Follow
Share

The ombudsman is helping me appeal, but never showed me a notice from medicaid saying that they are stopping payment. I think this sounds fishy. I should have received this notice to me in the mail, not the ombudsman and so far I have not. What am I to think about this?
One of the directors has been rude to me and did not apologize. Another staff member called me ugly. Another staff member said he would help me to move to another room, but did not.
The social worker did not help me look for other places to live. This nursing home is very awkward. It is as if it exists just to give money to the owners and upper management. It doesn't hire enough staff for the weekends. It does as little as possible for the residents.
May 4th is when I received notice from the nursing home that I was being discharged. Nothing has happened since then. The social worker did send one realtor over to speak to me. She had a one bedroom for around $1000 a month for rent. My social security is only $918 a month. Wouldn't she know this?
Besides that, I am in worse health now than when I first moved in. The ombudsman says when I go to a hearing to speak on the phone with the appeals officer, the questions won't be about my body. Why on the phone? Don't they want to see the condition my body is in to find out whether I AM in better health? No they don't. The ombudsman said she saw a lady that could not move at all be discharged because she did not have dementia. She lost her appeal. I wonder if this is the truth. Of course not. There are many people in this nursing home not being discharged and they are walking around not a wound to be seen. Many here have dementia, but some do not. I am in a room with a person without dementia. She has a broken arm. Most of her intestine is missing, etc. She is not being discharged.
This ombudsman says I will probably fail the appeal. I feel like a sham is going on here. Doesn't make sense to have a medical hearing on a phone. I think this ombudsman is lying.
Now I have to call medicaid to see about the Star+Plus plan. Supposedly they will take someone that is nursing home eligible already and then help them into an assisted living place.

This question has been closed for answers. Ask a New Question.
Find Care & Housing
Need more info.

Are you the one who is "...69 years old, living in a nursing home with diabetes, mobility problems, and osteoporosis."

In most states Medicaid will only cover those who financially qualify and are assessed to need long term care. Have you been assessed to need LTC? LTC is mostly for people with profound physical problems who cannot do their ADLs on their own at all. Many facilities do not accept Medicaid recipients.

Regarding your mail, this is a problem only you can fix. Do you get any mail at all? If so and you're not getting the mail from Medicaid, not sure what to say about this since mail delivery isn't selective. I would call a social worker directly to get a copy of the letter. I'm sorry you're having these problems. I wish you all the best in getting answers and a solution.
Helpful Answer (1)
Report

You need a full medical report from a physician. It sounds like they feel you are able to live on your own. If you are able to live on your own, Medicaid is not going to allow you to take up a bed that could be occupied by someone else who needs it. I would also contact a state social worker (APS) to see if they can help. The SW at the NH is not really there to help you, she is primarily concerned with protecting the facility's interests. Also, if you can live on your own, you will need a subsidized apartment where you pay a fraction of your income on rent. I don't know, it sounds like a tough situation for you, I think you are going to have to fight them and somehow convince them that your life might be in danger if they kick you out. You may also want to contact legal aid to see if they can help, and possibly the local news. If they kicked you out to a shelter it wouldn't be very good publicity for the facility. Just some suggestions, I hope it works out for you.
Helpful Answer (1)
Report

PureEnergy, are you the daughter writing this in 3rd party? Third party is very confusing for us. So, I am going to assume that the daughter wrote this.

Why is Mom in a nursing home under Medicaid? The illnesses you listed do not require a Long-term facility. Was Mom in the Hospital and sent to Rehab? Medicare pays for Rehab, the first 20 days 100%, 80 to 100-50%. The other 50% is paid by the patient if their supplemental does not cover it. If the patient can't afford it, then I guess Medicaid can be applied for? (I have never had to do this for Rehab purposes) I do know that after 100 days Medicare stops paying. If its felt the person needs to stay after 100 days they pay privately or apply for Long-term Medicaid. If Medicaid excepts them then Social Security and any pension the person receives is required to offset cost of the persons care.

Do you maybe have Medicare mixed up with Medicaid? With Medicare you personally do not get a letter you r being discharged. They just tell the Rehab they feel the person has progressed as far as they can and needs to be discharged.

Now if Mom has no home to go to and as the daughter you cannot care for her, you can claim "unsafe" discharge. But then, Mom will be paying privately or applying for Long-term Medicaid to stay there. If its felt she is not 24/7 care you will need to find another solution.
Helpful Answer (0)
Report

This question has been closed for answers. Ask a New Question.
Ask a Question
Subscribe to
Our Newsletter