Aug 20, 2015 - 01:34 PM
The prior responder did justice and I will just add several additional points:
Medicare is typically synonymous with short term rehab only. This is because Medicare is finite in terms of how it is allocated to skilled nursing and rehab facilities for use in care and post-acute rehabilitation. Medicare will cover up to 100 days for in-patient therapy subsequent to a 3 night hospital admission.
However, rather than writing the facility a blank check, they make the reimbursement subject to certain goals and objectives which must be met. Loosely defined, the goal is for the patient to achieve "prior level of functioning."
However, inevitably, most patients will not go the distance utilizing all 100 days on one in-patient rehab stay. This is because they will either achieve their prior functioning level in advance, or they will demonstrate an inability to achieve it.
However, the salient point is that Medicare is NOT a long term payor source for long term skilled nursing placement.
The aforementioned rules apply, and can be applied - irrespective of what state your Mom is in once she achieves a qualifying stay under Medicare.
Conversely, Medicaid is an excellent long term payor source for skilled nursing care, for those who qualify.
In order to qualify for Medicaid in all states, the recipient must meet clinical criteria with respect to their ADL's (help with Activities of Daily Living), as well as financial criteria with respect to their cumulative assets.
Although the nuances in determining eligibility varies from state to state, there is allot of overlap and for the most part the requirements are very similar.
For example, in the State of NJ, eligibility is met when the individual is at or below $2000 in total assets. In other states, the amount allowed may be a tad higher or lower.
Transferring Medicaid from state to state, in the event that Mom is already a Medicaid recipient residing in a nursing home in her hometown state, is not that big a deal.
The process in not that convoluted and not as tedious as it was for you to apply for Medicaid on her behalf the first time around.
Fear not, this is infinitely doable and can be achieved with the right amount of perseverance!
Contact the Board Of Social Services in the county where she resides to request more information, or feel free to reach out to me via my contact information.
Godspeed and best of luck!
Judah Gutwein, LNHA
Regency Nursing Centers of NJ