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Beware of Possession of the Body

By Gail Glockhoff-Long
GolderCare Solutions
Benefits Advocate

There is a lot of misunderstanding about nursing home discharge terminology and rules. These are situations we have heard many times and clarification of what is really happening.

Situation 1 – Dad fell and is on Medicare rehab and now the nursing home says he has run out of rehab days and they are discharging him.  Family knows he is not strong enough yet for them to care for him at home.  The nursing home is kicking him out.  Family panics.

Reality  – Dad has run out of rehab days approved by his insurance company and is being discharged from Medicare not the facility.  The nursing home is informing the family that if he stays he will be on private pay status of $300 – $350 per day instead of insurance co-pay of $0 – $195 per day.  You may be able to appeal to the insurance company for more rehab days.  If the appeal does not work, generally, a nursing home will gladly keep your loved one longer at the private pay rate.

Situation 2 – Mom has severe Alzheimer’s and Lewy Body dementia and can have extreme behaviors that her private pay memory care unit finds disruptive.  The facility tells the family that they made arrangements for her to go to a specialized facility 50 miles away but the family will need to pick her up and drive her.

Reality – Some facilities market their upscale building and cater to families that want that atmosphere.  Not all facilities are equipped to handle the disruptive behavior of some types of dementia.  In regard to moving your loved one, if the family picks mom up, they are taking possession of the body.  If the new facility does not accept her from the family, the old facility does not have to take her back.  The old facility handed all responsibility for mom to the family and have washed their hands of the situation.  This was a way for them to dump mom on the family.  Talk to the new facility and make sure all arrangements have been made and they are ready to accept mom.  The transfer should have been made by either the van from one of the facilities or medical transport.

Situation 3 – Dad is a nursing home resident on private pay.  The family does not want to pay the $8500 per month and do not even want to pay dad’s income to the facility for his care.  Against doctor recommendations, they sign dad out and take him home to have the family care for him.  They have taken possession of the body.  After 2 days of round the clock care they are exhausted and in over their head.  They take dad back.  The nursing home says no – they will not take him back.

Reality – The nursing home does not have to take him back.  Nursing homes can pick and choose who they take based on many factors including care needs of the resident, ability and cooperation of the family to pay the bill, or his income if they have been approved for Medicaid, and can they work with the family.  Once the family took possession of dad, the nursing home had no obligation to take him back.  The family now has to try and find a different facility that will take him.

Possession of the Body rules are important because they have ramifications on the resident’s rights.

If mom is in a nursing facility and you run out of money to pay for care and have not successfully gotten her qualified for Medicaid, or she is on Medicaid and you are not paying her income to the facility as required by Medicaid, the nursing home’s next step may be an involuntary discharge.  They will notify you in writing. There is a legal process and Mom has legal rights to an appeal as long as she is in that facility. They can also move mom to another appropriate facility that will take her, but that facility may be at the other end of the state. By law, the facility cannot leave Mom without appropriate care.

If you feel badgered by the facility and remove mom into your possession, you have possession of the body and mom loses all her legal rights to stay in the facility.

Contact a patient advocate before you endanger mom’s care.

GolderCare Solutions is an independent advocacy group for seniors, the disabled and those that care for them. GolderCare has offices in Moline and Bettendorf. You can reach GolderCare at (309) 764-2273 or learn more at www.goldercare.com.