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I am venting but if anyone wants to weigh in with any helpful advice I'd appreciate it.


My dad went into a NH under Medicaid pending. My mom did a spousal waiver and it took months and now thankfully his application was approved. So my sisters and I do not need to worry about him.


My mother is complaining that Dad's taken care of and what about her. This is the person who made my life an absolute hell when I broached the subject several times last year. Berated me, had a tantrum on the porch and told my sister not to trust me. I decided to let her drive the bus. She chose not to do anything for YEARS and now I am supposed to snap my fingers and make it all okay for her. It's just freaking miserable.


I am trying to get my mother into the same facility as my dad. I feel I've been given the runaround by the administration. Last week the admissions coordinator told me to get a PRI because without it, they could do nothing and cannot put her on the admissions waiting list. I bugged the hospice people who are handling my mom's case and they finally came through. I showed up today with the PRI and my mother's PCP assessment and met with the Admissions Director to try to see how I could get her in.


She told me that the facility has no long term beds available and I have to do this through the hospital. I have to bring her to the emergency room and tell them that she is not herself, has an issue of some sort and insisting on a "social admit" (I never heard of this) so that she can get rehab and enter the facility via rehabilitation and transition to long term stay (maybe only if they have a bed and Medicare does not discharge her.) There are no guarantees.


The Admissions Director also told me I we have to sell the house because she would be private pay because she will not qualify for Medicaid because she has a house. I thought that in NY the house does not have to be sold in the event that the the client changes her mind and wants to come home. She would need a home to come back to. My understanding is a lien is placed on the house and when she is gone, Medicaid will recoup the money.


I am pretty sure I am correct on the house thing. Of course I am contacting our lawyer but frankly I'm just down about this. She is outliving her money and even though she is frail and cannot do many every day activities there is nothing really wrong except heart failure which is being maintained by a pacemaker and very bad arthritis.


So essentially today I was told there was no waiting list for a community admissions (they led me to believe there was) and that I need to lie to get my mother into rehab by getting her into the hospital. And frankly I do not think this Admissions Director has a clue about Medicaid rules.


I'm off to write my email to the attorney. Just so done.

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Bumping up for answers.

Wishing you the very best, HH.
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How have you not heard of a 'Social Admit'? I mention that all the time on this forum.


If you tell the social worker at the hospital her husband is currently in one nursing home and she's on the waiting list, they will try to get her in there. She might not get sent there right away though.

You are wise to run everything said to you by a lawyer. Lying is second nature to anyone associated with a NH, AL, or rehab facility. Admission directors, social workers, nurses, etc... it's all about the bottom line profits and making sure their a$$es are well covered along with the company that signs their paychecks and bonuses.

As for your mother's berating of you and verbal abuse. Tell her plainly that she learns to keep her mouth and attitude in check or you will abandon her and she will be left to rot in the house. Then no one will be taking care of her.

NEVER tolerate abuse for one second from anyone.
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anonymous1732518 Aug 2023
Sad but unfortunately true, many facilities are like this
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I don't understand why the facility is being so difficult in this situation. The husband is already there, so you would think that they would want the wife to be there also. Don't they want the additional money?

Since you are private pay, nobody can force your mother to sell anything. However, as a practical matter, unless your mother is wealthy, the house will probably end up being sold to make the payments at some point in the future.

As my brother once said, "When it come to nursing home care, it is best to either be very rich or very poor. If you are in the middle, you're screwed."
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anonymous1732518 Aug 2023
It could be an issue of having a shared room available.

If Dad already has a roommate, the roommate would be "asked" to move so hubby and wife could be together.

That could be an issue for the roommate, especially if he has become used to the nurses, routine, etc.

This is coming from personal experience having been moved from a private to shared room. The shared room is farther from the therapy room, louder, the last to get meals served to name a few, plus there is the missing of a few really cool nurses on the floor.
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If the NH administrator is suggesting a social admit/unsafe discharge, does this mean no one is her PoA? It can also mean she has not medical diagnosis of dementia. Often this path is taken when the LO is uncooperative in moving into a facility. My cousin with ALZ had to take this path and she is in the psych wing of the hospital to which she was brought. If facilities are full at the moment, there's not much that can be done, I think.

Medicaid rules can vary by state. In most states, their Medicaid programs only cover LTC. Is this the case in your state? Has your Mom been assessed for this level or care? You mentioned hospice, so is your Mom in hospice? Also, NHs have a limited number of Medicaid beds and existing residents get first dibs on those beds. I don't know how it works if a spouse is already a resident. I think it is up to the NH to make this policy.
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anonymous1732518 Aug 2023
They would try to accommodate the other spouse, to the detriment of the roommate if one spouse has one ( roommate that is)
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If mom is on Hospice the Hospice Social Worker should be able to help with this.
Anyone that is on Hospice would not be considered a "long term" resident.
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Hothouseflower Aug 2023
She's on hospice but she is not actively dying. She does not have dementia, far from it.

I realize this hospice does not want to help us get her in a nursing home, even though it would be the best thing. They are advocates for in-home care -- that's their bread and butter. They gave me a hard time when I requested this PRI.

Only reason we have her on hospice is because she gets oxygen and an aide five days a week, three hours a day at no cost to her. And she sees a nurse once a week, which has been good.
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Good luck....if mom had been willing to go into the facility at the same time dad went in, things would have been so much easier. But of course selfish is as selfish does with most of these elders. Hopefully once mom is in a facility you won't have to go up and visit for months at a time anymore.
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Hothouseflower Aug 2023
It is sad that neither of them saw the handwriting on the wall and realized that they could no longer live in this house and decided to go into assisted living. Every time any one of us kids brought it up we were met with nastiness and suspicion.

We were in crisis mode when my father declined suddenly and we placed him in the NH (we did an ER dump in January). My father was the squeaky wheel. My mother didn't need as much help. We had to make decisions for him.

Decisions made while in crisis mode are frequently not the best ones. I wish we could have had a better plan. But we could only play the hand my parents dealt. It has been a bad hand.

I am looking forward to my mom being in a facility. It will be a relief.
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In my State, a house is an exempt asset. At this point, she would still get Medicaid. Since both parents will be in care, would be silly to keep the house unless u want to pay the bills and upkeep. When Dad went in were assets split, is Mom the Community Spouse? If you sell the house I would think the profits need to be split between Mom and Dad if both on the deed. Medicaid will stop until you spend down the proceeds, when spent down, then back on Medicaid.

I agree, the Admissions Director is wrong.
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Hothouseflower Aug 2023
To get my dad into the NH under Medicaid my mother did a spousal waiver meaning she refused to pay anything for his care and whatever assets they had together are now solely my mother's name. That included taking my father off the deed to their home. This was very traumatic for my mother, she felt terrible that she was doing this to her husband of 70 years. Very sad that this is what people need to do at the end of life.

My mother is the Community Spouse. The proceeds of the house will need to go to her care. Either now by selling the house or if she is on Medicaid when she is deceased and the house is sold.
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The house will be vacant and homeowners insurance will go up. Besides Insurance, who will continue to pay for taxes, heat and upkeep? That is because mom's income will go to the facility where she lives as part of her Medicaid. Plus she may not yet qualify for Medicaid. The Admissions director is correct. The LTC only has a few Medicaid beds and the rest is private pay. Many good places also have wait lists. Mom may not even get into the same facility if she qualifies now. However a private pay will go to the top of the list for a Medicaid bed if done months before the need
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HotHouse, I assume your update regarding why the house needs to be sold (because mom did a spousal waiver) is what you learned from talking to the lawyer.

You say that you did an ER dump for dad last year. "ER dump" and "social admit" are pretty much synonymous, in my understanding.

Are you going to proceed with that?
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