Does anyone have experience with bringing someone home from a nursing home after they qualify for Medicaid? In terms of reliability, is this a good idea or a bad idea? Medicaid pays very little. Does the family have to pay the difference or, if you use a Medicaid agency, do they accept whatever amount Medicaid is willing to pay?
IHHS will be a different application & eligibility system; it is a program within your States Medicaid HCBS / Home and Community Based Services. For the vast majority of States, IHHS is done through an approved agency with payment under a State contact. I’m mentioning this bc this can be super important if you are in a low minimum wage State. A lot of State’s are $7.25 hr min wage which means the IHHs workers make maybe $10-$12 hr. Which in turn makes it really hard for agencies to hire & retain employees & so waiting lists exist. IHHS will do an assessment on mom with a determination done as to # of hours of care needed. Most IHHS is at the 18-28 a week range, if she needs more care than that, costs are on her/you/ other family to private pay for this if you do not do it for free.
Right now if your mom is in a NH & has been determined to be eligible for Medicaid to pay for her long term care there, she’s on LTC Medicaid which is a different application and eligibility system. For those on LTC Medicaid in a NH, they end up on 3 things to enable to cover costs in the NH: 1. Medicare as health insurance + 2. Medicaid as health insurance (to cover whatever MediCARE doesn’t) and 3. LTC Medicaid which covers her custodial care costs (like room & board costs). LTC Medicaid will have a Share of Cost/SOC requirement which ends up being all her monthly income (like her Social Security) less whatever smallish $ amount her State has as a Personal Needs Allowance (tends to be $50-$75).
IHHS does not have the required SOC like LTC Medicaid does as the elder is in their home so has expenses to be able to live in their home; but IHHS will have some type of copay. Find out what your State does for copay as it will effect just how much of moms income she will have to be able to private pay for caregivers if the # of hours IHHS will provide just are not enough.
Right now she has some degree of 24/7 care and oversight at the NH. If she were to leave and exit LTC Medicaid, would it be at feasible for her to get the care she needs if she moves back home? Please pls take the advice that others have posted…… really she is best off staying in a NH unless she has a huge sum of disposable $$$ to fully private pay for caregivers and whatever equipment she needs to be able to live at home.
Don’t feel guilty. You didn’t cause the situation.
Count your blessings.
We are not made to care for someone 24/7.
My father in law was on NYS mediciad home health service and hospice. Service was minimal and reliability was dismal at best. Call outs weekly and our family was responsible for finding a replacement. 95% of the time my MIL ended up caring for him when call outs happen. Hospice had more reliability and end of life care but less nursing care services in terms of weekly hours.
Agencies are mostly selfpay unless you have LTC insurance. I am not sure if an agency would accept what Medicaid pays as full payment. I would imagine they wouldn't because it is a business that needs to pay for expenses.
Why do you/family want to do this? Are you unhappy with the facility? Feeling unnecessarily guilty or sadness for the situation? Feel you can handle the care yourself?