Most people don’t want to die, but they eventually do. Most people don’t want to end up in a skilled nursing facility, but many do.
When my clients came in last year, the husband was deteriorating, and it was obvious. The wife called me just recently and told me that he had been hospitalized and then discharged to an acute care nursing home.
Regrettably, she didn’t reach out to me for help earlier in the process. Perhaps we could have helped her fight against the machine to get a better outcome for the family. And the wife isn’t someone who knows nothing about healthcare. She spent her career as a registered nurse.
While Medicare covers a short period of stay in a nursing home, only private insurance or Medi-Cal will cover a long-term stay. Most people don’t have private insurance coverage, so they rely upon Medi-Cal for the payments.
The job of the discharge nurse at the hospital is to discharge the patients to home or some sort of facility. But, in some cases, the discharge workers seem to be quite aggressive and uncaring. The hospital sometimes just wants the patient to be gone. Out.
In one case, I had to encourage the brother, who was his sister’s only remaining family member, to fight for several days to have his sister discharged to Fairfield because that was near him so he could visit her. He was in ill health, and in his very late 70s, and it would have been nearly impossible for him to drive to Gilroy or Morgan Hill to see her more than once a week. The travel was exhausting for him, and after several days of negotiating and pleading, the discharge nurse finally placed his sister in a facility in Fairfield about ten minutes from his home. That was a good outcome for the family.
In the recent case above, they discharged the husband to a facility in Sacramento! The one-way drive for the wife is about two and a half hours. She’s in her 70s and would like to visit her husband daily, but five hours a day in the car can be grueling for someone who isn’t accustomed to driving and is weak and already frazzled from worry and trying to care for her husband. She should have held her ground and fought for her husband’s rights to be closer to his family, but she let the hospital staff run right over her without her objecting, and now they’re in a horrible mess which probably cannot be corrected.
And what about getting the husband on Medi-Cal to cover the $33,000 per month charge from the acute care facility? The facility referred her to a company that charged 400% of what I normally see charged. I couldn’t believe it when she told me. And to make matters worse, the company handling the application was in Southern California, and that made it even more difficult for the wife.
But in another act that could cause considerable harm to the family, the company who assisted with the Medi-Cal application failed to explain to the wife that the new Medi-Cal rules would go into effect in January of 2026, and then her husband would no longer qualify for Mei-Cal unless the family took specific actions with their assets so his Medi-Cal coverage could continue. That lack of knowledge could be devastating to the family.
The harm to this woman and her husband just continues because she took the hospital, the nursing home, and the Medi-Cal application company all at face value without challenging or questioning, and without seeking input from people who deal with these cases regularly.
I can’t fault people because almost nobody ever experiences placing more than one loved one in a nursing facility, so people have no experience with “the system” that they’re facing. People often learn from their mistakes, but then it’s often too late to correct the errors, and some harm has already occurred.
Be cautious. Realize the real goals and intent of people you deal with, and seek the input of experienced professionals if you’re uncertain. Protect your rights and interests.