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I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
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V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Mom is 90, currently bedridden. Prior to hospitalization, she was able to walk with a walker and perform daily hygiene tasks. I am unable to provide the care she requires at home.
You need to tell the hospital THESE WORDS EXACTLY: "I cannot accept my mother into her home. If you discharge my mother it is an UNSAFE DISCHARGE and I will call the Joint Commission (JCAHO) to relieve your hospital of its license to practice medicine. My mother is bedridden. I am physically, mentally and emotionally unable to care for her at this time. Whether you send her to placement or to rehab you need to have your social workers work on finding her safe placement now".
That's it. They key phrases here are "I am physically unable", "JCAHO", "Your license to practice medicine" and those magic words UNSAFE DISCHARGE. You will be seeing a social worker shortly. Get it together and decide what placement is right for your mother now.
Same scenario happened to us. My mom is wheelchair bound amputee living with us previously before her hospitalization. She was discharged even though we fought it, from the hospital into a skilled nursing facility. She was completely bed ridden, and prior to hospitalization, she was mobile, could make transfers to her wheelchair with ease. Not after the hospital. The hospital is not the place for your mom now, and you might be able to get a few extra days, but she will eventually be discharged. You should be given a list of skilled nursing facilities in your area by the case worker at the hospital. Do your research on the list of facilities, visit them, look at reviews, do your research. Pick one, the hospital will make the arrangements for transport to the skilled nursing facility. She'll have 20 days at the facility EVEN though Medicare pays for up to 120, it changes over to a secondary coverage with an 80/20 coverage with the supplemental insurance and the SNFs don't like to deal with that. I'm just telling you what happened to us, you might not have Medicare and plan F supplemental. We fought this whole way to get my mom the care she needed, and yet this is what happened. Discharged from hospital, then discharged from skilled nursing after 20 days - then what? She was still bed bound, refusing the PT offered, and a higher level of assistance needed than what the SNF offered on their assisted living side, so no place to live and no way could she come back home to us. Luckily for us, one of the PT people at the SNF whispered to me about a health rehabilitation hospital. It's different from skilled nursing. We got her transferred to a place near us, out of the SNF into a rehabilitation hospital. I had no idea rehab hospitals existed. I call it boot camp PT. My mom would not be with us today without that rehab hospital. There, she couldn't refuse PT, they really encouraged her, didn't give her the chance to say "no" and got her involved with group PT (they played corn-hole ha ha, she loved it) and got her back to making transfers with help. She wanted to come home, but the doctor there said no, not a good idea. She needed more assistance than we could provide at home. So after 14 days at the rehab hospital, she's discharged again, now what? They had a list of brokers that helped me find an assisted living place. We picked a broker, she came and interviewed my mom, and matched her with a facility. I toured the places with the broker, but the first place we saw I knew was the match. It is a little hidden gem in our area and I never would have found it without the broker assistance. It's been 6 months now with my mom at assisted living, she is thriving. I haven't seen her like this in years, plays bingo daily, puts her make-up on, socializing with new friends. We used Care Patrol as the broker to find an assisted living place, and I can't say enough good things about them. This is a long story, and obviously my experience is different from others. Maybe you can glean some info from my story. We fought the system the entire way, the hospital, the insurance, to skilled nursing, to the rehab hospital, to finally a place she is happy and healthy. It took about 2 months of her living there to realize she is actually likes it better there than our house, it's a big adjustment.
She needs to go to a nursing home now. Tell the case manager that and tell them that you are unable to safely care for her at home. She will have to pay for the nursing home though, so see if Medicare will pay for short term rehab. If they don't, whatever money mom has needs to go to the NH, and if it is not enough, she needs to apply for LTC Medicaid with the state. The social worker at the hospital should be helping you with all of this.
I agree with telling them she's an unsafe discharge, that you are not her caregiver (and cannot be under any circumstances) and to ask to speak with a hospital social worker about transitioning her directly into LTC (which is covered by Medicaid if she qualifies financially).
Tell the hospital exactly what Alva wrote and say it exactly as she said. Hospitals need to move people out to free up beds but they need to move to them to safe environments. Not sure why your Mom is in hospital or where your are located but if she was somewhat mobile prior to the hospital but is bedridden now, she may qualify for short term rehabilitation (STR) to see if she can gain strength and some mobility back. I was the admissions director at a local facility which did both short and long term care and we accepted many patients to help them see if they could regain strength. If your Mom has traditional Medicare it will pay for 20 days needed skilled nursing (SN) or STR. If the team at that facility determines that more nursing/rehab is needed, Mom can get an additional 80 days but Medicare will only pay 80% of the bill; the remaining 20% will need to be paid by Mom's assets or hopefully, her supplemental insurance if she has one. Be aware that the team can not "force" her to participate in PT and in order to qualify for continued PT she must be making progress. Also be aware, that in spite of all efforts she might not come fully back to her pre hospitalization state. The scenario changes a bit if she has a Medicare Advantage program. These programs are owned by private insurance companies and although they are required by law to off the same services as traditional Medicare, the time limits on those services are very different. I have had to discharge patients after 10 days if they were not deemed to be "making progress" by the Advantage program. Tell the hospital social worker you can not take Mom home (and don't be fooled by the " well, it you take her home tonight, we will get in touch with you tomorrow and help you out" line. It's not going to happen and once she leaves the hospital, she will be your problem. Before you pick up the list, jump on the computer and check out the ratings for the nursing/rehab homes near you on the www.medicare.gov site. They have star ratings for nursing homes from inspections submitted by the various states but remember, the state only visits about 5 days every 18 months so that the star rating with a grain of salt. Pick out a few you like and then check them against the list you get from the hospital. Call first to find out if they have vacancies and if they do... visit, visit, visit!! I recommend two visits if possible and if you can take someone along with you that's great.... two sets of eyes. Not going to bore the rest of the forum with visit details but find out if the facility can guarantee you a Medicaid bed should it be needed in the future. How many minutes of PT do residents get per day. You can ask about the nursing staff to patient ratio but what they have listed is rarely what is real; that's what happens when you don't pay people well or are short staffed to begin with. Get a sample of both the month's menu and the activity schedule. The National Institute of health: https://www.nia.nih.gov/ has a great list of questions you should ask. But remember on your visit, use your eyes, ears and nose to see how patients look, are dressed and interact with staff. Wishing you good luck on this part of your journey.
If you aren't a POA, you will have to get Guardianship. The hospital files a petition to declare your mom incapacitated. If she is under Medicare, her hospitalization will be covered. They kept my mom for over 2 months. Sell the house and spend down her assets. It's tedious work, but very necessary.
Since your kids have dropped out of your life (I'm so sorry), you need to make plans now for what your future will look like. Perhaps a senior community would be a good place to start. I'm not sure of your income level, but in your county, assuming you are in the US, you should be able to find low-income senior housing (probably has a waiting list) or housing developments geared to seniors (which often have a low-income section as well), or retirement communities. I don't know your age, but you should start to plan now.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
"I cannot accept my mother into her home. If you discharge my mother it is an UNSAFE DISCHARGE and I will call the Joint Commission (JCAHO) to relieve your hospital of its license to practice medicine. My mother is bedridden. I am physically, mentally and emotionally unable to care for her at this time. Whether you send her to placement or to rehab you need to have your social workers work on finding her safe placement now".
That's it.
They key phrases here are "I am physically unable", "JCAHO", "Your license to practice medicine" and those magic words UNSAFE DISCHARGE.
You will be seeing a social worker shortly. Get it together and decide what placement is right for your mother now.
Are you her PoA?
A social worker needs to send her to a nursing home, if necessary, a rehab facility before permanent placement.
The scenario changes a bit if she has a Medicare Advantage program. These programs are owned by private insurance companies and although they are required by law to off the same services as traditional Medicare, the time limits on those services are very different. I have had to discharge patients after 10 days if they were not deemed to be "making progress" by the Advantage program.
Tell the hospital social worker you can not take Mom home (and don't be fooled by the " well, it you take her home tonight, we will get in touch with you tomorrow and help you out" line. It's not going to happen and once she leaves the hospital, she will be your problem. Before you pick up the list, jump on the computer and check out the ratings for the nursing/rehab homes near you on the www.medicare.gov site. They have star ratings for nursing homes from inspections submitted by the various states but remember, the state only visits about 5 days every 18 months so that the star rating with a grain of salt. Pick out a few you like and then check them against the list you get from the hospital. Call first to find out if they have vacancies and if they do... visit, visit, visit!! I recommend two visits if possible and if you can take someone along with you that's great.... two sets of eyes. Not going to bore the rest of the forum with visit details but find out if the facility can guarantee you a Medicaid bed should it be needed in the future. How many minutes of PT do residents get per day. You can ask about the nursing staff to patient ratio but what they have listed is rarely what is real; that's what happens when you don't pay people well or are short staffed to begin with. Get a sample of both the month's menu and the activity schedule. The National Institute of health: https://www.nia.nih.gov/ has a great list of questions you should ask. But remember on your visit, use your eyes, ears and nose to see how patients look, are dressed and interact with staff.
Wishing you good luck on this part of your journey.
Since your kids have dropped out of your life (I'm so sorry), you need to make plans now for what your future will look like. Perhaps a senior community would be a good place to start. I'm not sure of your income level, but in your county, assuming you are in the US, you should be able to find low-income senior housing (probably has a waiting list) or housing developments geared to seniors (which often have a low-income section as well), or retirement communities. I don't know your age, but you should start to plan now.