I’m going to visit a couple of SNF/rehab facilities tomorrow. What questions should I ask?
I am familiar with the one I’m visiting first - they are very good and treated one of mom’s friends so wonderfully well she was out of there very quick.
The hospital hasn’t said when they plan to release mom, but tomorrow will be her third day - so she qualifies for the SNF, and I met her physical therapist today who told her, ‘if you’re alone at home, and you’re not comfortable with your level of strength I will recommend rehab for you.”
She agreed.
This emotional rollercoaster is also getting to me. I told her today that going straight home again is off the table. I will not be available for care. I’ll take care of the property and the bills and make sure everything’s paid on time and what not, but the commode changing days are over. Especially when I’m usually immediately ill after doing that.
I’m just not cut out for that part. And I’m depressed too. THAT needs to be addressed for me immediately. I’m not going down this road.
Thanks for listening.
Keep us up to date here, yes?
Also, the places that I dealt with had seen similar situations lots of times, they were able to help guide me. One thing that really worried me, is what would the facility do, if my LO demanded to go home and there was no one at her home. I'd get that cleared up.
Rehab is a time limited window of care and also an opportunity for you as her dpoa and primary caregiver and perhaps other family to take a reality check on what you mom’s care needs truly are. Rehab post hospitalization is a MediCARE benefit paid almost always at 100% for first 20/21 days assuming she is “progressing”; and if still “progressing” can continue up to 100 days but at 80/20 coverage. The 20% is mom’s copay and either it’s coming from a better MediCARE gap or advantage plan or she has free standing secondary insurance (like Blue Cross) or she private pays the 20%. It’s a fixed rate, I think like $185 day if private pay.
If mom returning back home is just not feasible, then you really really really need to use her in rehab time to gather up her financials to see where she is in ability to self pay for LTC (& for how long) or if it’s a smaller amount of assets she needs to do a legit spend down asap to be able to apply for LTC Medicaid. If she has assets, she’s going to just need to cash out and self pay. At this point in time, once they are in the hospital on their way to rehab, there imo is no creative financial planning to be done. That ship has long ago sailed.
Clearly speak with admissions and social worker as to if this place
- is both rehab and LTC
- has LTC Medicaid beds
- if they allow mom to remain there and transition from MediCARE paid rehab to LTC as a Medicaid Pending resident.
- if they do not do Medicaid Pending, clearly ask what the terms & contract read for her to stay there as private pay.
If you should find yourself wavering on her becoming a permanent resident of the NH, please realize that if you take her home and she lives at home for a few weeks or months that her being medically “at need” for skilled nursing care may not be no longer indicated in her medical chart. Right now she has a fat chart from the hospital along with discharge orders, daily rehab & nursing notes, strict medication management notes. All of which show “need”. Once back at home, that doesn’t happen, so getting her into a NH from living at home may be difficult to show her to be “at need” for skilled nursing care in a facility.
So, you are looking for at the SNF for rehab, right? And as a possible long term placement? So two sets of questions.
Rehab:
How often will mom get therapy? What will you do if she says "no not now"? (Will they encourage her, notify you, call in the SW to counsel her?"
How often do they shower their patients? Is this in line with what your mom is used to?
What is the daily routine? Will they respect mom's desire to rise earlier/go to bed later? (these are questions that you ask for BOTH rehab and SNF part; there may be different answers).
How much notice will you give us if mom no longer qualifies for rehab?
What is the process if we want to transition mom to LTC at this facility?
SNF:
What activities are available?
How is socialization encouraged? Is there an activities director?
Can we get a cognitive/mental health assessment?
What medical professionals are available at all times? Who comes in once a week or so.
Is dentist/audiology/podiatry/optometry/wound care/mental/behavioral health available on site? How do those get scheduled?
If mom has an offsite appointment, is there transportation available? Or can facility arrange a private pay ambulette? Will they provide an aide to accompany?
Are there religious services?
Thank you as always for this - I came home and sat down on the couch on Saturday and the next thing I knew it was 5 hours later and I was waking up to a gourmet meal cooked by Mr. Hotflash. I slept through THE. WHOLE. THING.
I visited the SNF that mom wants to go to, and just found out she will be accepted. This was the same place that we tried to get her in the first time but she was not Medicare eligible. They already know all about her, her care needs, and her home situation. Believe me I intend to stay on her care as she is there, and she will be seen by mental health, audiology, all of it. This place has it all there, and the residents I passed by today all seemed very happy, and I don’t know if I hit it at the right time but there was quite the laughing going on in the dining room when I went in.
Mom has a secondary insurance after Medicare thanks to my dad’s 30 years in the Army, so she is covered for all the things. Her recovery and come back is all up to her, I am just grateful that the wheels are in motion.
Mom has told me she 100% intends to work hard to get back home and get back to her life, this was not the way she wanted anything to go and fully realized and admitted to me how hard she knows it was on me. “You come home when you’re well,” I said.
I am glad I have this group.