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Old 09-16-2017, 12:38 PM
 
20,581 posts, read 16,637,575 times
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Quote:
Originally Posted by TheShadow View Post
My mom was on Medicare with Medicaid picking up the balance. She was coming out of acute care, and would have been eligible for Medicare for 90 days before reverting to Medicaid. They just weren't interested in the eventuality of that level of care for the small Medicaid reimbursement amount. It was a shame really, because in a better nursing facility she might not have died within those 90 days as she did. The lack of proper nursing care (proper therapy for her eating problems, proper turning, proper hygiene and wound care) caused what should have been healing and a better outcome to turn into a downward spiral ending in her death less than 90 days after her acute hospital discharge.
They often look at the hospital papers and even bring them to the therapists first to see if the patient is a good therapy candidate. It sounds like your mom was pretty extensive in care needs and not a good candidate for rehab. So they wouldn't have been able to get Medicare reimbursement for more than a couple of weeks, as therapy probably would only have been involved for a short period to establish safe transfer methods for nursing, for positioning and maybe splints if she needed them. If the therapy notes from acute care stated she wasn't appropriate for rehab, that would be more than enough for a facility to decline her. Medicare reimbursement rates are based on how much rehab a person is getting. Someone who can tolerate 3 hours a day is going to make the home a lot of money, someone who gets only 30 minutes of PT and 30 OT brings a paltry rate.

I know it sounds cold, it is...most of these facilities are corporate owned, or run by big management companies, there is little heart in health care today. I'm really sorry your mom suffered as well as your own.
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Old 09-16-2017, 08:22 PM
 
Location: Loudon, TN
5,785 posts, read 4,838,667 times
Reputation: 19463
^^^^^Thanks, I still get worked up over it.
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Old 09-17-2017, 07:19 AM
 
15,295 posts, read 4,033,310 times
Reputation: 11036
Quote:
Originally Posted by Lastfire View Post
Well, I may be one of the "fools" addressed in this thread. My DH developed dementia at a very early age....long before retirement age. So here we are 14 yrs later and DH has absolutely no medical issues. He will probably outlive me by 10 yrs. So long term care in a memory unit will be $80k per year for 10 yrs....guess he will end up in a medicaid facility. Does that mean we are stupid? Or that we should have divorced (49+yrs) or that I should somehow become super old lady and handle this 235 lb dementia man? Those of you who have had breaks in life go your way, good for you. But sometimes we fools need a little help from the "old U.S. government."
800K isn't really that much. The problem was the early age....

It's well known these days that a couple needs a minimum of 2 to 2.5 million in addition to their home to have some sort of financial stability.

But I do understand - that's what Uncle Sam is for...of course, I believe in Universal Health Care anyway, so the whole point is somewhat moot (although those with scratch could still go to "cadillac" homes).

So much of this is cultural. My guess is that in Asia (Japan, China) they would not put your hubby in a home...even in the US I think they (and even Hispanics) put elders in a home at a vastly lower rate.

But this supposes a way of life that we don't lead here where you have many backups in terms of children and relatives helping.

Heck, I remember when my extended family bought a rooming house type of place and installed a lot of the grandparents and uncles and others there. That particular grandfather drank and ate and played cards right up until the end...the story goes that he was playing cards and lifted a toast and fell over...that was it.

I wish the same for myself although I don't drink - maybe I should start?
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Old 09-17-2017, 08:33 AM
 
Location: R.I.
979 posts, read 606,070 times
Reputation: 4243
Quote:
Originally Posted by ocnjgirl View Post
I know it sounds cold, it is...most of these facilities are corporate owned, or run by big management companies, there is little heart in health care today. I'm really sorry your mom suffered as well as your own.
In one of my many R.N. jobs I worked as an MDS Coordinator at rehab/long term care facility owned by one of those large big named corporate enterprises. I almost had to walk around with a whip and chair to get the staff to do their time sensitive documentation so that it could be submitted to Medicare on time or else reimbursement would not be forthcoming. The Physical and Occupational therapists at this facility were required to use stop watches to calculate the minutes of therapy they would deliver to the patients, and if the patient could not meet the goals of therapy which means they are no longer in need of a skilled service bingo their Medicare A benefit would stop abruptly even if they were no where near their 90 day eligibility.

I would say of all the various different nursing jobs I ever had this was the worst because the focus is on performing timed tasks and not delivery of quality compassionate care to those that need it most our fragile elderly.
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Old 09-18-2017, 11:39 AM
 
Location: The South
5,226 posts, read 3,637,448 times
Reputation: 7916
Quote:
Originally Posted by craigiri View Post
800K isn't really that much. The problem was the early age....

It's well known these days that a couple needs a minimum of 2 to 2.5 million in addition to their home to have some sort of financial stability.

But I do understand - that's what Uncle Sam is for...of course, I believe in Universal Health Care anyway, so the whole point is somewhat moot (although those with scratch could still go to "cadillac" homes).

So much of this is cultural. My guess is that in Asia (Japan, China) they would not put your hubby in a home...even in the US I think they (and even Hispanics) put elders in a home at a vastly lower rate.

But this supposes a way of life that we don't lead here where you have many backups in terms of children and relatives helping.

Heck, I remember when my extended family bought a rooming house type of place and installed a lot of the grandparents and uncles and others there. That particular grandfather drank and ate and played cards right up until the end...the story goes that he was playing cards and lifted a toast and fell over...that was it.

I wish the same for myself although I don't drink - maybe I should start?
I reccomend a good bourbon and ice.
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Old 09-18-2017, 05:13 PM
 
Location: Philadelphia/South Jersey area
2,876 posts, read 1,405,246 times
Reputation: 10093
Quote:
Originally Posted by craigiri View Post
800K isn't really that much. The problem was the early age....

It's well known these days that a couple needs a minimum of 2 to 2.5 million in addition to their home to have some sort of financial stability.

But I do understand - that's what Uncle Sam is for...of course, I believe in Universal Health Care anyway, so the whole point is somewhat moot (although those with scratch could still go to "cadillac" homes).

So much of this is cultural. My guess is that in Asia (Japan, China) they would not put your hubby in a home...even in the US I think they (and even Hispanics) put elders in a home at a vastly lower rate.

But this supposes a way of life that we don't lead here where you have many backups in terms of children and relatives helping.

Heck, I remember when my extended family bought a rooming house type of place and installed a lot of the grandparents and uncles and others there. That particular grandfather drank and ate and played cards right up until the end...the story goes that he was playing cards and lifted a toast and fell over...that was it.

I wish the same for myself although I don't drink - maybe I should start?
Sweet Lord!! what are the majority of Americans goīng to do?? seriously 2 million. Supposedly 1/3 of Americans have no retirement savings and now they need 2 mil. the average 50 year old supposedly only has about 100k saved.
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Old 09-19-2017, 11:44 AM
 
Location: Loudon, TN
5,785 posts, read 4,838,667 times
Reputation: 19463
Quote:
Originally Posted by craigiri View Post
800K isn't really that much. The problem was the early age....

It's well known these days that a couple needs a minimum of 2 to 2.5 million in addition to their home to have some sort of financial stability.
Sorry, but no. One can have "financial stability" with much less, and in many different forms. A pension or annuity can provide financial stability. So can reducing your expenses to meet your budget, whatever that budget might be. I know many, many financially stable retired people (I'm one) who have no where near that amount, and never will.
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Old 09-19-2017, 11:48 AM
 
71,626 posts, read 71,751,865 times
Reputation: 49225
i love these blanket numbers that are thrown out without any regard for the actual situation's people have .
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Old 09-19-2017, 02:01 PM
 
Location: Las Vegas
13,889 posts, read 25,327,549 times
Reputation: 26385
It is pointless for me to worry about this because I can't change my circumstances. I make too much to get anything for free and too little to afford insurance. So yeah, if I need to be in a nursing home it will be that one in Florida. All I can do is hope I am so demented I don't know the difference.
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Old 09-19-2017, 09:17 PM
 
20,581 posts, read 16,637,575 times
Reputation: 38652
Quote:
Originally Posted by TheShadow View Post
Sorry, but no. One can have "financial stability" with much less, and in many different forms. A pension or annuity can provide financial stability. So can reducing your expenses to meet your budget, whatever that budget might be. I know many, many financially stable retired people (I'm one) who have no where near that amount, and never will.
It's in relation to needing long term care, not just retirement in general. It's health care that destroys savings, once you start needing help to just complete daily living tasks, you can go from financially well off to destitute within a few years.
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