My mother lives in a wonderful AL but will run out of money in a few months. Nursing homes have over a yearlong waiting list. What can we do?

Does the AL accept Medicaid? Start the application process now. Medicaid was the only option for my father.

Very true, it is heartbreaking and stressful, but the moment you decide to trust someone else with their care like I did with my grandmother, with a nursing home, that is when you should decide what you are going to do with their body when you see it, cremate them or have them buried. I made that mistake with my grandmother. She had been hospitalized for a couple of days at a hospital for , The New York Hospital in New York City, for dehydration, and like with everyone else they refered her to a nursing home for rehab , or physical therapy, because she was simply complaining of pain in the knees. The moment she was transfered into the Hebrew Home nursing home, in Riverdale, New York that is when her health began to deteriorate.

It hurts when you lose a family member. It is painful, but it hurts even more when someone else causes the death intentionally for one reason or another. Age should not be a reason to deny someone the right to live or at least the right to have medical attention. In this country supposedly discriminating against someone because of their age is illegal, yet some places like nursing homes " feed on these innocent and weak seniors " defrauding insurance companies and yet they are able to get away with it. No one seems to be able to do anything about it. Some of the seniors die like animals and their story never gets told because the system makes it difficult in this country to even complain. Nursing homes rely on this to continue their " work " , without fear of any repercussions for their criminal acts hurting families, and killing our parents and grandparents " in silence ". My grandmother was literally killed by neglect and denied medical attention just because she could not defend herself at a nursing home in the Bronx, New York. She was in a wheelchair and had been admitted for physical therapy. From day one they were being very careless about her needs. I had to clean her because they did not want to do anything. From day one the nurse was calling me to bring blankets because she said there was a " draft " coming from the window. I brought the blankets, but complained that they should do something about it. They did not. I tried to bring in an electric heater and they did not let me. Grandmom was always thirsty which meant that they were not even giving her water. I had to bring fluids to give her. At the same time I had my mother in the same place due to pains from a hip fracture that she was trying to recover from. They were both in there for physical therapy. They kept them separately and they were telling my mother that if she tried to leave they would have her arrested. Several times I saw my grandmother in the lunchroom by herself trying to eat while the staff was standing nearby looking the other way. Everytime I would bring my mother to see my grandmother the " staff " would look the other way and start walking away from us. On the record they wrote that they were keeping the family " informed ". We saw grandmom with bruises on her forehead. I grew suspicious and when I tried to inquire from the " staff " they tried to make it look insignificant. Suddenly we lost grandmom and on the records we read that their own radiologist had done X rays and recommended follow up care for her which they did not do. Had they told me I would have taken her to the closest hospital for medical attention which they obviously denied her. Someone who writes for the New york Times did their own investigation and found out that this Hebrew Home nursing home, Riverdale, Bronx, New York had 27 wrongful death complaints in the Bronx courts. The District Attorney of New York has not done anything about it. He recently resigned after complaints from women that he had mistreated them. He did not follow up on my complaint and the nursing home continues to do business as if nothing has happened.

If your mother or her spouse was in the military check out the veterans aid and attendance benefit. It can be used to help pay for Assisted Living facilities.

Depending on where you live, I would research the homes and ask questions. I take care of my mom and when I got sick I had to put her in a in home for dementia. It was a real home and not a nursing home. She loved it there. BUT it was expensive. if she had qualified for Medicare she would of stayed there. It was close to me and I could see her anytime I wanted. They took excellent care of her and she was never alone and she looked happy. I never called before hand, I just showed up. See if your state has Care homes. They are limited of how may they can have in the home(depending on size of the house). Make sure it is one you can just drop in and go visit it first and talk to the residents and ask for referrals etc.

Lynn2019, I agree with you totally. A lot off Medicaid nursing home issues would be solved by people taking more responsilibility for their finances. Medicaid was not designed to be the nursing home solution for everyone. It was supposed to be for the truly poor.

I took care of my grandmother who was killed literally at a nursing home. I am now taking care of my mom who of course is younger, but is needing attention and because I love her as much I loved my grandmother whom I had under my care for over 35 years I would do anything for her also. Everyone is talking nowadays about nursing homes, hospices, independent care, home care, etc. It is such a fraud. People should stop. When my grandmother went into the nursing home in the northeast she was quickly put in a room by herself with no heat. I of course visited her everyday and the only thing she was there for was to get physical therapy which she did not get because I always found her sitting by herself in a wheelchair alone, unattended, with feces and urine in her seat. I had to clean her all the time because those animals who claim they care for the sick only care to defraud insurance companies leaving the innocent residents by themselves. My grandmother was ignored and when I went there the " staff " would always look the other way and walk away. They wrote in the record that they were keeping the family informed. This was not true because their own radiologist did a chest X ray because of a cough that she was developing ( You would wonder why right? so clear ) and he found pneumonia in her lungs. The records say that he recommended follow up care, but they did not listen. I also found her with bruises on her face which the " staff " never cared to explain. They had security at the gate and I think that is why they felt so confident that they could do whatever they want. They are still open for business as if nothing happened. An investigation was made into this nursing home by a journalist who works for the new york Times and he found out that they had 26 wrongful death complaints in the Bronx, New York courts, but it does not seem to bother them. So, whenever someone talks about a nursing home please stop it. If you put your parents in a nursing home I think you should be ready for the bad news fast. In the case of my grandmother she went in fine with " excellent " blood work and a good prognosis by her doctor at the hospital. The only thing she was complaining about was pain in the knees and that is why the hospital recommended ( all hospitals like to recommend nursing homes ) physical therapy. It was the biggest mistake I ever made in my life, so if you want the same thing to happen to your parents then go ahead leave them at a nursing home, but you better get ready with money for either cremating them or burying them in a cemetery and there is nothing you can do about it because these criminals protect themselves and they get away with it. The system protects them. They know how to work the sytem. Dont give them business because all they care about is money and if you trust them with your parents or grandparents they will be doomed. So if you love your parents dont do like I did, I trusted the hospital and the nursing home. Dont trust those insensitive animals because you will be alone with the pain of having lost them like I am. Do whatever you can at home with them if you want to keep your parents/grandparents get friends to help you make time for yourself like I did, but the moment you trust them with someone else you will lose, and especially if they cannot move. They will either put a pillow on their face ( this has been on the news, just google it ), over medicate them ( also on the news ), inject them with chemicals to stop their heart ( has also been on the news, no kidding. This has led to arrests ), etc. Those killers in nursing homes should be prosecuted, but the state protects them. The fact is no one cares about your parents/grandparents. The moment you trust someone else with them that marks the end of their existence.

There is a comment down below here made by someone " AtWitsEnd2018 ". It does make sense and it would help in case you dont have any money, but if you have the space in your house and no family.

Do you live in a rural area? A year wait sounds almost unbelievable for urban or suburban areas. Call the SNFs yourself.

Also, how much money exactly does mom have left? Is it enough to move her right now to a SNF and private pay for a period of time? Then, the SNF would receive the financial benefit of her spend down (not the AL that's discharging her). SNFs are used to this situation, and some have spelled out the term that a resident has to be on private pay before they can stay with 'Medicaid Pending'. Of course, all this varies state-to-state because of the wacky way that Medicaid is funded (and it's about to get worse).

And, as you've noted, the quickest way to get to the head of the line and get to 'Medicaid Pending' status, is a hospitalization. Make sure, if the AL does send your mom out to the ER for an acute incident, that you are on top of it. Do not let the hospital put your mom in observation. It can be just a status, not a specific place. It may seem like she's been admitted because she gets a room, but they may not have her status as 'admitted'. Push back. She needs to be admitted or her time in the hospital doesn't 'count'.

Check with an elder law attorney and also her town's elder case worker plus social worker on staff. This is a dilemma, but file for Medicaid now.

Im curious. If you are running out of money on AL..how does one pay for Nursing Home? I have looked into this, for my father.for 'what if' situation, and I was going to have to put him into a Veteran's Nursing Home. What type of nursing home are you looking for? Medicaid covered? Nursing homes are much more expensive than AL

Sorry to hear your situation has deteriorated to this degree. I agree with you that you should have anticipated this but that’s water under the bridge now. The ALF should have advised you from your initial tour of their community what to expect and how to plan moving forward with her Financial and medical needs. At point of move in, this discussion should have expanded, with detailed information regarding your ability to pay and for how long clearly understood by all parties. Communication or the lack there of is what creates “crisis” moments like these, not the system. We need to work with what is currently set in place versus cursing an already overburdened system.

Contacting your local agencies on Aging is very important right now. If there is a discharge imminent from the ALF, reach out to your Ombudsman, Adult Protective Services etc. They can not carry out an unsafe discharge that puts the resident in harms way. This will prompt the ALF to go further to assist you and your needs.

Is the ALF your Mom is currently residing in a Medicaid approved community, after a private pay spend down? Do they have a sister community or a SNF that can assist. Press them, as there is nothing to lose. They are culpable in this situation. You should have foreseen this but they did not due their due diligence in assessing your ability to pay from the start.
Many SNF/ Skilled Nursing Facilities will take direct Medicaid or admittance after a spend down of 3-6 months private pay. The year wait seems excessive; is this a year for private pay or waitlist? If it’s a waitlist, then you need to call weekly to each SNF, since people on the list move into another facility, remain at home or pass away while waiting. It is only a guesstimate on their part and very fluid.

Going to the hospital is only a very short term fix. Getting a 3 midnight admission into the hospital to qualify for a Medicare event is not a given. Also, if admitted and discharged to a SNF; likelihood only a small fraction of the 100 days granted by Medicare is to be given. Medicare does not keep paying if certain medical metrics are not met.

Is there an a life insurance policy in place that has a value of $100k. The value in the policy has the potential to offset care costs. Companies will give a percentage of the policies payout value for needs like these. Something to explore.

Finding a live in might be your immediate answer. Look to your local churches and charitable organizations for potential candidates.

Good luck. Gods speed.

My mom lives in assisted living also. They have a benevolent fund for when her money runs out. Maybe you could ask about this. Her money is also about to run out soon, too. Good luck to you.

Take her to hospital...tell them you are no longer capable of caring for her...your health is suffering because of it. Tell them you want her evaluated for physical therapy & / or you believe she has UTI. Speak to Social Worker & let them work on a SNF placement. They’ll find something to keep her there 3 days. Either that or get At home Nurse Assessment & you’ll probably have to pay about $100. With that paper, take it to SNF admissions. Her primary dr can order Nurse Assessment. Hugs 🤗

Check with the Social Worker or Director where your Mom is now and see if they have Medicaid beds.
It is possible since she has been "private pay" they would keep her as a resident.
If not the Social Worker or Director may have insight as to where your Mom could move.
Often a call from the Social Worker or Director at one facility can open a spot sooner than if you were to contact them on your own.

Does she have any condition that could qualify her for home hospice care. They are quite helpful and resourceful in helping caregivers.

Check with state Medicaid. Home care help/live in or visiting care in the state of CO is paid for by Medicaid... unsure what they may offer in your state. You may also look into an assisted living facility with a daily care giver coming in, or maybe there is one on site... Medicaid pays for this here also.
State social services or county free client, or the local hospital patient advocate might also know of something. Approach it from the other end, check with home health care providers in area... they might have the answer as well. Also talk with the local colleges department head professor that runs the college program for the nurses/medical students that may be willing to exchange services for a place to stay while still in school. There are alot of homeless college students that need somewhere to stay...maybe one could be trained in the needed skills and exchange their help for room & board... just some thoughts. Take care & may God Bless and protect you & you family. He can & does provide miracles! Good luck.

I faced a similar situation. In addition to the other comments and suggestions, I've read something about a gap loan that may be used to cover the costs of care until you can get into a NH. Best wishes to your and your loved one.

Each state has a department of aging. you should call yours and see if they have any suggestions.

Your situation is heartbreaking, for you & your parent. It demonstrates the astounding lack of humanitarian resources in our so-called advanced nation. Make your circumstances known to as many potential resource options as you can. Advertise & inquire. What is your own housing? Can you possibly offer a live-in situation: offer room & perhaps some board to a person willing/able to help in exchange? I feel sorrow, as well as anger, for the terrible circumstances you have to navigate. I’m sorry we don’t do better as a nation - best of luck: I pray you find a solution.

I think you might be ahead to ask a social worker at any of the NH's about your options. They might be able to suggest something not thought of yet. Hope this helps.

if she is hospitalized for three days (a doctor can diagnose her with failure to thrive or whatever) she can enter into inpatient rehab (nursing home) for 100 days which Medicare pays for. https://www.summitmedicalgroup.com/library/adult_health/sha_medicare_coverage_for_physical_rehabilitation/

My parents were in an assisted living that also had to meet a town set quota for accepting low income residents. They both passed before running out of money, but I had done all the paperwork for them to be on the list in case they outlived their savings. The social worker at a rehab that they both went to after falling had helped me find the assisted living, which was one of the nicest in our area.

I agree with expanding your demographic area. Maybe it will be a 2-3 hour drive for you but could be better for mom. I live in central Mississippi and we have a lot of choices. My mom was in an excellent AL. We paid extra for nursing care and assistance with bathing for a total of $2900/mo. (She was not on Medicaid.) She was very happy there.

Considering all the lawsuits against nursing homes especially over falls, I am surprised any can stay opened at all. there is a nursing home somewhere..but it won't be local. If the NH is too far, it is not good for the person. You see, someone must visit very frequently, preferably daily and do a skin inspection. If the NH staff knows they are not being watched they will do less care and that's when the bed sores and other things happen.

I've been taking care of my mom with end-stage Alzheimer's for YEARS and it has taken enormous emotional, psychological, financial and physical toll on me. it's very hard and VERY stressful that I do not recommend this route for anybody. However, I love my mom dearly so I put up with anything she can dish out, and I care less about my own life and health and willing to sacrifice whatever it takes to keep her comfortable and going. Because when they are gone you will never see them again. I often get nightmares about this. I dream of my mom dying or turning into a skeleton in front of me and I wake up screaming.

I tell people put them in a nursing home if you can. Otherwise you will end up like me and every waking second is attending to a very old, confused, weak and sometimes combative person..and every second constantly on guard for her safety. It's very hard. It's a very heartbreaking..and backbreaking..experience.

Cast a wider net. Even a placement farther away sounds like a better solution than holding out for a closer placement that may not happen in time, anytime soon or not at all.

After a long and tedious search a friend of mine found a religious group that ran a little nursing home. There were only two dozen residents or so. They accepted Medicaid. The place was simple, clean, and the staff was friendly. She placed her older sister with them after the money from the sale of her sister's home was spent and she could no longer afford the "nice nursing home".

You have done a lot already. How sad and scary that the NH situation has come to this. We've had several closed, sold, or changing to AL in our area. Have you tried a Care Advisor? I tried prayer.  Big (((Hugs))).

Thank you everyone. The NH applications have been in a while and for places within reasonable visiting distance for us. Luckily that includes quite a number of NHs. We have consulted with AL and our state's Medicaid as well as a Medicaid consultant. Unfortunately Medicaid is very limited for the elderly in our state. There are only two ALs in our state that take Medicaid and their waiting lists are longer than the NHs.

In my state Medicaid will pay for an AL if the resident has private paid at least 2 yrs and the AL has not met their quote for Medicaid. Talk to the ALs administrator.

Your state Medicaid program may cover the cost of assisted living, have you look in to that? Some state Medicaid programs won’t pay for room & board but will pay for other associated costs.

Have you consulted with an eldercare attorney?

Get her on every waiting list you can. Visit homes AFTER she's on the list.

Make sure you are casting a wide geographic range.