CUSTODIAL CARE VS SKILLED CARE - What level of nursing home care does your parent need?

[@3rddegreeburns137]

Just found your channel today. Thank you so much for your help. I'm currently in the middle of dealing with this issue. My mother was placed in a skilled nursing facility due to weakness in her legs and the inability to walk with her walker. She was discharged from the hospital and placed in one facility for rehabilitation for a little over 3 months. She made enough progress and was walking at least 100 feet with the walker and assistance. Of course after multiple appeals and losing the last one she returned to her appt. Thinking she could do it but she couldn't. She was there overnight. Thankfully, the assigned nurse and my uncle went by the next morning and this started over again. She is currently in the 2nd facility that should have been at least 6 mos. It has been over a year. By the 6th mos they were saying she was not making progress in physical therapy. They no longer walked with her due to falling multiple times with staff. They move her with a hoyer. They stopped offering therapy between 03/2022 and 07/2022. Not based on the denial from the MAPD plan but the facility no longer wanting to offer the service. After getting the Ombudsmen involved, the facility agreed to start therapy again. That was from the end of 07/2022 to the beginning of 11/2022. Again, they ended therapy. We appealed and won the 2nd level appeal. Therapy started again in 12/2022. After 67 days, they have stopped it again due to no progress. So, the person who arrived with the ability to walk at least 100 feet now has no documented proof that the continuation of skilled nursing services is needed to maintain or prevent decline..per LIVANTA. Her care plan goal has always been return to the community. Not by herself. I will have to move there and take care of her. However, that was with the understanding that additional progress would be made and if not, she would still be at 100 feet and moving. They have caused great decline with her. This will result in her becoming full LTC (Long Term Care) by making it extremely difficult to be cared for under custodial care. Our elderly have rights. I suggest anyone with an aging loved one get familiar with Medicare Guidance and the Social Security Act regarding LTC facilities and the EXPECTATIONS for care, as well as the QIO (Qualify Improvement Organizations) like LIVANTA. They are failing our loved ones. I'm pretty much at my wits end but very greatful for finding your channel. Thank you so much.

[@fredortiz5145]

This is the best explantion that I have heard regarding Custodial vs Skilled care. Thank you.

[@SofiaAmirpoor]

Thanks Fred! I’m glad you thought so…it’s such a complicated topic!

[@chatswithcharles8798]

Just want to say I love what you are doing here on this channel! Keep it up! I will make sure to point our patients to your channel as well! Keep up the great content. Dont stop!

[@SofiaAmirpoor]

Thank you Charles!!

[@jetaime1316]

Thank you for your knowledge. How do you know if your parent currently in a hospital, should go to a better hospital, or a long-term care facility? And if you have knowledge about the differences of a Skilled Nursing Facility, Post Acute rehab and a long-term care facility versus an acute long-term care facility, I would greatly appreciate it thank you.

[@LostInThisGardenofLife]

Wow that was amazing. Thank you for this informative video…and I have a question: are there any nursing homes that are not “profits over care?” 😬

[@SofiaAmirpoor]

Hi Christopher. Yes, there are some non-profit nursing homes out there, a small %, but they do exist.

[@Bali_Evie_Buns]

Excellent explanation, thank you!

[@SofiaAmirpoor]

Glad it was helpful!😊

[@heatherg7563]

Are the 100 days a lifetime maximum or does that start over if there are other medical events in the future?

[@SofiaAmirpoor]

Not a lifetime max. After the first 100 days, if skilled care still needed, you might have to pay out of pocket. But you will be eligible for another 100 days if out of the nursing home and hospital for 60 continuous days and have another qualifying 3 day in-patient stay at an acute hospital. Hope that helps !

[@smilinmoo]

That was helpful-thank you.

[@jeancorwin5891]

You failed to mention "private pay" for skilled or custodial care in the nursing home after the 100 days when Medicare runs out. Isn't that a possibility?

[@janetsavona7590]

What if no one can do custodial care for them

[@cadlac1533]

Hello Sofia, would you like to video about how to gear up VA , please ?

[@SofiaAmirpoor]

Hi there! I’m sorry, I’m not sure what you mean by “gear up”. I have a playlist for VA benefits , maybe you’ll find something helpful there😊

[@dancingponies7971]

Is custodial care at a nursing home…?

[@SofiaAmirpoor]

Yes, it can be