She's been there since mid-June and requires assistance with transferring. I think it's because there's a new ED and she's clearing out all of the seniors with higher levels of care. They are concerned about their acuity rankings. Can they do this? They say put her in SNF.
If the new ED has come into a place which isn’t very attractive for new residents, perhaps she really is ‘clearing out all of the seniors with higher levels of care’. It’s a sensible business decision, and AL is a business. Unfortunate, but true.
It is fortunate that there are very limited reasons one can legally discharge someone from a nursing home (due to federal law, which is typically also reiterated in state laws). Assisted living facilities are governed state - by -state, so one needs to start with that state's statutes. Some are more protective, others less so.
We had to move our stepmother from AL to MC as she had mentally become beyond the point of staying there.
You may not see all that happens early in the morning or in the evening so it may appear to you that her needs have not changed when in fact they have.
It may even be a matter of time. If she required 1 person to assist her to get up and that took 5 minutes but now it takes 1 person 15 minutes so they get another person to assist that takes staff away from others that need help.
Depending on where you live ALF can not use equipment to make the process faster and easier so helping a person can be m ore of a safety risk for both the resident and the staff.
SNF can use equipment to make transfers safer, easier on the resident as well as safer for both staff and resident.
I would suggest that you look at the contract it may spell out what can and can not be done. It is very possible that your LO should have been in SNF from the get go.
There were levels of care within MC, and by the time we were able to visit her on a regular basis, her needs had become both difficult for her AND her very caring staff.
Through the kindness and concern of the MC staff, she continued to live there until it became obvious to all of us that her presence WAS distressing to other MC residents who had fared through the disease better than she had, and she was moved to the next door SNF, where she lived for a year in hospice care.
What grieved me was that she’d failed as much as she had, and that year was certainly the most difficult, but the decision to move her was clearly the correct one.
The rent may stay the same for a year but its usually 30 day notice when it comes to Mom leaving on her own or the AL is saying we cannot care for her.
In my brother's ALF the line they walked was fine indeed. Many residents, including my brother, were overall mentally and physically fit. There were certain some residents in W/C. And there were the usual levels of care from I to IV. There were some folks with early dementia (my brother had a dx. of probable early Lewy's Dementia), but when anything progressed to needing more care, or as disruptive to the community cottage in general, moves to more comprehensive and better staffed care was required. They tried very hard for families who could not afford moves to MC, but when residents complained overmuch of the needs and requirements of a single resident, or the workers said that they were not well staffed enough to meet that resident's needs, a move was required.
Basically the answer is that they like CAN ask for this move. Your best hope is to TRY to find out EXACTLY what the problem is, and see if it can be remedied in some way. If not, I am afraid there isn't a lot of choice. I am sorry and surely do wish you good luck.
If an AL feels a resident is a 2 person assist or a huge fall risk, they are not approved to live there or asked to leave as a resident. This is for the safety of the resident and to insure they won't be sitting there for an hour waiting for transfer assistance to the toilet if the facility is understaffed.
Everyone seems to see nefarious reasons behind the rules an AL creates, yet by asking a resident to go into a higher level of care, they're losing a huge check each month. Its mind boggling how much an elder can decline, mobilty wise, in a 3 month period.
Get mom into a situation where she can be properly cared for, that's my suggestion. Good luck.
We definitely don't want to burden our adult children if we end up needing day-to-day care.
I was so worried....
I called The Quality Improvement Program and appealed it and the next morning ,I got a phone call that we'd won the appeal.
Maybe they could help you too.
NC pertinent law:
https://info.ncdhhs.gov/dhsr/acls/rules.html
Section on discharges and appeals of discharges:
https://www.ncleg.net/EnactedLegislation/Statutes/HTML/BySection/Chapter_131D/GS_131D-4.8.html
p.s. I am not an attorney, but a nursing home attempted two legally baseless discharges on my mother. They lost both times. If you go this route, you can private message me for input.
Moving her is a big deal and I get your resistance to do it, but things change on a dime with the elderly. It is a constant mode of evaluate and adjust.
I wish you luck in finding a new place that fits all of your moms needs. We have had to downsize my moms things several times. First when I sold her home and moved her into assisted living and then again when we moved her into memory care and then again when we moved from private pay memory care to medicaid accepting memory care. Their world keeps getting smaller and smaller and their need for assistance and care keeps getting bigger and bigger.
Regardless of what we think, numerous things can cause this situation:
-your Mom truly needs care they can not provide, but also
-there is a change in management with new priorities
-the facility wants the bed
-staffing has changed, etc.
Your state should have an Ombudsman program, to help you maneuver this situation. They can tell you the laws too. You can challenge this, and they will take up your Mom's case in court.
In the meantime, call for hospice to come in. Hospice came in to provide extra care for my Mom during this transition. AL wasn't happy about this, but you have to just think of your Mom's care right now.
The AL also worked with my sister, and my Mom actually ended up staying way beyond the 30 days due to personnel, dating and delivery errors of the AL.
I don't want to get ahead of myself here for you and your situation, because there is a lot to digest now for you. But my story is taht my Mom came to live with me (I had done CNA work previously, and was between jobs), but I'm was very sorry that my Mom wasn't here sooner. IF you go this route, make sure her hospice is set up before moving her, and AL gives you a Care plan. AND, any move like this is traumatic. My Mom had dementia, and was in a dementia unit, but actually was very happy to be here and leave AL behind.
In the mean time, you can show "good faith" by talking to some NH, I also contacted Elder Services in my state, and they were super. As well as my local Senior center.
I know this is a lot. I'm so sorry that you and your Mom are in this situation. It was certainly not what were were expecting, and just felt so wrong. A real betrayal.
Feel free to PM me. I could write a book on this, but must be off to work.
<3 to each of you!
One day we may require such care. in JMJ TomK
Would sure love to know what occurred when you spoke with the facility, and what they had to say about their reasoning for their decision. Also what you plan moving forward. It so helps to know if you have a response to our suggestions.
A Skilled Nursing Facility may be paid under Medicare or Medicaid with a doctors order for up to 100 days, otherwise it will be private pay unless they qualify for Medicaid in your state. M.