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Is There Such A Facility??
CareGiverWife
Posted: Tuesday, July 27, 2021 3:41 PM
Joined: 9/19/2020
Posts: 110


My husband  will be needing intensive physical therapy but I have a double fold problem.

After therapy he will need a skilled nursing facility and I cannot find a place that take Alzheimer’s patients.   

I was told today by a professional Medicare that there is no such place.   Is there such a place?

Thanks for any info.


Beachfan
Posted: Tuesday, July 27, 2021 4:12 PM
Joined: 2/1/2018
Posts: 731


My mom was in a skilled nursing facility (NH), but did not have Dementia/Alz.  There was a secure wing in the building for Alz patients.  Alz and SNF residents could qualify for Medicaid (my mom eventually did), but I don’t think Medicare paid for SNF, only for rehab prior to her admittance to the SNF.  I hope this makes sense; we are in PA.
Crushed
Posted: Tuesday, July 27, 2021 4:26 PM
Joined: 2/2/2014
Posts: 6691


Was he in a hospital? 
Did he have a qualifying stay ?
Medicare may be telling you they won't pay for something but hat has nothing to do with whether the facility exists.

According to the Alzheimer's Association 2020 Alzheimer's Disease Facts and Figures report, 48% percent of nursing home residents are living with Alzheimer's or other dementias. Among older adults in residential facilities, including assisted living, 42% or more have some form of Alzheimer's or other dementias.May 11, 2020

for the rule on paying start at  
 

https://www.medicare.gov/coverage/skilled-nursing-facility-snf-care

   


  


Stuck in the middle
Posted: Tuesday, July 27, 2021 4:44 PM
Joined: 6/4/2017
Posts: 1367


My mother's NH had a locked ward with a number of patients that had no disorder other than mental as far as I could see.  So, such a facility does exist.  Will the hospital help you place him, since he can't come home?
Cynbar
Posted: Tuesday, July 27, 2021 5:02 PM
Joined: 2/29/2020
Posts: 785


Most nursing homes in our area have both long term patients and short term rehab patients, the latter are an important source of revenue for them. Some of those rehab patients don't do well enough to go home, and remain there long term with payment either private pay or Medicaid. Medicare pays for the short term rehab but not long term care, that's considered custodial. I'm not aware of any that refuse Alzheimers patients, in fact most have at least one locked unit. At any of those, your husband could go in for short term rehab (aggressive physical therapy) and stay in the facility when his rehab days run out. There are a couple of solely short term rehab places, but those are generally for younger patients with more rehab potential. I don't know where that person's information comes from, there are plenty of duel purpose facilities around. Just make sure you pick one that accepts Medicaid if that is in your DH's future plan.
Jo C.
Posted: Tuesday, July 27, 2021 7:46 PM
Joined: 12/9/2011
Posts: 11948


Hello; I am a little confused and wonder if you could provide a bit more information. Is your husband presently a patient in the acute hospital?

If so, has he been there for three 24 hour days which is the "qualifying period" along with medical necessity that is required to be able to be admitted on transfer into an inpatient Skilled Care Rehab under Medicare.  However, if you belong to an HMO Advantage Program, they often do not require the three 24 hour day qualifying period.

OR . . . . is your husband having outpatient rehab either at home or in an outpatient setting?

Who or where was the "professional Medicare" person you spoke with?  The information sounds a bit off. 

It may be that the wording is confusing things.  If your husband needs to be placed into care AFTER the rehab is complete, you are actually looking for long term custodial care which means one of two things - either Memory Care or Nursing Home care. Neither of these are considered "Skilled Care." or a skilled facility; they are Custodial Care and  custodial care is different.   In either of these type of long term custodial facilities, Alzheimer's patients are very much accepted. 

NOTE:  There are facilities that have beds for Skilled Care Rehab as well as long term custodial care.  In these facilities; if one is going to have Skilled Care Rehab for a short period of time under Medicare; one will need to fulfill those qualifying days to gain access; but NOT if one is going directly to long term custodial care.

I see you are in Florida; according to other Members, there is more difficulty accessing long term custodial care facilities in that state; but we need more information to be able to try and help.

There are indeed such  places.  Memory Care is most often private pay.  However; you can check and see if there are any Memory Care facilities in your area that accepts Medicaid if that is what will be needed.  There are two different types of Nursing Homes regarding payment; some NHs will accept only private pay; other NHs will accept Medicaid, so you will want to ask about that if it is important to you.

Why not try contacting the Alzheimer's Assn. Helpline at (800) 272-3900.  If you call, ask to speak to a Care Consultant.  There are no fees for this service.  Consultants are highly educated Social Workers who specialize in dementia and family dynamics; they are very supportive, have much information and can often assist us with our problem solving.  They may even be able to get you to an office in your area in Florida to assist you; sometimes they even may possibly have names of such facilities.

 Let us know a bit more, we would like to be helpful..

J.


M1
Posted: Tuesday, July 27, 2021 9:54 PM
Joined: 8/22/2020
Posts: 1496


CGW, I'm glad to know he's better to the point of considering rehab. It's the hospital's responsibility to identify the next level of care and to identify the facilities that will take him. Let their discharge planners worry about it, you shouldn't be having to do this.
harshedbuzz
Posted: Wednesday, July 28, 2021 8:22 AM
Joined: 3/6/2017
Posts: 2963


What M1 said. Let the discharge planner sort this out.

That said, be aware that if he can't/won't participate in his rehab or stops making progress towards goals, he will be discharged. 

Here, most SNF also have rehab available, so he wouldn't have to be moved. In PA Medicaid doesn't pay for MCF, so those who a Medicaid bed are in SNFs.
Jo C.
Posted: Wednesday, July 28, 2021 2:09 PM
Joined: 12/9/2011
Posts: 11948


I just smacked myself on the head!  I suddenly recalled your husband has been in ICU for a blood clot; that had somehow slipped my mind.

The person who coordinates discharges may be called a, Discharge Planner or a Case Manager.  If you have not seen one of these, you can ask for an RN on your husband's care unit to have one contact you.

If that has happened and this is the "Medicare expert" you spoke with, did she/he tell you just why there is no place to send him?

Sometimes Skilled Care Rehab is used for healing complicated wounds, etc.; other times it is for actual physical rehab.   For physical rehab, the person must be able to understand and follow directions. 

It is important to know that Medicare law was changed; in that a person does not need to be able to recover increased function although that is a goal; skilled care rehab can be used to assist so that a person does not lose the usual present level of function after a hospitalization. There is still the need to be able to understand and follow directions for P.T.

If the admission is for complex wound care or IV meds, or other care requiring a licensed nurse, that is usually accepted.

It really is a bit confusing at first; and M1 and Harshed Buzz are correct; let the person who coordinates discharges on your husband's care unit assist in helping find a place to discharge to.  If this is the person who told you there is no place, then ask to speak to them again and ask them to detail just why there is no placement available.  You should not have just been left hanging.

If your concern is not about Skilled Care Rehab, but is for Long Term Custodial Care for after rehab, either in Memory Care or a Nursing Home setting, those facilities do take Alzheimer's patients.

Let us know how things are going, we will be thinking of you.

J.


CareGiverWife
Posted: Wednesday, July 28, 2021 7:41 PM
Joined: 9/19/2020
Posts: 110


Good news, my husband is out of ICU!   Next step physical therapy.   Thanks to all who posted.
Jo C.
Posted: Wednesday, July 28, 2021 8:53 PM
Joined: 12/9/2011
Posts: 11948


That is great news!  I am sending warmest thoughts and best wishes your way.

J.


 
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