Mom Needs a Nursing Home, Now What?

Barbara Ellington-Lofton, Resident Benefits Specialist

This is the time of year for summer vacations or for coming home to visit relatives.  For many adult children coming to town for a visit, the joy and excitement are replaced with anxiety and fear.  You come to town and find out that your parent is not as functional as last time.  You see warning signs - expired food, prescription bottles that have too many or too few pills for the dosage, a state of appearance that does not meet minimal health standards, weight loss, unopened mail such as bills or bank statements.


At this point you have 2 options:
1.  Survive the visit and leave hoping daily you will not get a call that a crisis has occurred.
2.  Try to find out what is going on and take steps to resolve before a crisis strikes.


Option 2 is surely the best one for all involved.  You make an appointment to see your mother's primary care provider.  You schedule a checkup for her.  You speak with neighbors and friends to see what they have noticed in recent behaviors.  This may mean you need to stay in town a few extra days.
Your mother, family, and the primary care provider determine that she can no longer manage on her own.  Options such as sitter services, assisted living or living with a family member are ruled out.  The next option is full time medical care in a nursing home.
How do you get there from here?
The nursing home admission process is essentially 2 fold. The first is to select one or more facilities that you feel will meet your loved ones needs. As far as COVID restrictions allow, visit the facility. One test you can use is what one of our administrators terms the AA test:
Aroma - does the nursing home smell overpower you when you walk in the door?  Everyone understands when an event has just taken place and the staff is addressing it.  But that should be the exception.  The expectation should be for the aroma to be pleasant.
Attitude - how does the staff respond to your presence?  How do they respond to residents and other visitors?  You should be greeted warmly and with a smile. You should observe residents being treated with respect and dignity.   

Once you select a place, that admissions staff will guide you in the next steps. They will need to review your loved one’s medical condition to make sure their staff can meet all needs. The primary care provider will usually fax the most recent history and physical and medication list to be reviewed by an admission team. Once your loved one is accepted for admission, there are several medical tests and orders required. These have to be completed within 30 days of admission.

The second part of the admission process is to determine how nursing home costs will be paid. Medicare does not cover long term nursing home stays. Sometimes Medicare will cover a short term stay of up to 100 days following a 3 day in-patient hospital stay. Medicare Advantage plans may not require the in-patient hospital stay. For long term nursing home stays the options are private pay, long term care insurance, or Medicaid. In Mississippi private nursing home charges are usually $6000-8000 per month. Some long term care insurance policies cover only a portion of this, so paying the difference by private pay or applying for Medicaid are still needed.

Medicaid is a government assistance program that is needs based. People on Medicaid must have limited income and assets. The asset limits vary depending on whether the applicant has an at-home spouse and how the asset are structured. For instance, home property valued at less than $500,000 and located in the state of Mississippi is always excluded. The balance of retirement accounts that produce a certain amount of income is not counted. The current gross monthly income limit is $2523. Those whose income exceeds this limit may still qualify by agreeing to pay income less exclusions to the nursing home.

Conclusion: The trip home for food, fellowship, and family got a lot more complicated.  But with time, energy, and resources, you can return home knowing mom is in a safe place and her needs are being met with the highest quality of care and compassion.


Barbara Lofton can be reached by phone at 601-450-3744 or by
e-mail at [email protected].