I added my mother to a wait list through kaiser for placement. She has medical and Medicare. She suffers from dementia real bad to the point where I can't take proper care for her anymore. We'll She was denied because she can still walk. Still walk I can't believe that. I'm out of answers.
Are you meaning a nursing home that is Kaiser-run?
Can you provide more details here for us?
I applaud you for knowing your limitations in caring for her. You are having difficulty finding placement for your mom. You’re caught between a rock and a hard place.
I certainly hope that you can resolve this issue soon. Wishing you and your mom all the best.
Normally, to qualify for Skilled Nursing care with Medicaid or any other way, an elder needs to be unable to perform 2 or more Activities of Daily Living.
What are the 6 daily activities of living?
The six standard ADLs are generally recognized as bathing, dressing, toileting, transferring (getting in and out of bed or chair), eating, and continence. ADLs are the most common triggers used by insurance companies to determine eligibility for long-term care insurance benefits.
How Do You Qualify for Benefits? Many insurance policies state that you are eligible for long-term care funds if you can't perform two or three out of five or six activities of daily living (ADLs), including bathing, dressing, continence, toileting, transferring and eating.
Also, Kaiser has an appeal process I'm sure you're aware of. With Medicare, KP is FORCED to adhere to the MEDICARE rules first and foremost. So it's up to you to make sure they are. Sometimes the right hand doesn't know what the left hand is doing at KP. For example, I once got a denial letter AND an approval letter for a surgical procedure on the same day.
Who did the assessment?
Were you there?
Did you see the written denial?