Skilled nursing facility will not sign off on form to let mom go to Memory Care

Jolynn05

May 2022 we placed my mom into the local nursing home after a stay at a memory care facility that was over an hour away and turned out to be bad. She didn’t really need the nursing care (she just takes the regular medications that an Alzheimer’s/ dementia patient does) but we decided it would be better to have her only a couple miles from all of us. It has turned out to be worse than the last place. We now have found a small memory care facility that comes highly recommended with a maximum of 16 residents and she has been on the waiting list for a room. One became available and they evaluated her and accepted her. They needed all the transfer information which included a Florida form 1823 where the SNF fills out her levels of care etc and check yes or no at the end whether they feel her needs can be met at an “assisted living facility” and they checked no because the form does not specifically mention memory care. They (the nursing home doctor and director of nursing) said they will not change it and without it we cannot move her. The reason we want to move is this place has turned out to be awful. A nightmare; and her lack of care is evident daily. My question after all of that is has anyone dealt with this?? I am the medical surrogate and POA for her and no one even spoke to me before filling it out and rejecting the transfer. NOTE: We pay $11,000 a month for her to live there in a tiny shared room. Please help we’ve been trying to find a lawyer to talk to to no avail and don’t know how to move forward. (I should also note that one of my sisters who is joint POA financially has been against the move from the beginning so note sure how involved she was in this) TYIA

Ci2Ci

Hi, Jolynn05. I messaged you privately about this but posting a response here, as well.

I have not dealt with this personally. But, wondering: What has the ALF-MC that you want to transfer your LO to said about it? Do they have any authority to override the decision of the SNF? Can an outside doctor make the referral to the ALF-MC rather than the facility?

Ci2Ci

Also, contact Elder Affairs agency and find the Ombudsman for your area. Call them and see what advice they can give. They (Elder Affairs Ombudsman Office) are the agency designated by Florida statute to assist with nursing home matters. YMMV.

towhee

I second getting in touch with the long term care ombudsman- Home - Ombudsman (elderaffairs.org) They should know all the regulations regarding level of care and they would be objective about what memory care usually handles vs nursing home.

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harshedbuzz

@Jolynn05 said: (I should also note that one of my sisters who is joint POA financially has been against the move from the beginning so note sure how involved she was in this) 

This is likely part of the problem. If you can't get an attorney on board, I would contact the Area Agency on Aging. Is this form necessary? Could you, as medical POA take mom home for a few days and then admit her to the new facility from there?

HB

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Last Dance

So what would happen if you just stopped paying $11,000 a month, Or who signed her in they would be the one who could sign her out. What would happen if you said you wanted to take her home, And then transfer her to the other memory care home that you would like her to be in. Having two people being joint POA ‘s is not good. This is why most lawyers do not recommend it. As sad as it may seem I think the only two options you have is to get your other sister on board with you or file an injunction to have your sister removed as associate POA

jfkoc

"Form 1823 Resident Health Assessment for Assisted Living Facilities - Florida"

This is an Assessment form and nowhere did I read that it kept you from moving your mother to where ever you wanted. It is their written assessment and they are standing behind it. Period.

Has the facility where you want your mother read the assessment and decided they could not handle her care? It seems that they are the ones holding up the transfer,

Do you disagree with any of the answers made on the form?

Is the POA a DPOA?

towhee

In my state a doctor also determines level of care, and fills out a similar form. If they determine that someone's lack of ability to do ADLs means they need a nursing facility, then no assisted living will accept that person. State regulations say they can't. Now if the doctor says someone will be ok at an AL, but you want to put them in a nursing facility, you can do that, you can go above a stated care level, (private pay anyway) but not below.

Now the thing is, that most doctors are only seeing a patient for 10 minutes, they don't have time to test the ADLs, and they can't trust what a person with dementia says, so who do they usually ask? family and caregivers.

I would get a look at the form they filled out, and see whether you agree with their determination of her ability to do the various ADLs, although if you do not, do not expect anyone to admit they were wrong. I repeat my previous advice to contact the ombudsman.

Jolynn05

Thank you everyone. I did take the advice to find local ombudsman and she has been SO helpful. She agrees the SNF my mom is at is one of the worst she has ever seen. She did talk to the new administrator that just started last Monday and he is to call me. She has hopes he can help make the needed changes to the form we need. The memory care unit (within an ALF) we want to move her to has already evaluated my mom and is ready to accept her whenever another room is available - we lost the last one but are still on the waiting list. She does need help full assist with most ADLs but can still feed her self to some degree. We will be paying $500 extra a month at memory care to always have two person assist for her which seems to be the main complaint from SNF that seems to think she won’t get that - which again is a joke as she’s lucky to get one person assist at the place she is now. I’m praying for a good outcome when I talk to the new administrator. Thanks again for all the advice, especially about the ombudsman as I had never heard of that and she has been a wealth of information.