Part Four: Follow the Golden Years Road of the Last

                       

nce upon a time, a not so young man was swept away by the sudden swirl of events into the Land of the Last.

There he was sent on a quest to find the Magical Nursing Home that would rescue his mother from the evil witches of Sunset City. It was to seem a daunting task, but he had a plan for following the Golden Years Road, although after a while it seemed more a maze of dead ends.

There were in this particular county 24 such places sometimes called Skilled Nursing Centers and sometimes called Long Term Residences. It would seem a lot of choices, but not so much for a poor boy.

Although it was not strictly a matter of cost, that certainly played some minor part. Throwing aside the Veteran's Administration Facilities, of which there were two, neither ranking well on the Medicare 5-Star Ranking System (1 Star for each or much below average), the average yearly cost for a home was $8,219 a month for a semi-private room (slightly more for a private room at $9,223 a month). These ranged from a high of $14,752 a month (a place that rated 4-Stars or Above Average) to a low of $5,627 a month (and a rating of 1-Star or Much below Average).  Cost did not always correlate with the ranking. A home that charged $9,794 a month, the sixth highest, only received 2-Stars or Below Average, while the second cheapest (not counting the VA Homes) at $7,300 a month got 4-Stars or Above Average.

The place where the not-so-young man's mother was imprisoned ranked eleventh in cost, about the middle of the pack, at $9,277 a month, but was one of only two in the county to receive but 1-Star, or Much below Average.

Do you see why he needed to rescue her?

If cost was not a real criteria, the fact his parents had no real resources was. They would have to go into a home under Medical Assistance or not at all, and not every home accepted Medicaid. He could eliminate eight immediately for this reason.

Of course, Sunset City was where his mother lay, so it was subtracted from the mix. So could one home because his mother had insisted from the beginning he must stay away from there, although he never understood why since several people recommended it and the home had a 4-Star rating. Also eliminated was one of the two VA facilities, because his dad said he never wanted to go there.

That left 14 facilities that would accept Medicaid.

The Not-so-young Man eliminated three as being tucked away in a bewitched far corner of the county. They would be places of last resort.

He then contacted the remaining 11 Skilled Nursing Facilities and it began to seem to no avail. He toured four and was placed on the waiting list at three (these included Mushmouth Manor). He did not apply at the fourth because it was the only one in the county to require an application fee. The fee was $250 and since he was now applying for both parents (explanation will be in following posts) that would have cost $500 just to risk being rejected, another last resort home.

He learned from another source that his parents would never get accepted by Mushmouth Manor with their lack of money, confirming his earlier impression of the place.

He was advised at the first home he contacted that he should put them on at least four waiting lists and if one offered a bed to snatch it up. "Demand is high," the lady said, "and everyone has long waiting lists." This was proving true as he searched on.

Two quickly let him know they would not take his parents, one or the other, and the remaining five were not returning his calls (including the one VA facility he had contacted) and as time passed it seemed they never would.

He had reached out even beyond that county, but it was going the same elsewhere. He even went back to PassingGo Home, begging them to reconsider since they did accept Medicaid and that was now what his folks were applying under.

And just when it seemed his plight could not get more desperate, it did. His mother's insurance company dropped her coverage.

Indeed, he wasn't in Kansas anymore.



(Photo on left is from the 1925 silent version of The Wizard of Oz, co-wrote and directed by Larry Semon, who also stared as the Scarecrow [he is on the left]. The Tin Man in the middle is Oliver Hardy, who gained much greater fame later when partnered with Stan Laurel. The actor on the right is O. Howe Black [you read it right], who not too surprisingly was cast as the Cowardly Lion.)

Part Three: Lost in the Land of the Last

I had exhausted the lineup of homes my mother and her friends had suggested. It was time to step away from the few to the many. But how?

I began by that new old fallback, Google. I thus stumbled upon a website that listed every Nursing Home known to man and then some. It gave general information, such as name and address and phone number, a few tidbits such as number of beds and affiliation and lastly the Medicare Rating.

Medicare has a Five Star Rating System for all Nursing Homes that accept Medicare. 5-Stars are the most a home can receive and I am told by professionals in the Medical Field this is very difficult to get. The lowest is 1-Star. There is no such animal as a Zero-Star nursing home. Everybody gets something, even if only a Certificate of Participation.

For Instance, Sunset City only had 1-Star; translation -- Well Below Average, while my mom's vaunted Mushmouth Manor managed 2-Stars, or below Average. Her latest ideal of PassingGo Home wasn't bad at all with an above average rating of 4-Stars.

But these were out of the running for a permanent solution at this point. I needed fresh storage space in the warehouse district of the elderly.

Since Medicare ranked every Nursing Home they came in cahoots with I had some pruning to do. The list did allow you to select by state, so I started with that, but it didn't go so far as allowing the selection of  county. (Later, after more hard-knock education in this field I did find the actual Medicare ranking site and it did allow selection by county, even by individual home. Here is the website to save you the trouble of Google fishing for it if you are ever interested or need it:)

http://www.medicare.gov/nhcompare/include/datasection/questions/proximitysearch.asp?bhcp=1

I then spent an eye-glazing, mind-numbing time scrolling through all the Pennsylvania Nursing Homes and copying all located in my parents' general area to an Excel worksheet. From that list, which in itself was fairly long, I selected those homes rated above average. There were very few near my parents stomping grounds. I then contacted around six homes by email or phone.

Email seemed the better way I found. You could say more and might get a quicker response back. Telephoning connected you to an automated voice allowing you to choose from a menu of buttons just to get to someone's voice mail where you could leave a message, which may or may not ever result in a return call.

From those I emailed, I received an email response, mostly acknowledging they had my email and would contact me in the near future. These places obviously calculate the near future in a different galaxy than mine for I still await that follow-up contact from them.

From the phone calls I received brochures from one, a "Don't call us, we'll call you if we ever decide to care," and a polite but firm turndown from another.

One home did call and invite me to take the tour. My wife and I went on the appointed day and promptly got lost. Once again a road with a hidden part, much like Mushmouth Manor. When we did arrive it was to the wrong building. We finally got to where we were supposed to be and the Admissions Director was very kind and gracious, although we quickly learned there was no hope of placing my parents there. They not only didn't accept her particular form of medical insurance, but they did not accept Medicaid.

Despite this she was extremely helpful and still gave us the tour. This was another lesson learned. Medicaid was not universal in the Land of the Last. I needed more than Medicare ratings, I needed to know who accepted what.

I received about this time a packet from the Department of Aging. Within was a list of the county homes and most importantly whether they accepted Medicaid as well as Medicare. I now changed my approach from less shotgun to more rifle.

TO BE CONTINUED

Part Two: In the Land of PassingGo

Ever since the subject of a Nursing Home reared its ugly roof, I was hearing Mushmouth Manor. It was becoming pretty apparent that wasn't going to happen.

But somehow around this time a new mantra appeared, PassingGo Home. I can't remember who said it first, I just remember I got asked about it and told it was nice. Mom's Speech Therapist also spoke about it to her.

Why an employee of one Nursing Home would bring up another I don't know for sure. My guess is it was an indirect comment and came about from some casual conversation. My mother one time years ago worked for the Valley Maid Potato Chip Company. They really made the best chips around, but eventually they were acquired by Bachman and after that the chips were so-so. One of mom's fellow workers who she had befriended was now a resident in PassingGo Home. Apparently, the Speech Therapist had some business at that Home and when mother mentioned this lady's name told her the woman was in PassingGo.

Now my mother was fixated on that place.

I decided to visit PassingGo next time I went to visit mom. I skipped dad that day and went early, going what I considered a more direct route. It was at least one that took you to PassingGo -- eventually. It twisted and turned about the fields above This City, where my mom was, and I was almost certain I was lost when it popped into vision ahead. A tall building with a curvaceous parking lot and long path up to the front doors.

I went to the receptionist and told her I wanted to get some information about the place.

"Do you have an appointment?" she asked.

"No."

"You should have called and made an appointment," she snapped.

She picked up the phone and called someone. She hung up and pointed me down a hallway.

"Go to the third door on the left and see Maude."

I did as I was told. I came to the third door, which was half open and I saw a couple women inside. One was a somewhat stocky lady with a stern face. Turned out this was Maude, the Admissions Director.

I began to tell my tale of woe when she abruptly stopped me. She took me to meet Madeline Mild, her assistant. Madeline was very sweet. An older lady with a gentle voice. She gave me the ten-dollar tour and then we sat while she showed me the admittance form to be filled out and returned. As we parted she asked me to send her a copy of my mother's insurance cards so they could see if it was acceptable. I said I would.

I then went back to This City and visited mother. At least I could tell her I was at PassingGo.

From that moment on I was to hear PassingGo every visit and then within emails from her friends. I had to get her into PassingGo. When would we hear from PassingGo? How much longer until she went to PassingGo?

But as usual these things took time. I emailed a copy of her insurance card to Madeline Mild the very night of my visit. I waited a week and heard nothing. I called her on the phone. It was her day off, she wasn't there. I called the next day. No, she never got the email. She had been out, she said, and perhaps someone else got it and didn't know what it was. Could I send it again?

I sent it again and then called her again. She was not there; she had left for the day. It was very difficult to establish when this lady actually worked. Finally I got ahold of her and yes she had received the email. She had forwarded the copy of the Insurance Card to the business office. We would have to wait until the business office found out if they accepted that insurance.

I waited a week and called Madeline Mild again.  Gloryoski, she was in, but she didn't have the answer. This time the Business Manager had been gone, all week on vacation. She had just returned and Madeline Mild didn't want to bother her until she got caught up. So I waited some more.

After another week I finally got my answer. Sorry, but PassingGo Home would not accept that insurance. Do not pass GO; do not collect your mother and try to bring her here. Go directly to jail in Sunset City.

I now began a search in earnest. I looked first at the sheet the This City Hospital Social Worker had originally given me and saw I could have saved myself a lot of time and trouble. PassingGo Home was one of those crossed out because it didn't take my mom's insurance.

But even so, my mom and her friends kept up the chants for PassingGo Home as if constantly repeating its name would overcome reality.

As it were, I wasn't quite completely done with the place, but the rest of that story will come later. I had a lot of other stops in-between this end and that end.

TO BE CONTINUED