When a family member needs long-term care, it is scary.  It’s scary to see a loved one deteriorate.  It’s scary to see someone who has taken care of themselves your entire life, perhaps even taken care of you at one time, need care themselves.

To top it off, providing for the long-term care that loved requires is scary.  The long-term care field is quite complex.  There are multiple types of long-term care—home health aides, adult day care centers, assisted living residences, nursing facilities, and continuing care retirement communities.  And the cost of long-term care is stunning, anywhere from $2,000 to $12,000 a month.

The people who work at the nursing homes and assisted living residences do the work they do for a living.  Compared to you, they are “experts” at what they do.  To you, the entire process is an unknown and a scary event, scary because of the expense, scary because you are unsure if you are doing the right thing for your loved one.

In short, when a loved one suddenly requires long-term care, you are in a very vulnerable state, and it is little wonder that the people who are in the long-term care field exploit that vulnerability.

Nursing homes are repetitive abusers of the lay person’s vulnerability.  Nursing homes frequently tell family members and residents things that simply are not true.  Just last week, I had a client who was the victim of these lies.  A well-respected senior advocate group has written a booklet about the twenty most common lies that nursing homes tell people, and I recently re-read this booklet to brush-up my knowledge on the subject.

Most people enter a nursing home after they are discharged from a hospital.  The patient enters the nursing home for rehabilitation.  For instance, Mr. Smith falls and breaks his hip.  Mr. Smith goes to a hospital for surgery on his broken hip.  Mr. Smith spends several days in the hospital, then is discharged to a nursing home for rehabilitation of his newly-mended hip.

Most people don’t think of rehabilitation facilities as nursing homes, but they are.  A nursing home provides rehabilitation and long-term care services under the same roof.  When you are in a rehab center, you are in a nursing home.

After anywhere from several days to several weeks, Mr. Smith will be ready to be discharged from the nursing home because the nursing home believes that Mr. Smith has achieved the goals that were set for him as far as his rehabilitation.

Mr. Smith’s family might believe that Mr. Smith needs to remain in the nursing home.  Perhaps Mr. Smith was beginning to suffer from dementia before his accident, and the accident and subsequent surgery has caused his dementia to kick into high gear.  (This is not uncommon at all.  In fact, this is what happens in a great number of cases.)

Assume that Mr. Smith has very little money.  The nursing home may tell the family, “We don’t have a Medicaid bed at this time” or “We have a waiting list for a Medicaid bed that is two years long” or “We require you to give us a security deposit of $10,000,” which Mr. Smith does not have or “We require private-payment for one year before we’ll accept Medicaid.”  The facility will then tell the family that they have to take Mr. Smith home.

All of these statements, which are probably made every day at some facility, are lies.  The fact of the matter is, the nursing home is stuck with Mr. Smith.  In short, the nursing home cannot discharge Mr. Smith unless the nursing home can implement a safe-discharge plan, and Mr. Smith’s family is under no obligation to provide the care Mr. Smith needs to Mr. Smith.  Sending Mr. Smith home without a 24/7 care plan in place is an unsafe discharge, and the nursing home cannot do that.

Federal and state law prohibits nursing homes from requiring a patient to pay privately for a period of time before it will accept a resident on Medicaid.  So, the bottom line is, Mr. Smith can stay in the nursing home and can begin receiving Medicaid benefits and there is nothing that the nursing home can do about it.  Ironically, it is the nursing home that is in the weaker position, not the resident.  The nursing home is just far more adept than the layperson at flipping the dynamic and making it appear as if the family member is in the weaker position.