Why are some nursing homes so lazy and unhelpful in financial matters?

Many nursing homes have no financial advocate or they will deal only with the Medicaid question. You have a very complex financial and legal situation, what with the personal injury claim conflicting with the Medicaid coverage. You can't have both, and when a big settlement comes in, Medicaid wants to be paid back every dime they spent forth. Workmen's comp is just as bad, my BIL may get a million dollar settlement, but then the comp board wants to be paid back every penny they already paid out.

You aren't alone. Mom was released from the hospital after 3 days and we were given a list of qualified rehab centers Medicare would pay for the first 20 days. After that, she had to leave, which she did, to enter another ( substandard) rehab facility in her network. We followed all the rules of the people in the know, yet 8 months later I got a bill from the first facility for over $3000. I was shocked! I have appealed to Medicare and am awaiting the answer, but mom is now a Medicade patient in a nursing home with no assets. No one really guides you, and when these things happen, it's YOUR FAULT. It's not enough to be stressed out about the health issues and dependency of your parent, but they want to stick you with the complete responsibility of making sense of a very complex maze of rules and regulations. It is a learning curve for sure.

The health of each parent per se that you're going thru seems similar to what my parents were. Mom had gone in for fractured hip surgery, BUT maybe she had an anesthesia-caused stroke, maybe an embolism, who knows, but it was a bad stroke. If she hadn't had the surgery, she would have been institutionalized for uneven hips. After the surgery/stroke, she was institutionalized. Dad had been compromised by leukemia, subdural hematoma & brain surgeries for 3 years before - but ambulatory, just not driving, could live at home - but seeing Mom in her post surgery condition, plummeted his health. Bless the love & respect of a good longtime marriage.
At any rate, Dad had been in the acute hospital post his brain surgeries for 6 weeks of therapy - then when the time came, all of a sudden the hospital's Social Services & Pastoral Care were assumptively involved with routing us to a SNF for convalescent care & therapies before he would be recovered enough to come home to VNA homecare therapies. Fortunately we didn't have issue with the SNF the hospital was assuming for us - as it was the best in our community, and one that our church benevolently helps out at. All thru Dad's 6 weeks at acute hospital - and the ensuing 6 weeks at the SNF, I was there to assist b-fast, Mom was there to assist lunch, and we'd both be there to assist dinner - we'd have 90% of the day covered with our being there as care support & advocacy for Dad. All of us - it is a have-to, must, that we have "an advocate" (good friend and/or family) thru our medical care, whatever age. It's a racket! (I'm childless, so Clueless who will be my advocate one day.)
Anyway - I will never forget when the SNF Administrator called me to her office that they needed the monthly fee. Dad had semi-retired from his office, but still worked til 76 when the subdural hematoma happened - and I had thumbed thru the office insurance handbook, and was sure I'd seen a section on SNF insurance. I told the Administrator to submit the Medicare form AND the office insurance secondary insurance form. She was cock-sure no insurance would cover. I said "Send them anyway - the worst that can be said is no." She grudgingly did so. Lo & behold - about 3 weeks later it about killed her to have to phone & say we'd have to stop by her office to co-endorse the insurance check. The office insurance did pay, and continued to for the duration of our 6 weeks. It gave me great joy & pride at the Administrator having to eat her words.
We were VERY fortunate.
For myself & whatever's in MY future, I'm just very grateful to have LTC insurance - for home care, or SNF if that's what it takes.
I have a 68-yr-old cousin & an 82-yr-old retired M.D. friend, whose wives are going thru long-term prolonged end-stage Alz at SNF's right now - and a friend who lucked out when her husband's Alz died of kidney failure after just one month in a SNF... if he hadn't have, they were calculating the prior resident of his room of 6 yrs, was over $1M of SNF care. Oh, the 82-yr-old's wife was just told besides the $10G/mo. SNF care, that she would need to hire independent caregivers in the SNF at $24/hour. My goodness, $10G/month fee care isn't enough? Something's wrong with this picture.

I just don't know how you cope with all this. Nightmare.

But kthln3, there's your answer - the nursing home won't employ people to help you with this because it's too darned difficult and if they make a mistake it'll come back to bite them. Know any nice friendly accountants?

Hello Kth! I understand fully what you are going through. I have been through this mess since October. At a time when you can least concentrate on anything because of a loved ones illness, and if you like me are suffering from major depression which makes concentrating almost impossible, they, meaning Social Services and the Nursing Home, aren't much help at all. They talk all this lingo that you have no understanding of because you have never been through it before. It all really needs improving!!!! But the bottom line I have learned is money!!!! MONEY MONEYMONEY, not care! I have found myself so angry the past couple of weeks, I can hardly stand myself. There needs to be advocates that will walk you though this mess. And it's not your fault honey that you have experienced this. Don't feel that way. If your family is like mine, we only had enough money to keep a roof over our heads, and food in our mouths, much less pay for insurance for long term care. That is an individual's responsiblityf to do for themselves, not for a family member to have to worry about.

The "job" of the nursing home is to care for patients. They are not in business to spend time educating you and your siblings about Medicaid. Start with Medicaid and have them explain what they need for benefits, and your mother has a lawsuit from the hip replacement manufacturer for a defective product. These are usually class action lawsuits, so that may take some time to resolve. Take one day at a time, and as long as your mother and dad are being cared for, there will be light at the end of the tunnel. Just keep believing that. That is all any of us caregivers do. Believe.

I totally relate to what you're going through. We went through this too (minus the personal injury aspect). My dad's nursing home had great information for us and guided me through the Medicaid process however I was so overwhelmed (before I put in the SOS call to my brother because I needed his help) that I didn't understand that I needed to begin the Medicaid process ASAP. That information just did not stick in my brain and then we found ourselves in a huge mess because of me. The day I found this out I was at the facility with my uncle, crying hysterically (because of the oversight but also because I was just plain too stressed out) and sat down on a glass table and BROKE THROUGH IT! I was laying on a bed of glass. It was a mess!! Everyone thought I was crying because of that but I was still crying because I had too much on my shoulders to be able to take care of everything. I couldn't stop crying and I have not cried that way in years.

I agree with you, we should discuss all of this with our parents way before it gets to this point and my dad used to assure me that he had it all taken care of which he did not. But I trusted him and I know he thought he had it all taken care of but all he had was a letter. A LETTER. Explaining that he wanted to donate his damn books to the veterans! That was all the instruction I had. But looking back I should have demanded to see what he had put together but how did I know? Like you, how were you supposed to know what to do? I used to try to talk to my mom about this and she'd refuse to discuss it because it was too unpleasant.

You can be damned sure that I have already begun to discuss this stuff with my 20-year-old daughter. She hates to talk about it too but I remind her of what I went through with my dad. She saw it all, how horrible and confusing and heartbreaking and stressful it all was.

I'm sorry your nursing home isn't more on top of this stuff. But my dad's nursing home was and it was just as stressful. Having my dad in a nursing home was a full-time job for me. Everyday it was something. Every. Single. Day. The accountant would call me or the social worker would call me or the nurse had a question about one of my dad's meds or my dad would call me at midnight to tell me he can't find his pant and then I'd wake up and do it all over the next day. It was pure hell.

But my dad was finally accepted by Medicaid....2 months after he died. Medicaid is retroactive but my brother gets a bill from the nursing home every month for $500. We have no idea what that's for and we don't care as we have no intention of ever paying it.

As you said, it's a horrible ride. A total nightmare.

My brother does not help me at all with my parents. I found out that he and his family were in town last week, they only live a bit over an hour away, stayed the night with a friend of ours, but never let my dad know he was in town, nor did he go see his mom in the nursing home. If I call him I have to talk to his wife, which relays the messages to and from him. Could someone help me to figure him out? His parents aren't getting younger and better, and he is just ignoreing them.

You folks are right on point here. My wife's been in 3 rehabs in the past year and all they wanna do is discharge her. She needs 24/7 care and needs to be in SOME facility. She doesn't get enough SS to qualify for SNF or other options. Long long story I'm sure you all know. But; keep in mind; they WILL lie to you and they will mislead you; and tell you things just to get you off the phone. It's really an impossible situation to deal with and you just do the best you can.