. She left / stopped her care plan before it finished. And now is back trying to get the care for the same condition she walked out on. Sometimes insurance won’t pay.
& should she need a NH in the future, going AMA is in her chart. Many NH try not to take this type of resident if they can help it.

Fwiw You didn't mention how NH was getting her SS income. If mom made NH her SSA representative payee, that will have to be changed back. Is NOT on the NH to do this. She will have to do this with SSA on her own as SSA does not recognize POA. Only after, can it be switched back to go into her old checking acct or new representative payee made. Could be weeks. Whether or not balance of the month is returned by NH will depend on admissions agreement she did when entering. By going AMA she violated terms of care & the contract. NH may charge a storage fee for her items or consider them abandoned. Whatever $ left in her personal needs account, sent to State Treasurer. Read over her/your POA copy of the admissions contract to see what’s allowed. By her or you signing admission paperwork, it’s terms accepted.

As far as you’re “paying her pays on the outside”. Once they become a LTC Medicaid resident in a facility, copay required. If they have credit cards or continue to keep their exempt-as-an-asset home, they will have basically no $ to pay on/for these. NH Medicaid does not care about debts, it is all about income (which has to be a copay)and nonexempt assets (which must be spent down to whatever the limit is for her State, most $2,000). Either family pays her debts or she defaults. LTC Medicaid by & large = impoverishment.

Not trying to be harsh, but going AMA can have serious ramifications.
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AlvaDeer Oct 2023
Thanks Igloo for making this so crystal clear.
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You’re about to find out how you have taken on way more than you than you realize. But you’re determined to make it seem like it’s no problem. Can’t say you weren’t warned.

As an aside… not using basic punctuation in your posts make it much more confusing and thus harder to give you any help because it is all thrown together and makes it harder to understand because it’s just like someone who talks and talks and the listener has a hard time understanding what you actually need and I’m not trying to be rude just saying to keep that in mind okay thanks
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What you are describing is a person who needs full-time hands-on nursing care and is currently in a nursing home. You haven't mentioned that you have experience with this sort of caregiving - or any other.

Taking care of her is going to be a difficult, time-consuming job that will exhaust you and leave you with little time or energy to live your own life. Your husband may tire of your home being a sickroom. Does he have any idea what it will be like? Do you?

Please consider this very carefully. This board is full of posts from people who have done exactly what you plan to do. It usually doesn't turn out well.
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Don’t do it! You will regret it, and getting her back where she needs to be will be a MAJOR pain. Leave her right where she is.
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This sounds legit to me that the nursing facility would need her and you to sign any paperwork if she's wanting to leave, but my question to you is why in the world would you want your mom to move in with you when you say in your profile that you're already raising one of your grandchildren? Don't you have enough on your plate already and what makes you think you can give your mom the daily care she requires?
Your profile says that your mom is only 65 which is very young, but that she's had a stroke. Are you truly prepared to care for her, yourself, your husband and your grandchild without one or more suffering because you're being torn in too many directions?
And I truly hope you're not wanting to do it for her SSI check, as the way you've worded your post it makes me think you do.
Sometimes things sound good in theory, but when reality sets in that's a whole other story.
I would think long and hard before you make this life changing decision.
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Sizeash22 Oct 2023
absolutely not doing it for her SSI she barely gets any money as it is and her few dollars would not help me anyways i'm paying what bills she has on the outside anyways the nursing facility gets her SSI and her medicaid for her staying there i'm only concerned for her well being not her money because if i wanted her money she would have never been placed in a nursing facility to began with she was placed there because I did want her taken care of and I was working and couldn't give her the proper care she needed at that time she was living on her own in her own house and had a fail and was sent there for rehab so before you start judging people you might want to ask more questions i thought this site was to help people like us not judge them and accuse people of things
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We really don't know any details about you, your Mom (her condition mentally and physically), or whether she is capable of making her own decisions to leave care or not. She clearly either put herself into care or someone else did. Can you tell you about that?

Are you POA for your mother? Do you know how to do that, all the record keeping involved? How did your Mom come to be on Medicaid without your understanding it was happening.

Will have to leave this to you, but I would take great care not to be accused of elder abuse. Some people take elders out of care in order to get their assets, savings, or SS. I am not saying that is YOUR intention; I am saying it does happen in the world of elder care. If the nursing home is worried about you they will contact authorities.

Clearly your mother has some possessions at the facility. How is it you have not gone there to do discharge papers with her, and to move her belongings?
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Sizeash22 Oct 2023
that's the thing she came to our house and under her boobs is so raw there almost bleedi0ng i feel as if there not properly taking care of my mother the way she needs to be taken care of when my mother went to the nursing home she had community medicaid state medicaid i called the nursing facility today and let him be aware of what we were wanting and that's to discharge her with a few referrals and i told him that she didn't want to come back to the facility but once he got all the paper work and referrals together Give us call and we would be glad to come by and sign those he said that wasn't possible that my mother needed to be in the facility and that we may come back and get her friday she doesn't want to go back and i don't see were they can make her
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Hello.

I am I hope you as well, Thank you. If you can handle it, bring mom home.

The facility wants her back so they can do the discharge according to your state's laws and not get in trouble. Her decision to leave, you should have little to no issue making that happen.
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