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I have been caring for mom for 14 years now, however, it is becoming dangerous for her and my family. She is denied Medicaid. Makes too much money. The immediate issue is that the hospital is releasing her and when I told them she cannot come back here, they said either I pick her up or they will deliver her by sheriff. Can they do that?

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No, hospital can not do that. It is there responsibility to have a "safe discharge" plan. Therefore, they must find her a facilit to go to.
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JoAnn29 Feb 2020
OP has not responded since the 19th. Seems she bowed out.
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Sorry, with all the responses, I did miss Tiredmomma’s follow-up post. I did not mean any offense.

Someone mentioned Memory Care. There are more & more Continuing Care facilities offering this service now, including the Senior Community where I live. That sounds like the right place for someone with dementia. The hospital should give you a list of Continuing Care facilities, as I obtained for my husband and successfully found him a good one not far away from me.

When my brother went to Continuing Care, he had to deplete whatever little savings he had; also, his social security check was sent directly to the care center. Anything extra was paid by Medicaid so it does not make sense what is happening in your Mom’s case. Unless rules have changed since then.

On the right of this page, there is a sidebar to contact Teresa Ann, Care Advisor. It might help to contact her to see if she could give you some guidance.

I only wish I could help you more. It’s hard going it alone. I know: I had to make the decisions for my father, my husband and my brother. They’re all gone now and I miss them terribly, but I know I did the best I could.
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gladimhere Feb 2020
Teresa is actually "A Place for Mom", owns this site.
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Tired has not posted since Feb 19th.
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mstrbill Feb 2020
I don't think she's going to come back, unfortunately. She had said she was going to bow out.
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She cannot go on Medicaid until her money is gone. That’s the rule for everybody & you can’t get out of it. You shouldn't be trying to get her on Medicaid. The money she saved is for her to use in her old age for herself, and right now she needs it! If there’s is any money left over, then it goes to her beneficiaries. Please don’t expect the govt. to finance you with other people’s taxes. I had to pay plenty for my husband. I think I answered you once before when I said you should find a nice nearby nursing home for her. She’s your Mom - let her get the best care she can in her old age. I haven’t heard of it, but maybe, by law, the sheriff is allowed to force her to leave the hospital and, if you have no continuing care place for her to go, she will have to live with you! By the way, Medicare (not Medicaid) will pay for some of the care, but not all, if she is in the Skilled Nursing section of Continuing Care. Ask the coordinator/social worker at the hospital to help you.
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mstrbill Feb 2020
You apparently haven't read the thread and OP's responses. Mother does not have any money, she takes home $1400 a month, has no other assets or savings. She has not been successful finding placement in a NH. What the hospital SW should do is help find placement. It is not safe for any of the parties involved to have Mom remain in the home. Hopefully APS will be able to help if Mom was sent home.
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No or else they can be sued. Does the hospital want to face a lawsuit? Dementia mother has nobody to take care of her at home & needs to be placed in facility. So demand to see Social Worker & tour a couple of places near you. Stress that it would be an unsafe discharge. Also make appointment with Elder Atty to see how you can pay for her care & save her $$$ as well. Good luck! Hugs 🤗
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Snice she us not safe to return home and has no asserts or income, I would get the hospital social worker involved to assist in long term placement under Medicaid. As a hospital social worker, I realize that Medicaid beds are hard to procure but for her safety the social worker need a to intervene. The area agency on Aging should be contacted for any assistance they can offer in regards to emergency placement and the long term Medicaid grant application should be completed as soon as possible. Both the social worker and the agency onaging should be able to assist with its completion
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I think magnumpi just likes to push peoples buttons. Magnumpi is back pushing buttons on here with disgustedtoo.
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NeedHelpWithMom Feb 2020
Crazy.
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Try to find a geriatric care manager to help you with finding a suitable place for your loved one. They can be a tremendous help at a time like this and the hospital or the doctor's office can likely recommend a few they work with...good luck!
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I agree with other post who says the system is broken.-hence my posting name of medicaid maze-applying for, eligibility requirements, availability of beds, wait list, behaviors etc. facility requirements/check list of who they will take or not take-they are not required to fill all beds in the first place.

My sister's current facility says if I don't like what they are doing care wise, I could take my sister to ER for "change in behavior". Sister behavior is fairly stable in spite of minimal care or concern at the facility-but still wanting to get her out due to loosing weight, injuries, being unclean. I have been digging for better placement for 4 months-several have refused her bad behavior, several wait list and several say no thank you for either behavior or because we don't have a bucket of money for self pay.

I did agree to hospital evaluation before as her behavior was out of control with agitation and elopement-resulted in nearly 3 weeks of being in restraints. Meds were changed and seem to be helpful-only because we knew she would not be able to return to assisted living-she was not doing well there-she needed more help than they were willing to provide at AL level. Only because we knew a change of care was imminent we started looking as soon as she was hospitalized-with only one option available as now sister has "agitation felony" on her records-not too many places are willing to take her on.

We were unsure as to how she might do in our home with my family members who sister does not know or recognize anymore would cause more problems for sister too. I have a couple more housing options to look at crossing my fingers again that one will work out for my sister.

I have had several communities ,including the current facility, recommend other communities for potential placement that have been cited for abuse-it is obvious to me that the staff who are making these recommendations are not doing any kind of vetting of care/quality before they pass along or set up a placement on your behalf.

All the resources available for finding senior housing are just going off a list too-they are not doing any research to narrow down best care choices either-they have no insight as to what the facility is really like-they have no power to move you to the first in line-even if they could do this -not always going to match up with when you need a bed.

Unfortunately, It is up to the family to do their own research and when it comes to hospital discharge the time can be very limited to figure out where to go in a short amount of time. As I have mentioned before the good places have few if any beds available when you might need one. I think there should be minimum standards of care required for a place to remain open-no community cited for abuse should even be out there waiting for the next emergency placement to come along. We are at the mercy of insurance, hospital discharges, available placements and quality of care.
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MountainMoose Feb 2020
Great post, Medicaidmaze20! One thing that hurts families trying to find options is that to read government or insurance websites, there's so much tech-speak that they make no sense to anyone reading them for the first (or subsequent) time. Those sites are WRITTEN by people who know all about what they're typing but READ by people who know little about it.
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I just wish that the OP would come back with an update.

She is probably overwhelmed with all of this, as I am.
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disgustedtoo Feb 2020
More than likely OP won't be able to update until after the appointment with the EC attorney.

OP has responded to comments, but until something happens (hospital follows through with threat to transport mom back via sheriff or she can make them see the light) there isn't much OP can say right now.
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See this for details:
https://www.elderlawanswers.com/how-medicare-beneficiaries-can-fight-a-hospital-discharge-12218

Did you get any paperwork from the hospital when mom was admitted or prior to this "discharge" notification? There is more detail in the link above, but it mentions them being *required* to give you a notice within 2 days of admission (An Important Message from Medicare about Your Rights (IM)). It would explain  discharge and appeal rights. It says it must be read, signed and dated. Did you get this paper and sign it? Hopefully as POA or rep, not as yourself or "responsible" party.

The link also says you should get another copy of this paperwork 2 days prior to discharge. It doesn't say anything about reading/signing the second copy, but do go to the link above. There is a place you can contact about appeal (indicates Medicare Quality Improvement Organization (QIO) and says the phone # should be on the IM.)

Read the rest of the link. If you didn't get the paperwork, I would contact Medicare ASAP and inquire about getting this appeal in the works! It might not buy a lot of time, but any time will give you more time to work out what needs to be done!

(I clicked on the QIO link in the web page above and selected NC - it shows these #s
North Carolina

KEPRO
888−317−0751 (toll-free);
813−280−8256 (local);
855−843−4776 (TTY);
833−868−4058 (toll-free fax)
www.keproqio.com
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To anyone else who joins in (currently about 92 answers), please NOTE the following if you are not going to read the other comments and replies:

1) OP's mom has advanced dementia
2) mom's been in the hospital for psych eval
3) mom's income ($1400) > Medicaid limit
4) mom's income way < MC facility ($4000)
5) mom has no house, no assets of any kind - no spend down or home sale
6) mom is dangerous to have in home with minor children (and adults!)
7) there is no Miller trust in NC
8) OP has appt with EC next week
9) OP did NOT dump mom at the ER or hospital
10) OP WANTS appropriate placement for mom

I've probably missed a few points, but the above covers most.

Rehab won't be an option, she isn't "recovering" from a treatable medical condition. Medicare is cracking down on ALL rehab, but this wouldn't qualify.

Mom can't afford LTC. Her income exceeds Medicaid limit in NC.
This is a place TOO many people are in (kind of like the donut-hole for Medicare drug coverage.) Income too high for Medicaid, not nearly enough for ANY kind of LTC care. SS is NOT going to cover the cost of LTC - it was only intended as a buffer for those with little or no retirement income. Not everyone has a great job with great benefits and ability to save large amounts of money to cover this kind of care. It's only going to get worse as more pensions go the way of the dodo bird (not everyone had one to begin with!) Sure, investments are great at the moment, as they were before 2008. We all know what happened then, eh?
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NeedHelpWithMom Feb 2020
Nice recap of info! Thanks, disgustedtoo.
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I can't seem to find the reason for hospital admission.
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Llamalover47 Feb 2020
Beatty: Good catch. There are 92 posts. Hmm - I'll try to look.
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IMHO, this would be a BOLD move by the hospital, though it could be legit. Could you get her physician to sign off on the fact that she needs additional care?
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You are right Needhelpwithmom!!! We have a very broken system in New York State. I don’t know if it is everywhere or not. But luckily i won’t be charged with anything because I don’t live with her and she doesn’t live with me, she’s competent in the eyes of the law, and I don’t have guardianship of her. I won’t ever get arrested. My elder lawyer once told me just because someone makes bad choices doesn’t mean they are incompetent. The law is on the elders side. My advice, don’t live with an elder!!!!
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NeedHelpWithMom Feb 2020
Elaine,

You got that right. You can’t let them drag you down. You just can’t.

The law absolutely protects their rights! It gets downright ridiculous!
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They can release her to a skilled nursing facility or rehab center and depending on what type of insurance she has, they will keep her at least 20 days. You need to get her qualified for Medicaid ASAP or use the money she has to get her into a facility and spend the money down on it until she is qualified. It takes forever - been through this and it is a mess, but do NOT sign anything as a "responsible party."
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disgustedtoo Feb 2020
Rehab isn't likely, she was in for psych eval.
Already queried Medicaid, income is over the limit.
She has no money to spend down (no assets at all, never had a house.)
Income $1400, MC $4000, shortfall $2600 (pull the funds out of someone's butt?)
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NO. they cant do that. well, at least not in new York. where I live. if you sign your mom out of the hospital you are than responsible for her and her bills. they can not force you to take her home and they cant force you to sign her paperwork either.
I would go to an elderly senior lawyer and see what your rights are.
don't let anyone force you into anything you wont or cant do. what they do is put them into a nursing home, rehab, or whatever they have room.
I took care of my dad 93, my mom also 93, both with major health issues for years. I also at the same time took care of my husband who has parkinsons, blood clots in his lungs, irregular heart beat, prostrate cancer( that's to name a few). my son was having marriage problems and I some how some way had to care for my two granddaughters also. . so if anyone knows what you are going thru its me. don't feel guilty for anything. you did what you did and for as long as you could. You don't have to explain anything to anyone either.
my father passed away in my arms, three weeks later my mom passed away also in my arms. I sent the grand kids packing since I knew that the parents were not going to live much longer and didn't want the them to witness it at such an early age.
I am still my husbands caregiver and that's ok.
it was hectic to say the least. I am still dealing with issues with my parents will, house lawsuit and four ex-sisters who refused to do a damn thing for mom or dad. didn't even go to the wake or funeral.
check your options first as you could be opening up a can of worms for yourself if you sign mom out of hospital....
good luck god bless
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NeedHelpWithMom Feb 2020
Wow, lizzy

You have been through the mill too! So sorry.
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Needhelpwithmom, thank you for defending me. I get so sick of justifying my actions to people who have no idea what is going on. Magnum pi you are more than welcome to come take care of my mother. You can have the house and the contents in it!!!
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NeedHelpWithMom Feb 2020
You’re welcome, Elaine. Yes, people don’t have a clue how hard it is if they haven’t walked in those shoes.
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Dementia itself is not a "justifiable" reason for hospitalization. The hospital will not get paid (by Medicare or insurance) for any non-justified hospitalization, so the patient will be released. It's a matter of money. Medicine has become largely controlled by business interest.
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disgustedtoo Feb 2020
She was in for psych eval
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Tiredmomma. What happened today? Did she come home? Or at least did they try to send her home. If not today, hospitals usually push to discharge on Friday afternoon. Hopefully there is an alternative placement for her.
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Not sure I understand. If she has Medicare and is not able to take care of herself and you can't take care of her at home, then she is entitled to 100 day of "rehab" care paid by Medicare IF her doctor orders it. After the 100 days are up, then you have a serious problem. If she has "too much money", then she's stuck with paying privately. After her funds are drawn down, then she can apply for Medicaid. But she still must meet Medicaid's rules, i.e., inability to perform ADLs, etc. Medicaid may only approve her for six months and then re-evaluate her at the end of that period - depends on the state. She is entitled to keep her home (if she owns one and $2000 in cash assets - that's it - no more. You probably need an attorney.
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Mysteryshopper Feb 2020
Just know that those 100 days of rehab care are not guaranteed.  Medicare can and will pull that coverage at any time ( with48 hrs notice or so?) for a multitude of reasons.  Or, sometimes Medicare only approves rehab for only a few days at a time and family never knows when it will stop.    Then, trouble starts again because you suddenly have an unwell person who needs ongoing care who is again being discharged from an institution that is supposed to help.    My hope would be that everyone gets their 100 days, but don't be counting on it.   Some get their 100 days and some don't. Always be looking at and thinking about what will happen if the 100 days doesn't happen.  Even if you get the full 100 days, the next plan needs to be in motion before that time is up.
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If she makes too much money, she can just be self pay. Call hosp back and talk with social worker to get help with placement. Call her doctor as well. Let both of them know you no longer have a home that is a safe place for her. Call the Ombudsman's office in your area to tell them what is going on.
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AT1234 Feb 2020
There is a huge gap between making too much to qualify for Medicaid and that amount being enough to pay for 24/7 care. Most people barely get by, this OP can not care for her safely at home. This is a much bigger problem than most of society knows, but as those of us baby boomer caregivers age it will become a complete tsunami.
I’d appeal and continue to appeal. Even after they assign a social worker, it still can be a cab. Do your homework.
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If She makes so much money why not hire senior care companions to sit with her at home and give you a break. As far as becoming dangerous her primary doctor should prescribe medication if neccassary,maybe she has a uti? Also i see hospitals usually TRY to talk family into putting in nursing home, Anyhow something doesnt add up. Thats teh prblem with these message boards, we only get one side and we only get limited information yet you want everyones advice.
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disgustedtoo Feb 2020
It was stated that she's in later stages of dementia. There aren't always medications that can or should be used and often don't work. I know there were some living in mom's MC who were "painting" the walls with poop. HIGHLY annoying, time consuming and gross, but benign. In OP's case, the mom has been threatening and dangerous - I wouldn't want that in my home and my kids are grown/on their own! OP has young child(ren) who have been threatened with harm. NO way would I want that woman back in my home, medication or not. Responsibility or not. Normal caring for kids or adults is fine, has challenges, etc, but with dementia, all bets are OFF!
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Joanne, my answers are default and already set for newest first. Aren’t everyone’s default setting newest first?
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cherokeegrrl54 Feb 2020
Mine are
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Yes Needhelpwithmom I did feel like screaming!!! I was very polite at the hospital and held back my anger until the woman called me from the hospital and said “Are you going to let your 95 year old mother get in a cab all alone?” Yeah, I saw red!!! I SCREAMED at her “ Are you going to let my 95 year old mother go home knowing it is an unsafe discharge AND failure for her to thrive home alone?!?!?!?!? Year, I went ballistic and was screaming!!!
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NeedHelpWithMom Feb 2020
I don’t blame you one bit, Elaine. I am polite too but enough is enough. She hit on your last nerve and pushed all of your buttons. How could you not lose it? I would have lost it!
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Bootsiesmom you are not exaggerating at all!!! The doctors and pharma companies are getting RICH off the elderly living to be 109, 101, 102, 103 and counting!!!!
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Bootsiesmom Feb 2020
Right? And in addition to making sure those folks enjoy their high salaries off the backs of the elderly, it's up to us to figure out who is going to take care of our loved ones and what that looks like.
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Needhelpwithmom, I really don’t know how those hospital workers sleep at night knowing what they do!!!
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NeedHelpWithMom Feb 2020
Nor do I! When will this insane nonsense end???
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Elaine,

It’s ridiculous. The hospital should be ashamed of themselves for sending your mom home alone in a cab. I don’t give a crap whether it’s legal or not. It’s an awful thing to do to your mom and you, her daughter!
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When I told the case manager it is easier for you to find a facility for her to go to than it is for me, she looked at me with 4 eyes and said to me “who told you that?” I said her primary care physician. She just changed the subject and said she was competent blah, blah, blah.
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NeedHelpWithMom Feb 2020
Grrrrrrrrr! Don’t you just want to scream, Elaine? I’d like to see how that woman would feel if she were in your shoes. I bet she would be the first to be screaming bloody murder, right?
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Rovana, you are right!! We are living too damn long!!! 95 is too friggin long!!!!
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