Cost of living for the elderly - Nursing homes, etc.

[MN-Investor]

Rather than hijack the thread on giving your money away while still alive, I'm starting a thread about the cost of growing old. I've been involved with my parents' finances since '01 when they moved to be closer to my brother and me. My dad died in '08, my mom died a couple of weeks ago.

I guess the two points of this post are 1) a discussion of how expenses change after you retire and how they may balloon in your final years, and 2) a discussion of the government's role in paying for nursing home costs.

My dad was a physician, first living in a small town in Wisconsin back in the days when doctors did house calls, then, when the long hours started taking a toll on his health, as a psychiatrist at a state medical health institute in Iowa until he retired. Mom was frugal and my parents were savers, so they paid for all seven of us children to attend private Lutheran colleges. Dad made some wise investments (and some not so wise ones), so Mom and Dad were in fine financial shape in their retirement years.

Both Mom and Dad were driving at age 80 when they moved up here in '01 and their health costs were manageable. They could live in their own home. Based on their current expenses at that time, Dad thought they could easily afford to buy two $150K variable annuities, one for each of them, with us children as beneficiaries.

But Mom, with her severe osteoporosis broke a hip. Three months later the other broke. Living on their own was no longer an option. Fortunately they did not have to sell their house (good for them psychologically) to afford to move into an assisted living facility. Mom and Dad lived at the assisted living facility from Nov '06 until Oct '10 (Dad died in Jan '08). The rent on their 2-bedroom apartment was in the neighborhood of $3,700/month. They also paid to have a nurse manage their prescriptions.

By Oct '10, Mom could no longer manage by herself at the assisted living facility, so she moved into a nursing home. The average stay at a nursing home is just over 2 years. Mom was there for 6-1/2 years. When she went in, the daily room rate was $163.03 for someone like her who didn't need a lot of assistance. That translates to almost $5,000/month. I don't know how it works in all states, but in Minnesota the state is involved in the decision of how much a nursing home can charge. There's a whole table of rates depending on the level of care you require. A nursing home cannot charge a private pay person different than a medicaid financed person. Minnesota approved a large rate increase at the beginning of '16. The current room rate Mom has been paying is $274.95/day - basically, $100K/year. That's still for someone who doesn't need a lot of nursing assistance.

So, while you may not be spending all your RMDs and social security at some point in your retirement, that may all change in your later years. Realize that! Plan for it. After Dad died, we children received the payout from Dad's variable annuity. I think all of my siblings asked me if Mom could afford to not have that money. At that time, I told them that Mom was ok. By 2016 Mom's investments were running low. It was either sell the house or cash in her variable annuity. Fortunately enough years had passed so that there was no penalty. Another fun fact: It was with AIG. Fortunately, it was still there.

Do you know what you will do when your health declines? Are you prepared to pay for a nursing home? Have you thought about the costs of your spouse needing nursing room care while you are still living in your own house?

Have you had to deal with your own parents' finances in their later years?

Part of what prompted this post was a comment on another thread which stated:

Jun 27, 2017 19:25:08 GMT -5 @heart2heart said:

I have seen first hand how my government, in one swoop, can nearly wipe out a family's life savings, their assets, and their children's inheritance, (that is, if trusts have not been prearranged properly) to help cover the costs of nursing home care. You have to be extremely wealthy to maintain nursing home expenses.

In my opinion that's the very definition of entitlement. In my humble opinion, if you can afford it, you pay for your own nursing home costs. You don't stick the government with those costs in order to leave money to your children. On the other hand, I don't want one spouse to be penniless because of the other spouse's nursing home costs. That's just tragic.

[swamp]

It kills me when people say, "I dont' want the government to take my money if I go in a nursing home." No, sweetie, the government isn't taking your money. You are paying for your care. And if you have the money, you should pay for it.

Private pay nursing home is about $10k a month here.   I'll pay as long as I can, then I have no problem going on Medicaid.  I paid in plenty.   

[The Walk of the Penguin Mich]

Those numbers are about what I have seen.

When I went to rehab, I was in a nursing home.  The social worker explained to me that my insurance company was not willing to pay $3000/day for me to be on the orthopedic ward when a nursing home would cost $300/day....or $9000/mo.  This was in 2012.

[Lizard Queen]

People should pay what they can, but it shouldn't cost so damn much, either.

[Deleted]

Totally agreed with you on the people who want Medicaid to cover their nursing home costs and still hold $$ aside to leave to their heirs (although I think the rules about how much the spouse at home can keep are really stingy- in effect the spouse is "sentenced" to dependency on Medicaid unless they have enough assets for two nursing home stays).

I should be able to afford a decent nursing home since most of my other expenses will disappear- home, car, travel, (probably) church pledge, etc.  and at that point I'd sell the house, which I'll own outright when I'm 77.  The only major item that will remain is out-of-pocket medical and dental.

I'm also aware, having been married to a man 15 years older, that as you age you need things that will enhance the quality of life and make it less dangerous/strenuous.  Hearing aids, glasses and dental care aren't covered by Medicare.   You need to hire out more work around the house.  You're less open to "roughing it" when traveling- Business Class on long hauls is more restful, you may want a hotel closer to the attractions rather than a 15-minute walk and a subway ride away, you'd rather get a private car to and from the airport rather than dragging your stuff on and off public transportation.  I'm hoping that as I enter the stage where I need to hire more out, I'll be less inclined to travel to exotic destinations and that will be a wash.

[kittensaver]

I agree with swamp . If you have the money, you should pay. It is fundamentally dishonest to hide behind loopholes in the laws [although many people do it!] just so someone down your family line can have an inheritance.

It irks me no end that the same folks who *love* judging and bashing poor people for their use of government benefits are *some* of the same ones who have no issues with transferring property, setting up trusts, offshoring accounts and hiding behind tax laws so they can access government benefits intended for folks who are truly impoverished. *SMH*

As far as planning for us (me and DH): all I have to say is that it will be interesting. On my side, one parent died suddenly when I was young; the other is 94 and still living in her own home. So no nursing home experience there (at least yet). She keeps talking wistfully about a *very* pricey assisted living place in her community (where they wait on you hand and foot), but she lives on a fixed income (SS payments) and a reverse mortgage, and there's no way in hades she can afford it. We can't afford it either! It's one of the things I worry about when I'm staring at the ceiling at night trying to fall asleep (how to find a decent Medicaid nursing home should she need it).

On DH's side: his folks moved to assisted living for what turned out to be the last few years of their life. FIL had a government pension and retiree healthcare, she had social security and together they had investments, so they paid cash each month. In the early 2000's it was about $3500 per month for the both of them. I'd hate to think what it is now! When she died and assisted living could no longer care for him/dementia, we moved him to a private pay home. It was just slightly more for him-only than what they'd been paying for the two of them in assisted living. He had just under 2 years of payments left in his portfolio when he passed away, so we never had to face dealing with Medicaid.

We are hoping to keep ourselves healthy and age in place. So far so good! But the one thing I DO know: if we need nursing care, we will be spending what we've saved first and then apply to Medicaid. No one in our lives has any expectations of getting money from us.  

[MN-Investor]

Jun 28, 2017 15:36:06 GMT -5 Lizard Queen said:

People should pay what they can, but it shouldn't cost so damn much, either.

I don't think the nursing home aides are getting rich. I don't know where the money is going and how much profit margin there truly is.

I think there also needs to be better end of life discussions with the elderly before they arrive at a nursing home. It's so easy to say "Mama would want us to do everything possible to keep her alive as long as possible" when what Mama really wants is to just go to sleep and wake in Heaven. Extraordinary means can be painful, expensive, and not very effective. CPR on my mother with osteoporosis would have broken every rib, for example. It's not morbid to have these discussions. It's important.

[Deleted]

Is long term care insurance no longer a good idea? 

[kittensaver]

Jun 28, 2017 15:56:48 GMT -5 minnesotapaintlady said:

Is long term care insurance no longer a good idea? 

I think it's a personal decision. The plans we looked at were relatively expensive and had lots of exceptions and exclusions. And they only paid out for a certain number of years in certain settings.

We debated it, and in the end starting putting what would have been a monthly premium payment into savings. *fingers crossed* we will either not need large chunks of it or it will last long enough should we need it. JMHO YMMV

[suesinfl]

Jun 28, 2017 15:53:53 GMT -5 MN-Investor said:

Jun 28, 2017 15:36:06 GMT -5 Lizard Queen said:

People should pay what they can, but it shouldn't cost so damn much, either.

I don't think the nursing home aides are getting rich. I don't know where the money is going and how much profit margin there truly is.

I think there also needs to be better end of life discussions with the elderly before they arrive at a nursing home. It's so easy to say "Mama would want us to do everything possible to keep her alive as long as possible" when what Mama really wants is to just go to sleep and wake in Heaven. Extraordinary means can be painful, expensive, and not very effective. CPR on my mother with osteoporosis would have broken every rib, for example. It's not morbid to have these discussions. It's important.

This was my sister with my mom. Mom had started losing her memory in her late 60s and finally  passed when she was 88. A couple of years before she died mom had pneumonia and bronchitis. She could no longer get out of bed, feed herself or tell you her name. Everyone said not to treat it and just make her comfortable until she passed. Nope Sis told the doctors to do what they had to do to make her well. My mom would not have wanted that and everyone knew, but Sis kept believing in miracles.  

[souldoubt]

Jun 28, 2017 15:36:06 GMT -5 Lizard Queen said:

People should pay what they can, but it shouldn't cost so damn much, either.

If someone needs 24 hour care even if you have that at home for $12 an hour for a full month that can almost cost you 9K a month.  I know based on my wife's experience a lot of the people working at those places aren't raking it in as it's not a lucrative career.  I'm sure some in administration make good money but those places also have a lot of insurance and overhead costs.  They can get pricey especially depending on the level of care one needs but the good ones schedule activities and keep residents involved and active while providing 24 hour care.  Keeping them involved and active keeps them sharp as I've seen first hand and I'm sure you have that when people stop moving and stop having hobbies/chores/whatever their mind and body goes.  You're paying for care but also for peace of mind.   

[Deleted]

Jun 28, 2017 15:53:53 GMT -5 MN-Investor said:

I think there also needs to be better end of life discussions with the elderly before they arrive at a nursing home. It's so easy to say "Mama would want us to 'd everything possible to keep her alive as long as possible" when what Mama really wants is to just go to sleep and wake in Heaven. Extraordinary means can be painful, expensive, and not very effective. CPR on my mother with osteoporosis would have broken every rib, for example. It's not morbid to have these discussions. It's important.

Totally agreed. I cringe at the thought of them trying to do CPR on a lady with osteoporosis! DH and my mother both decided after receiving terminal diagnoses that they didn't want aggressive treatment with a 3% chance of success. Both died quietly at home with support from hospice. Hospice, at least, is a positive development. My Ex also died in hospice- he had no written directives but fortunately all of us (DS, who had the final say, plus my X-SIL plus DS' pastor plus DH and me) agreed- "let him go".

OTOH, there's an elderly couple who used to belong to my church- not sure of their ages but they've been married 52 years. She got aggressive leukemia and a stem cell transplant failed. I'm not sure how she even got one at her age- while they can be miraculous, more often you end up fighting graft-vs-host disease in one or more of its ugly forms and that can kill you. A year later, the leukemia is back.  Her husband, in the meantime, developed esophageal cancer and the family started a GoFundMe account for their OOP medical expenses. The goal is $75K and they've raised only $3K.

[giramomma]

Jun 28, 2017 15:44:34 GMT -5 @athena53 said:

I'm also aware, having been married to a man 15 years older, that as you age you need things that will enhance the quality of life and make it less dangerous/strenuous.  Hearing aids, glasses and dental care aren't covered by Medicare.   You need to hire out more work around the house.  You're less open to "roughing it" when traveling- Business Class on long hauls is more restful, you may want a hotel closer to the attractions rather than a 15-minute walk and a subway ride away, you'd rather get a private car to and from the airport rather than dragging your stuff on and off public transportation.  I'm hoping that as I enter the stage where I need to hire more out, I'll be less inclined to travel to exotic destinations and that will be a wash.

This is what we've seen with the inlaws, sort of.

They used to be in town 5-6 months a year. The rest of the time was spent at a cabin, traveling in the US and abroad.

When they hit 67 or so, they just could not do back to back trips anymore without getting run down/sick. (We're talking being gone a month, coming home, and leaving for Europe two days later).

Now they are in their early 70 and have hired a cleaning service. They cut their travel time down to maybe 2-3 months out of the year. Much of their travel time is spent going to BILS to hang with the newest grandchild. They take 10-14 days for each trip. They also drive, because it's still cheaper than flights, and they can stop and see things on the way down and back.

I didn't know this, but MIL is already offering to watch the child that I'm currently growing. We didn't ask. In general, we do not rely on them for child care due to their extensive travel. They did watch the peanut one day a week for us when money got really tight for us. 2 years later, MIL still talks about how much she misses having the peanut around. However, I think they are realizing that their relationships with BILs kid (and future one that will come in another 2 years) and our last will be much different than the relationship DS has with them.

I think their priorities have changed, in that they want to get to know their all grandkids, while they are still able bodied. Which means they are giving up the extensive travel. I think they are OK with it.

[Lizard Queen]

Jun 28, 2017 17:06:36 GMT -5 souldoubt said:

Jun 28, 2017 15:36:06 GMT -5 Lizard Queen said:

People should pay what they can, but it shouldn't cost so damn much, either.

If someone needs 24 hour care even if you have that at home for $12 an hour for a full month that can almost cost you 9K a month.  I know based on my wife's experience a lot of the people working at those places aren't raking it in as it's not a lucrative career.  I'm sure some in administration make good money but those places also have a lot of insurance and overhead costs.  They can get pricey especially depending on the level of care one needs but the good ones schedule activities and keep residents involved and active while providing 24 hour care.  Keeping them involved and active keeps them sharp as I've seen first hand and I'm sure you have that when people stop moving and stop having hobbies/chores/whatever their mind and body goes.  You're paying for care but also for peace of mind.   

24 hr care at home would be 1:1 ratio. At a nursing home, it's nowhere near that. In assisted living, I imagine it's even that much less. So we're not comparing the same level of attention. I agree that the front line folks are getting the shaft much of the time.

[zibazinski]

Has anyone ever been in a nursing home that doesn't reek of shit? That enough makes me cringe.

[MN-Investor]

Jun 28, 2017 17:40:20 GMT -5 zibazinski said:

Has anyone ever been in a nursing home that doesn't reek of shit? That enough makes me cringe.

My mother's nursing home was great. When the new hospital was built (only about a mile from my folks' house) they added a long term care center wing. It was bright and clean with many large windows. The staff was outstanding too.

[Bonny]

Jun 28, 2017 15:20:40 GMT -5 swamp said:

It kills me when people say, "I dont' want the government to take my money if I go in a nursing home." No, sweetie, the government isn't taking your money. You are paying for your care. And if you have the money, you should pay for it.

Private pay nursing home is about $10k a month here.   I'll pay as long as I can, then I have no problem going on Medicaid.  I paid in plenty.   

But Swamp, didn't your folks transfer their home to their children's name as prep for Medicaid?

I have a hard time wrapping my head around some of the stuff my folks have done. Mom has passed and I was so grateful that her disease progression was so quick because I would have hated to try to deal with her health issues at the same time as dealing with her creditor problems including having her home go into foreclosure.

Dad is technically gaming the system by being on the poverty level Medicaid health plan while living in his long-term girlfriend's house and handing over his $1200 SS check and buying groceries with his $50/mth in food stamps. I can live with that scenario because that's a lot cheaper for the taxpayers than him also living in subsidized housing. I wonder how he is going to be affected if the Medicaid subsidies are yanked from the states if the GOP pushes its program through. Talk about reaping what you sow! He's a Fox News parrot and I don't think has a clue what's coming.

My biggest concern is when it's time for him to get into nursing care and whether there will be space for a Medicaid patient. I suspect that in an area like San Diego County which has a lot of retired people that there may be a long waiting list and that I'm going to get stuck funding his care for the first two years. Given the stories I've shared about how money was handled in the household  I grew up in you can understand how resentful I feel about the situation.

[souldoubt]

Jun 28, 2017 17:21:21 GMT -5 Lizard Queen said:

Jun 28, 2017 17:06:36 GMT -5 souldoubt said:

If someone needs 24 hour care even if you have that at home for $12 an hour for a full month that can almost cost you 9K a month.  I know based on my wife's experience a lot of the people working at those places aren't raking it in as it's not a lucrative career.  I'm sure some in administration make good money but those places also have a lot of insurance and overhead costs.  They can get pricey especially depending on the level of care one needs but the good ones schedule activities and keep residents involved and active while providing 24 hour care.  Keeping them involved and active keeps them sharp as I've seen first hand and I'm sure you have that when people stop moving and stop having hobbies/chores/whatever their mind and body goes.  You're paying for care but also for peace of mind.   

24 hr care at home would be 1:1 ratio. At a nursing home, it's nowhere near that. In assisted living, I imagine it's even that much less. So we're not comparing the same level of attention. I agree that the front line folks are getting the shaft much of the time.

Of course not but at a nursing home they generally have a wider variety of services and more importantly a bigger skill set between all of the people working there.  The place my wife works at the person who oversees all of the caregivers is a nurse, they have people who are knowledgeable about dealing with people who have Alzheimer's and dementia, music therapy, comfort/therapy animals, daily activities and the list goes on.  At minimum wage or close to it you get one of the caregivers who can give you good 1:1 care but that individual isn't going to know as much about healthcare, Alzheimer's, dementia and the list goes on.  If we're talking about one of those corny commercials on TV where someone comes out to hang out with an elderly person who is more or less self sufficient that's one thing but the more help you need or the more your body and mind are failing a nursing home is generally a better option.  

[MN-Investor]

I remember when my mom first went into the nursing home. She kind of thought "This is it, I'm always going to be confined to this facility." We quickly disavowed her of that idea. Yes, she was living there, but when her children were visiting from out of town and staying at her house, we would bring her over to the house for the day. My DH and I live about 35 minutes north of Mom's town, my brother and his wife and four young daughters live 35 minutes south of Mom's town. That made it easy for us to celebrate birthdays at Mom's house with Mom attending. Plus we could take Mom down to her granddaughters' plays and concerts in my brother's town. The biggest change was that Mom was mostly at the nursing home. Her time with relatives was not reduced. Psychologically, that was good for Mom.

It was only the last 2 years where Mom's mobility was so reduced - instead of being able to use a walker, she was confined to a wheelchair - that we could not bring her over to the house. We brought the celebrations over to the nursing home instead.

[The Walk of the Penguin Mich]

Jun 28, 2017 17:40:20 GMT -5 zibazinski said:

Has anyone ever been in a nursing home that doesn't reek of shit? That enough makes me cringe.

Yes.  The one I was in was excellent.  My biggest gripe was that it served only Kosher food, and overcooked everything.  But it definitely did not stink.

[dannylion]

My mom had a debilitating stroke at age 87 that made her dependent on skilled nursing care. My folks were living in a continuing care retirement community at the time, so she was cared for in the community's nursing center. Dad spent most of every day with her until she passed away 3 years later. The cost of the nursing home in addition to the fees for their independent living house Dad was still living in was about $10,00 per month.  Fortunately, they had the resources to pay for all the care they needed. Dad lived another 3 years, most of it independently, only requiring skilled nursing care for the last few months.   

Since I don't have any family, whatever care I receive will be from paid professionals. I hope to be able to stay in my own home, wherever that might be in the future, as long as possible with in-home caregivers, but if nursing home care is required, then that's what I will have to have.  I have sufficient assets to provide for my care, and if the stars align and the financial markets cooperate, it is possible I will be able to cash-flow the cost.  If not, I will liquidate assets as needed. I understand how very fortunate I am not to have to worry about care as I age and need more help.

I hope I can find a continuing care community that serves my needs as well as the one my folks lived in did theirs.   

[dannylion]

Jun 28, 2017 17:40:20 GMT -5 zibazinski said:

Has anyone ever been in a nursing home that doesn't reek of shit? That enough makes me cringe.

My mom was in a facility in Pennsylvania that was maintained in a very clean state.  (It was a Mennonite facility).  In the event of an accident or even the hint of an unpleasant odor, the room in question was scrubbed from top to bottom to return it to an acceptable state. 

The food was really good, too.  Nothing fancy but well planned and well prepared. 

[zibazinski]

I hope I end up in one like that if I need to. I'd hate for my family to have to put up with that stench while visiting me. I'm assuming I'll be so far gone I won't know it smells like shit.

[Deleted]

I've never been in a stinky one, but some are kind of depressing. 

[Shooby]

Jun 28, 2017 15:36:06 GMT -5 Lizard Queen said:

People should pay what they can, but it shouldn't cost so damn much, either.

We always say what something shouldn't cost. But what SHOULD it cost?  What do you think is reasonable for round the clock care?

[swamp]

Jun 28, 2017 18:00:18 GMT -5 Bonny said:

Jun 28, 2017 15:20:40 GMT -5 swamp said:

It kills me when people say, "I dont' want the government to take my money if I go in a nursing home." No, sweetie, the government isn't taking your money. You are paying for your care. And if you have the money, you should pay for it.

Private pay nursing home is about $10k a month here.   I'll pay as long as I can, then I have no problem going on Medicaid.  I paid in plenty.   

But Swamp, didn't your folks transfer their home to their children's name as prep for Medicaid?

I have a hard time wrapping my head around some of the stuff my folks have done. Mom has passed and I was so grateful that her disease progression was so quick because I would have hated to try to deal with her health issues at the same time as dealing with her creditor problems including having her home go into foreclosure.

Dad is technically gaming the system by being on the poverty level Medicaid health plan while living in his long-term girlfriend's house and handing over his $1200 SS check and buying groceries with his $50/mth in food stamps. I can live with that scenario because that's a lot cheaper for the taxpayers than him also living in subsidized housing. I wonder how he is going to be affected if the Medicaid subsidies are yanked from the states if the GOP pushes its program through. Talk about reaping what you sow! He's a Fox News parrot and I don't think has a clue what's coming.

My biggest concern is when it's time for him to get into nursing care and whether there will be space for a Medicaid patient. I suspect that in an area like San Diego County which has a lot of retired people that there may be a long waiting list and that I'm going to get stuck funding his care for the first two years. Given the stories I've shared about how money was handled in the household  I grew up in you can understand how resentful I feel about the situation.

No they did it to avoid probate.  But they don't have much money anyway.  If the Time comes, I'll sell it.  I don't want their money, nor do my siblings.  Were all doing fine. 

[suesinfl]

I'm hoping that I never have to put my kids through all of this stuff. That doesn't mean I haven't talked to my kids, but I would really just like to go quietly without needing all the medical care/facilities.  

[zibazinski]

Jun 28, 2017 19:21:38 GMT -5 Shooby said:

Jun 28, 2017 15:36:06 GMT -5 Lizard Queen said:

People should pay what they can, but it shouldn't cost so damn much, either.

We always say what something shouldn't cost. But what SHOULD it cost?  What do you think is reasonable for round the clock care?

Round the clock care? Skeleton staff at night. God forbid you really need any help, you can wait forever. One of my aunts was in a nursing home recovering from a stroke so her mind was functional, her body was needing some rehab. She ended up going to the bathroom in her pants while two employees sat at the desk. I had asked them to help me with her. Nope. Never got around to it and I watched them just sit there. Then they had the nerve to complain that she'd wet herself. I got ahold of the administrator the next day. She could have cared less. Thanks but no thanks. The typical 30 days of Medicare paying for rehabilitation. I know plenty about therapy and when I started questioning the therapists, her care and treatments improved so she did as well. You have to know what's going on or you'll get treated poorly. Or not at all.

[Lizard Queen]

Jun 28, 2017 19:21:38 GMT -5 Shooby said:

Jun 28, 2017 15:36:06 GMT -5 Lizard Queen said:

People should pay what they can, but it shouldn't cost so damn much, either.

We always say what something shouldn't cost. But what SHOULD it cost?  What do you think is reasonable for round the clock care?

First of all, we should recognize it for what it really is: 24 hour availability, not 24 hour care. There is a ton of down time in there, and assisted living? Probably more like on call round the clock, with housekeeping and meal service.

I'm not talking so much about bed ridden patients, but someone mentioned paying $100k/year for very little actual assistance. That is both unreasonable and unaffordable for most people for any length of time. It should cost less overall for people to be in a group living situation with care, than the same amount of care paid for at home. Group care, many have studio apartments or even share rooms, not a whole house to themselves. They are sharing availability of helpers. There should be economies of scale.

[Lizard Queen]

Jun 28, 2017 19:58:55 GMT -5 zibazinski said:

Jun 28, 2017 19:21:38 GMT -5 Shooby said:

We always say what something shouldn't cost. But what SHOULD it cost?  What do you think is reasonable for round the clock care?

Round the clock care? Skeleton staff at night. God forbid you really need any help, you can wait forever. One of my aunts was in a nursing home recovering from a stroke so her mind was functional, her body was needing some rehab. She ended up going to the bathroom in her pants while two employees sat at the desk. I had asked them to help me with her. Nope. Never got around to it and I watched them just sit there. Then they had the nerve to complain that she'd wet herself. I got ahold of the administrator the next day. She could have cared less. Thanks but no thanks. The typical 30 days of Medicare paying for rehabilitation. I know plenty about therapy and when I started questioning the therapists, her care and treatments improved so she did as well. You have to know what's going on or you'll get treated poorly. Or not at all.

Exactly