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Post by mikklynn on Aug 11, 2023 12:54:53 GMT
How aggravating! I'm not an expert in nursing or care facilities, but those seem like basic needs for a skilled nursing facility. Are they understaffed? I suspect that is the issue, although they aren't saying that.
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Post by mikklynn on Aug 11, 2023 12:55:49 GMT
That is crazy. Do they kick patients out when they decline? That is what I asked, too! Not directly, as my sister was the lead person on this.
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Post by mikklynn on Aug 11, 2023 12:59:06 GMT
1. He isnt being "kicked out of rehab". He is being discharged. 2. From, there, he would go to a Skilled Nursing Facility (SNF) and receive rehab services while there. Skilled Nursing Facilities can have short term care and/or long term care. 3. If the "nursing home" you are looking at doesnt have rehab services, he cant go there and receive services. Hence why he would require "too much care". In reality, it is that they do not offer the services he needs. His insurance company is kicking him out of rehab. They won't pay for a skilled nursing facility, either. They say he won't get any better with rehab, so they won't pay for it. It was fortunate for us that dad did rehab at the care facility where they live, so he is just staying put. My idiot brother through fit when dad completed rehab and Medicare quit paying before the maximum 100 days. He could not understand you aren't guaranteed 100 days. Dad completed his goals, so we have to pay. He also refused to believe me on the cost of $12,000 per month. That is why he's my idiot brother. I wish he could stay at the current facility, as the care is excellent, but they don't have assisted living apartments for mom. Plus, they are 2 hours away from all of us. We hoping to move them within 10 minutes of 3 of my siblings, 20 minutes for me.
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Post by christine58 on Aug 11, 2023 13:01:37 GMT
How aggravating! I'm not an expert in nursing or care facilities, but those seem like basic needs for a skilled nursing facility. Are they understaffed? I suspect that is the issue, although they aren't saying that. I am just so sorry that this is happening. It just makes no sense. A friend of mine’s stepdad is at the local Jewish home in like their memory care facility/rooms. He’s a retired pharmacist and has quite a bit of money. Thank God because it’s costing them $500 a day for him to stay there. The amount that it cost us to take care of our elderly is just beyond absurd.
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Post by mikklynn on Aug 11, 2023 13:04:57 GMT
Kerri W Thank you for chiming in! I understand he is far beyond assisted living. This place advertised as a Parkinsons specialty center with independent living and skilled care. I do think the issue is staffing levels. They said they don't have RN after hours, but he doesn't need that. It's frustrating!
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Post by cannmom on Aug 11, 2023 13:22:05 GMT
I'm so sorry. That's so frustrating.
I think many people get confused about the differences in Rehab facilities, Assisted/Independent living, and nursing home facilities. Also, with what insurance/Medicare will pay. it can be very complex. If you have a family member that is hospitalized and needing some type of out of hospital extended care your best ally can be a facility's Social Work team. they know all the details about which places will be the appropriate placement and how insurance and Medicaid/Medicare will pay.
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Post by crazy4scraps on Aug 13, 2023 4:26:13 GMT
I’m so sorry. That has to be incredibly frustrating! I truly hope your family is able to figure something out for his care.
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lizacreates
Pearl Clutcher
Posts: 3,919
Aug 29, 2015 2:39:19 GMT
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Post by lizacreates on Aug 13, 2023 6:27:45 GMT
1. He isnt being "kicked out of rehab". He is being discharged. 2. From, there, he would go to a Skilled Nursing Facility (SNF) and receive rehab services while there. Skilled Nursing Facilities can have short term care and/or long term care. 3. If the "nursing home" you are looking at doesnt have rehab services, he cant go there and receive services. Hence why he would require "too much care". In reality, it is that they do not offer the services he needs. His insurance company is kicking him out of rehab. They won't pay for a skilled nursing facility, either. They say he won't get any better with rehab, so they won't pay for it. I’m sorry for what you and mikklynn are experiencing, and most especially sorry for the fathers needing care. I don’t understand your second sentence, though. Isn’t your father on Medicare? He was hospitalized, right? What I mean by that is he was admitted as an inpatient, correct? If that’s the case, Medicare pays for skilled nursing facility after a 3-day minimum inpatient hospital stay. It pays 100% for the first 20 days in a benefit period. From days 21-100, there’ll be a copayment (the limit is, I think, $200/day copayment in 2023). After day 100, the patient pays all. In order to qualify for an SNF, his doctor has to certify that it’s medically necessary. Could it be that Medicare is saying this won’t be covered because there’s no certification? That might be where the problem lies. You might have to really clarify this.
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Post by anniefb on Aug 13, 2023 7:47:18 GMT
I'm so sorry to hear that you are having to deal with this. Incredibly frustrating.
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Post by katiekaty on Aug 15, 2023 16:50:47 GMT
I am definitely not defending the facility (they should have done their homework before accepting her dad), but there are state/federal requirements that determine where a senior goes. A 'skilled facility' is typically where someone goes to get help with their condition (Parkinsons) and it's possible they can recover enough to eventually go home vs. getting help for everday needs of getting older. Nursing Homes are where you get the most help with everyday needs like showering, toilet help, etc but they are also for those who aren't going to get better. And add in if Medicaid is ever expected to have to help chip in money (I DO NOT KNOW THIS IS THE CASE), then they can regulate where they go as well, and limit what they pay for. Its all a big a$$ headache, all the way around. Timidly raising my hand as the owner of a small assisted living facility. ALL OF THIS ^ We do not have the choice on what level of care we accept. It is not because we are understaffed or that we're trying to make more profit or that we're providing substandard care. The state has levels of operating certificates with oh so many regulations and laws for us to comply with. We cannot keep a resident who does not meet that criteria. If we do, and a surveyor visits, we lose our certificate of operation. It is very black and white. AS IT SHOULD BE to keep residents safe. That said-I'm sorry for the frustration the OP is experiencing. It is SO hard. And it doesn't sound like it was handled well on the part of the facility. Thank you for clarifying that it state that has operating certificates for for differing levels of care and residents that don’t meet the criteria cannot be there. Those regulations have always been there and do change over the years based on changes from the Centers for Medicare and Medicaid. It really doesn’t have to do with political parties as changes rarely happen with one political party or the other but rather changing medical trends, insurance dictates, Medicare and Medicaid laws, etc. Sorry to the OP and I hope your can get placement for your father quickly!
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