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They want to be assured they will get paid. I applied her for medicaid last August. Before that, we had a PRI done which concluded that she should be in a SNF. I submitted applications to 4 different NH's & she was put on waiting lists for all. She has dementia, has a serious balance problem, can only walk short distances with a walker, can no longer manage taking her medications correctly, & cannot take care of herself. Now she is getting more forgetful, most of the time can't follow a conversation, & isn't eating nutritious food. She is currently living in an over 55 apartment complex, not assisted living or any kind of help. The medicaid caseworker now tells me they can't approve her for NH medicaid unless she is currently in a NH, they tell me she should apply for community medicaid. The NH director of admissions tells me they can't admit her without medicaid 1st being approved. I feel like a ping pong ball getting bounced back & forth. She is falling through the cracks because nobody will go a little extra to steer me in the right direction. She needs to be in the care of a NH but, at the NH director of admissions urging, I told the medicaid caseworker to go ahead & change the application to community medicaid. I don't feel comfortable with that because she can't do so many things for herself. Since the NH won't work with medicaid pending, how can I get her admitted without waiting for something to happen to her? She is willing & ready to go, she knows she needs to be there.

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I don't know why you want to skip the community Medicaid part. Once she actually has Medicaid, the managed care company that has her case can smooth the transition to a nursing home. Why fight it?
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Socrates, the person asking for help clearly states that her mom is in an over 55 apartment complex, why did you start babbling on about property liens? You are doing it to be a troll... telling people they are terrible for using NH services? Not everyone was born with a silver spoon up their bucket. You know NOTHING about nursing home LAWS, state or federal or NH admissions, or care about elderly people as you stated, you would NEVER put your mom in a home and you can afford to keep mom at home...your own words. Where is your compassion? Still feeling superior?
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Sorry about your mom. As far as getting her admitted to a NH, you must get durable POA, you should have a copy of the 1st mcaid application completed in August. How much money, or liquidable assets does she have. Frankly, mom must be absolutely broke, except $2000 in assets, or a ppd burial plan is acceptable. In my state, Mass., she should be in the state computer system by now as having applied. And the above poster is correct, 100% or all of moms monthly income, SS, pension, retirement is used to pay for NH care, minus $72.80 that mom can keep per month. Mom has to spend all her money. And liquidate any assets in case mom has to begin her NH stay as a self pay resident until she is out of funds. If I were you, my first step would be to call on the status of your moms medicaid application. Why isnt she approved yet? Too much money? Missing bank stmts? Is there a life insurance policy? Medicaid needs everything. 6 months is way too long, she should have already had a medicaid caseworker assigned by now. It sounds to me like medicaid ia missing some info. You, as the next of kin, are going to be doing all the legwork for medicaid, (even if you chose to hire a lawyer) so DPOA os imperative. What is holding up her mcaid application? I think that is the 1st question. Good luck, stay strong. I lost my mom in december, 2015.
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Reverseroles, it wasn't a waiver program. I'm not sure we have waivers in NY. In fact, I'm not sure what a waiver is. This was community medicaid. Meaning, you qualify for medicaid, but still live in your community. In NY, legislation was just passed that requires everyone on medicaid to choose a "Medicaid managed care" provider, like visiting nurse service, centerlight, guildnet, etc. A person from one of those managed care places came out to do an eval for services. Whatever that nurse recommends is what the person gets. For dementia, it's too dangerous for the person to be left alone to walk out the door, so the decision was made to provide 24/7 care. Some managed care companies are more generous than others. If you can, make your mom look really bad at the eval. i hate to say this, but if you do things that make her display the confused behavior more, she'll get more hours. It may be a terrible thing to say or do, but all this RN get's is a snapshot to make a long-term decision. Someone from the company gave me that advice. good luck.
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Socrates, your advice is deliberately incorrect and misleading. You do this deliberately for your own amusement.
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Just to give the correct information here:
In 1993, the U.S. Congress passed The Estate Recovery Act which demands that each state seeks repayment for Medicaid benefits from certain people and for certain services

People over the age of 55 who have received Medicaid payments in a specific time period

Payments for nursing homes and nursing care facilities, home and community-based services, related services at hospitals, and prescription drugs.

Most people's assets are is in their houses. Now this targeted groups will find that money is sought on death

While some states do have s homestead exemption or personal residence waiver your state amy still seek financial recovery after you die. In some states the house might be safe as long as your husband or wife is still alive.

Either way they will still come after the money
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We just get community medicaid "approved" for both our folks AND that was ALL our local NH needed to admit them BOTH in the same room, no less. Now we are submitting docs for the "medicaid" for NH care! AND it was fast and fairly simple for the community care process too (less than 2 months). Wishing you all the BEST in your process. They are both doing so much better than they were at home even with extra helpers coming in......both have dementia too.
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i admitted my mother to a Geriatric Psychiatric Facility for evaluation. After 3 days, the attending psychiatrist determined that she required Skilled Nursing in an Alzheimer's lock down unit. Medicare will pay for the 1st 100 days of skilled nursing when a patient is transferred from a Psychiatric Facility. You still need to speak to an elder attorney. I hope this helps. It's so overwhelming.
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By applying for and getting approved for Community Medicaid you are essentially showing the Nursing Home that she is Medicaid Eligible.
That way they can admit her knowing she will just switch her Medicaid from "Community" to "Institutional". Many people enter a NH following a hospital stay but in this case, Community Medicaid could provide her with in home services or go with her to an Assisted Living depending on what your state provides. In our state you must apply for Community Medicaid if you are living in your own home. The program provides, case management, meals, cleaning, transportation, laundry, medication management and administration and a Life Alert.
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IMHO, hiring an attorney is a waste of money. The BOM at the NH of your choice should be able to give you the correct forms to complete, especially since the implication is that your mom is pretty broke, to be brutally frank. Even if you hire and attorney, YOU, as nok or DPOA, will be doing all the legwork such as getting any and all bank statements, getting any prepaid funeral arrangements, getting any life insurance policies, getting proof of her monthly income....YOU will be doing all the work and then the attorney takes the paperwork that YOU collected and fills out the form. Seriously.
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