<p>And to answer your question, if you mother is on psychotropic drugs that could impact the admission to a skilled nursing facility. They are heavily scrutinized during inspection for the use of psychotropic drugs. Not that they aren’t allowed, just have to be thoroughly documented with mental illness diagnosis etc. Basically, the licensing agencies just want to make sure the medication is not used inappropriately (such as a “chemical restraint”) and often that other less invasive means have been tried first. Some SNF’s are reluctant to admit with these medications because they know they will be evaluated on this, and it can be difficult to meet the bar regarding documentation of “least restrictive” if it has been an long term med. And sometimes there is not good documentation in the medical record from the transferring hospital to support it.</p>
<p>CountingDown,Go to [U.S</a>. Department of Veterans Affairs](<a href=“http://www.va.gov%5DU.S”>http://www.va.gov) and put it in Aid and Attendance. You’ll find eligibility criteria, benefits,etc. There is alot of paperwork involved but it is worth it if it comes through. We are putting together an application now for my 90 year old MIL as she is the widow of a World War Two vet.</p>
<p>CountingDown, You can find more detailed info about Aid and Attendance at [url=<a href=“http://www.veteransaid.org%5DHome%5B/url”>http://www.veteransaid.org]Home[/url</a>]</p>
<p>CountingDown, The correct link actually should be [Veterans</a> Administration Aid & Attendance Benefit Program Information by VeteranAid.org](<a href=“http://www.veteranaid.org%5DVeterans”>http://www.veteranaid.org) . Click on A &A Program on the left. The needed forms are available online.</p>
<p>A good source of information about which facility to choose is your mother’s primary care physician. All of them visit patients in skilled nursing facilities and they would know the ones that provide the best care. Those places are also the ones that may not have vacancy. It’s never too early to check them out and put your mother on their “list”.</p>
<p>Not to contradict cbreeze, but there are many, many primary care physicians who never, ever set foot in an extended care facility. I knew of an MD who had a thriving practice picking up many patients whose own primary care MDs did not visit SNF’s. Some MD will continue to follow, but only if the patient (referred to as a resident once in an extended care facility) is able to have follow up visits in his/her office, necessitating either making transportation arrangements with a service or with family members taking the resident for the follow up care. </p>
<p>So I do recommend speaking to the primary care physician to see if they do rounds in extended care facilities or not, but know that while it is a requirement that residents be seen on a regular basis, that standard can be met either in the facility, in the office or with a new MD.</p>
<p>Montegut,</p>
<p>The Case Manager at the hospital should provide you with a listing of SNFs in the area and will be able to advise you as to who can care for your mother. You will want to ensure the SNF you choose has a nurse dedicated to care for Wound Care so your mother can heal and return ‘home’.</p>
<p>Due to your mother having Medicare while in the SNF receiving rehabilitative services (Medicare.gov) - as long as you continue to pay her rent at the ALF she will be able to return to her home like environment. I would suggest you definitely apply for Aid and Attendance (VA.gov) - your mother should qualify for something and she needs to be living in an ALF during the application process in order to be approved. The Social Services Department at the SNF should always be in communication with you in case mom has to transition into long term care so you are best prepared.</p>
<p>As for ‘payer mix’, depending on where your mother currently is - this may not be a challenge. For example, if your mother is in New Orleans currently, there are a lot of Medicaid certified beds. You may want to speak with ALF she is currently at to ask which SNFs they have worked with in the past and would have availability should she need long term care.</p>
<p>As far as her cognitive status - as long as your mother isn’t physically or verbally abusive, you shouldn’t have a challenge with placement.</p>
<p>I hope this helps. I do work in long term/rehabilitative care - so if you have any questions at all, please ask. I have learned so much within the past 9 years, I want to help everyone I can with all I’ve learned.</p>
<p>Hope all goes well and your mother has a speedy recovery.</p>
<p>I would start at VA.gov and search for aid & attendance. You will be able to find lawyers who are able to assist with this application process.</p>
<p>[Veterans</a> Pension](<a href=“404 - Page Not Found - Veterans Benefits Administration”>404 - Page Not Found - Veterans Benefits Administration)</p>
<p>Click on #7 question to find out more about Aid & Attendance ans how to apply.</p>
<p>If you contact your local VA office, they should be able to direct you regarding assistance with home aids or home health care. These items are always on a case by case basis - but go straight to the experts to find out, VA.</p>
<p>Hope this helps.</p>
<p>Is there an income chart somewhere? If a senior has SS and some sort of pension, too, would they qualify for A&A when they reach the needing assistance time of life?</p>
<p>Thanks for the links on A&A!</p>
<p>Coming up for air here a minute to update, guys.</p>
<p>Mom has moved from the hospital to a skilled nursing unit in a facility next to the hospital, owned by the hospital.</p>
<p>Medicare pays 100 percent for the first 20 days, then 80 percent for the following days up to 100 days.</p>
<p>We were dismayed to find out that her Blue Cross supplement does not cover the other 20 days, so we will have to pay around 150/day for days beyond day 20.</p>
<p>Also found that they do not do her laundry, which I know is a minor thing, but I was blindsided by this, as I only brought her a couple of dresses and had to get on a plane. I’m trying to contact her ALF to see if they can help me out with that.</p>
<p>I am starting the VA process and will be tracking down Dad’s marriage license and death certificate now that I’m back home, as well as trying to make phone calls and set up appointments for when I return to Houston.</p>
<p>Our goal is for Mom to get rehabbed quickly and go back to her ALF, let them know our intention to put her in a Medicaid bed ASAP, and get better educated for where she’ll go next time this happens. </p>
<p>Luckily, there are still some funds in the bank to cover any shortfalls, but those will be quickly, quickly depleted, and she will be left “homeless”. </p>
<p>I am looking into hiring an elder attorney to help me with applying for Medicaid and putting aside funds to cover costs not covered. I’m willing to pay for that service.</p>
<p>Putting aside money, Mom was able to go to a facility that is clean and has a great PT unit, and she is able to keep the doctor that took care of her in the hospital, who she really likes. </p>
<p>I am not so happy with the administration, as they are not the family atmosphere that we have at our ALF, but I guess that’s the reality of “medicine for money”. And despite their faults, I will move Hell or High Water to get Mom back to her ALF, where she feels at home. I just have to be prepared for when she requires SNF again, that I can find someplace where we not only feel comfortable with her medical care, but also a place we can trust and feel comfortable with on an emotional level.</p>
<p>Thank you for all your input. I can’t tell you how much you all have and are helping me.</p>
<p>Take care and God Bless.</p>
<p>I don’t have any advice to offer, but hugs to you and Mom, Montegut.</p>
<p>Best wishes for your mom’s speedy recovery!</p>
<p>I am so glad that you are able to work through all of this. If you have questions, also make use of the resources available within the facility (they should have a social worker that you could contact).</p>
<p>Take care of yourself! Wishing you all the best with this process too.</p>
<p>Re: Aid and Attendance Benefit from the VA… be aware that this can be a very long process. My Dad lives in an Assisted Living Facility in NY and we were first told about this benefit by the case manager at the facility. She put us in contact with a local veterans group (The Suffolk County Veterans Service Agency) that assisted us with completing the necessary forms. We basically brought them the information and they filed the forms for us… no charge. The gentleman was very knowledgeable since he fills out this paperwork all the time, but realistic. VA will kick back your paperwork if the smallest thing is missing or amiss and sometimes you don’t find out about it for months. Then you have to resubmit the application. A friend of mine filed the papework for her Dad and it took 18 months before he was finally approved and received a check. Good news is that it is retroacitive to the date they filed so he got 18 months of benefits at one time. The amount you receive is based on your income so obviously the less financially set you are, the more you receive. I think they told me the maximum benefit was about $1500-1600 per month. We were told it takes on an average between 3-9 months before you get a decision. We filed in November and received a letter shortly after filing saying they got the paperwork, and another notifcation the other day stating they were very backed up and still reviewing the paperwork and would let us know if they needed more documentation. Hopefully, we will get a decision soon. One very important thing to note: The form filled out by the physician attesting that the applicant needs aid and attendance is VERY CRUCIAL. It is imperative that this is filled out correctly to PROVE that the person needs assistance. The doctor at the assisted living filled out the form for us and the Veterans Service Agency made us take it back and get it filled out again because it was so vague and didn’t underscore the need for help. The case worker at the assisted living facility helped the physician fill it out the 2nd time, with more detail, and then the agency accepted it for submission. Hope this is helpful. Good luck.</p>
<p>Montegut – Peachy267’s advice is spot on from what I’ve heard. The veterans organizations can be hugely helpful even if your dad never belonged while he was alive. They can be a big help in helping you get the necessary paperwork proving his service if you don’t have his discharge papers. (And on the off-chance that your dad was ever a POW, for any amount of time, be sure they know about that. There is a group that helps POWs and their spouses, and the benefits are more significant and approved a lot faster – the paperwork is still quite picky, though.)</p>
<p>We just got discharge/separation papers for FIL by requesting them online so that we could move forward for Aid and Attendance for my widowed MIL. Did it online and had the info back within 10 days. [National</a> Archives and Records Administration](<a href=“http://www.archives.gov%5DNational”>http://www.archives.gov) eVetrecs for Veteran’s records.</p>
<p>Re: VA Benefits</p>
<p>While in Houston, I actually went to the VA office, way across town, bad part of city, to meet with a “case worker” face to face. The drive there and back and the meeting took most of the two business days I was in Houston, but I wanted to have a face to face with someone to do this. That’s the type of person I am. I have to look at a person across the table and have a rapport with them to get things done. The “case worker” is actually getting Dad’s discharge papers for me. I had talked to a local person a few years ago when I first heard about this benefit, and she looked up my Dad’s service times and actually got his Service Number for me, which was a huge help. She had also advised that the local VFW office may be able to help with this as well. I delayed the process because at the time, Mom’s assets were still more than the VA required, and I also was unsure what city to apply in, our hometown or her new city. </p>
<p>Putting this out there because if you feel that financially, you don’t qualify for VA, you can still get some tedious paperwork done beforehand.</p>
<p>Thanks again for all your support and keep us in your prayers.</p>
<p>Peachy, thank you so much for your post. I just handed the doctor form to mom’s ADL facility director before I hopped on the plane, so I will make sure to contact her to make sure it is filled out correctly. I am worried about this part because I don’t know what mom’s condition will be when she returns to her ADL, and it will perhaps be too “sunny” to get her the benefits she would need. Thank you also for the dollar amount info. I know she probably won’t get the maximum, but good to know not to expect any more than that amount. This will help us plan financially while we wait for Medicaid qualification to come through.</p>
<p>Montegut makes a good point about getting some of this out of the way now if there is a good chance a parent or in law will need A & A in the future. It is a good thing to locate things like separation papers, marriage certificate , death certificate, social security number before any of that is needed . That way you can order those kinds of things if they can’t be located and you will have all of this kind of thing ready to go when it comes time to make an application.</p>
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<p>Are you saying your 20% = $150/day</p>