Expert Tips for Georgia Medicaid: Six Tips to Getting into a Nursing Home Without a Hospitalization

Tips for Getting into a Nursing Home

Finding a nursing home bed in the Metro Atlanta area can be difficult. In May, we published a blog about this issue that you can read here: https://hurleyeclaw.com/2018/05/09/finding-right-nursing-home-metro-atlanta/ In summary, you can read that many of our nursing homes in Metro Atlanta are accepting residents for short-term rehab (or sub-acute rehab) only and do not want to accept residents that need long-term care. This makes finding a nursing home that will offer you a bed without a hospitalization very difficult.

From Home to Nursing Home

Medicare requires that a person be hospitalized for at least three midnights before being eligible for short-term rehab (or sub-acute rehab) in a nursing home. What do you do if you need nursing home care for your long- term care needs but do not need to be hospitalized or to receive any rehab services? Here are our six tips for finding a nursing home bed from home:

  1. Temper your expectations—This process is difficult as long-term care beds are in short supply in the Metro Atlanta area; it will require time, energy, and perseverance to find a bed. You may also not get a bed in the nursing home that is the most convenient to you or that is rated the highest by Medicare. There is more demand than supply in those highly-rated homes (which you can read about here)  so you may have to settle for your third or fourth option.
  2. Be prepared to pay privately—We hear many families say that they plan to use every last dollar to pay for home care or assisted living care, then move into a nursing home once they have run out of money. This strategy will likely result in an even harder process with an even worse outcome. Be prepared to pay for 2-4 months of nursing home care privately. At $8,000+/month, that means using your last $16,000-$32,000 on nursing home care in order to find a good, convenient nursing home bed. It is not impossible to find a nursing home bed and immediately apply for Medicaid, but it is very difficult. You cannot apply for Medicaid until you are in the nursing home, and if you don’t have money to pay for the nursing home care, you are asking the nursing home to go without any payment until Medicaid is applied for and approved. This process has burned many nursing homes—they have given care to residents that never complete or never get approved for Medicaid, so they never get reimbursed. Because of this, nursing homes are wary of admitting someone who is “Medicaid Pending.” Your best bet is to be able to pay privately for a few months.
  3. Meet with the nursing home admissions coordinator—Building a relationship with the nursing home coordinator can help you get a bed offer. Nursing home coordinators receive tons of inquiries from hospitals, social workers and families every day. Most of those inquiries are electronic or come by fax or phone call. Making an appointment to meet with the admissions coordinator in person can help your inquiry to stand out, especially if you are kind, professional, and easy to work with.
  4. Have your primary care physician complete the necessary paperwork—Each nursing home resident must have a doctor’s order, a negative TB test, a DMA-6 and a Level I completed prior to being admitted to a nursing home. The nursing home also needs a recent medication list, history and physical, and medical notes to review care needs. If you are moving into a nursing home from the hospital, the hospital does this work for you. If you are coming from home, you must collect these documents from your physician yourself. Having these completed and ready to give to a nursing home admissions coordinator can ease the process of finding a nursing home bed.
  5. Communicate often with the nursing home—If a bed is not immediately available, stay in contact with the nursing home admissions coordinator regularly (maybe once every 6-10 days). Bed availability changes daily, so you want to stay in contact with the nursing home. Do not rely on them to remember to call you. If, however, the nursing home says that they cannot meet your care needs, you do not need to continue following up with them.
  6. Be ready to move on short notice—When a bed becomes available, you are expected to move in within a day or two of being notified. Nursing homes do not like to have empty beds in their facility, and they will likely offer the bed to another person if you cannot move in within a short amount of time after being offered the bed.

It is hard but not impossible to find a nursing home bed without having to first be hospitalized. Our firm has three care coordinators on staff to help our clients navigate this process. If you have any questions or concerns, please contact us at (404) 843-0121 or at https://hurleyeclaw.com/contacts/

If you are wondering how you can find a good nursing home that accepts Medicaid, check out our blog on this topic here.