Approaching the finish line?

After many months of phone calls, paperwork, nurse assessments and anxiety, my mother was approved by 12 hours / day of home care by VNS. Today is November 24th and next Monday is the first, only one week away and still things are not quite in place.

Last Thursday I found that the home care agency is waiting for VNS to contact them before they can start services and VNS is waiting for Medicaid to send them their "list" showing my mother is approved. I spoke with a Medicaid caseworker on Friday and was happy to hear that my mother was on the approved list, and they were on board with the arrangements I made to divert John Hancock long term care insurance reimbursement from my mother to the home care agency which will effectively lower her surplus amount significantly (over $3000).

On Thursday VNS stated they were waiting for the list from Medicaid which would arrive on the 23rd and another on the 27th (Thanksgiving). I called VNS today and a worker told me I'd have to wait until they received this list. I expressed my concern that services were supposed to begin in one week but they explained that was procedure. After getting over my exasperation, the worker was sympathetic and stated she'd let me know tomorrow. She called me later today at about 4:00 pm to inform me that they received the list and my mother was on it.

Now I have to call VNS back tomorrow and hopefully get them to give the home care agency the thumbs up to put services in on the 1st of December. My concern is that VNS keeps on talking about the assigned nurse who will come in to do an assessment. This is fine as long as my mother is still getting home care. They seem to imply that the nurse would come in first and then assess again my mother's needs, which is disturbing since choosing VNS was contingent on the 12 hours they told me she would get. I'm staying hopeful that this will work out.

My advice is be persistent and call everyone: Medicaid, the managed long term care company and the home care agency that will be involved. I also found out last week that the home care workers who I had apply to the agency did not complete the process which is yet another area where something can go wrong. Managing the care of a loved one really is like a second job.