We are having a difficult time trying to admit my mom into a nursing home. She lives at home now with a care giver and all nursing homes are saying it is much easier to admit someone from a hospital rather than from home, but no one is telling me why?
What I did was have my mom work with her MD's within her gerontolgy group and not the MD at the old facility. Many of the MD's in the group are also medical directors of NH and so know how to write up a chart to show the need for skilled nursing. Just being old, demented or whatever, is not enough. They need a fat file to show skilled medical need.
There are simple things, like change a medication from a pill to being a compound; or have their Exelon pill changed to a patch (which they can't do easily on their own); also they monitored and did labs more often. The day she got a critical H & H and a 10% weight loss and a couple of other issues, was the day she got the orders for "skilled nursing needed". Got her moved within the 30 day window and Medicaid pending. When they are living at home, there isn't the fat file like you have after a surgery &/or hospitalization. You have to work to have it done. Took about 6 months of every 4 to 6 week doctors office visits. Also if they are at home, you need to make sure that within the chart it is documented that they are self-dependent on their medications and ADL's. Good luck.
The other issue for the nursing home is per-admission screening, physician orders etc,, It's not really that hard to come directly from home it just takes an admissions coordinator that's willing to hustle to get the work done and a willingness to help with the transition.
Good luck!
Do you want your mother admitted permanently, or would this be temporary for some kind of rehab to get stronger and return home?
So, what I'm guessing is that it's easier for the skilled nursing facility if we have our parent admitted to the hospital first - for evaluation and payment purposes.