What do I do if Mom’s been in Rehab too Long and Medicaid Won’t Pay to Keep Her Apartment?
21 days, 12 days, 42 days⊠zero days. These are just some of the states and how long theyâll hold your mom or dadâs apartment while theyâre in the hospital on vacation or a skilled nursing facility. Today weâre talking about the Medicaid Bed hold.
This exact situation just happened to a client of ours at Clear Path. Her mom had spent her money down to Medicaid at an assisted living facility in Washington state. Then her 85 year old mom got sick and ended up in the hospital. After that, she continued her recovery in skilled nursing. Then, the daughter, weâll call her Sarah, gets a phone call from the community telling her that if her mom didnât return to the community by 20 daysâŠwhich was only a few days away⊠that she would lose her apartment of two years.
So today weâre going to talk about this rule and the options you might have. Now keep in mind that every state is different and Iâll put a link in the notes that lists the Medicaid bed hold policy state by state.
By the time Sarah got to us her head was spinning.She had no idea what she was going to do. Her mom hadnât even been at the skilled nursing facility for a week and she was pretty sure she wouldnât be making it back by the 20 days. At this point, she wasnât sure her mom would even be a good fit for her assisted living any longer. She had gotten pretty weak from her hospital stay.
Sarah felt backed into a corner. Not only was she facing having to clear out her momâs apartment in a few days but the skilled nursing home was talking about putting her mom in hospice all while her mom was saying over and overâŠI can get strongerâŠIâll get stronger. The situation seemed impossible.
SoâŠwhat if this happens to you? What options did Sarah have? Well, there are many variables.
First, Medicaid allows families to pay the bill in these situations. The assisted living is only allowed to charge what Medicaid was paying so youâll need to find out what that amount is. You can find out through the community or the Medicaid case manager. This is a way to hold the apartment until your loved one is discharged home or a way to buy yourself some time while you make other arrangements. The other option is giving up the apartmentâŠmoving everything out then when momâs ready to discharge and if the community has an available apartmentâŠmove everything back in. I knowâŠthat sounds terrible!
Sarah was also facing the question of if her mom was even going to be a good fit with her increased physical weakness and she did not think her mom was ready for hospice. On a side noteâŠif you think your loved one isnât ready, remember hospice is a choice⊠It can be an amazing choice if itâs time. But it is a choice.
However, the decision of if someone is able to return to a community is the communityâs decision. Their nurse will go to the skilled nursing facility and complete an updated assessment. They may request that Medicaid increase the daily rate if care needs have increased. But this assessment is typically not done until near the end of a skilled nursing stay. In Sarahâs case, her mom had just arrived. Typically, a stay is one to two weeks or longer so Sarah was faced with the decision of whether or not to pay to keep her momâs apartment without knowing if the community would even take her back.
Ok, so what if Sarahâs mom loved her assisted living and they say her care needs are too high? Well, there may be the option of in-home care and continued at-home physical therapy. Medicaid may cover a very small amount so beyond that there will be an extra cost, but it could be an option to keep your loved one where they want to be.
The other option in the state of Washington would be to look for another living situation such as an adult family home or assisted living that can provide higher care.
But what if your family doesnât have the extra money to pay to keep the apartment or to pay the spend down to Medicaid at a new place or to pay extra for a private room? Unfortunately, many families are in this situation. And unfortunately it means possibly moving everything out of your loved oneâs current bed hold expiring apartment and hopefully back into another apartment at the same community. If after doing another assessment, the community says your loved one canât return? Hopefully, your mom or dad is at a Medicaid skilled nursing facility. These facilities take Medicaid and must do a safe discharge hopefully giving you time to find another living situation. Many of these facilities also offer long term care and in some states this IS the only option for a Medicaid resident.
Sarah left our meeting feeling so much better. She said if we were in person she wouldâve hugged me. She felt more in control and armed with choices.
Do you need help with your specific situation? if youâre saying yes then youâll find our contact information in show notes. Our consultation services are very affordable. Hopefully even this episode helps make your journey a little more doable.
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