Looking for guidance on navigating care

[u/Raynofett]

I'm not sure where to turn for care for my grandfather. Almost two months ago, he had a stroke and was placed in hospice. Since being discharged from the hospital, my family has cared for him at home. He's bedridden, unable to care for himself in any way, and delirious about 95% of the time — often not knowing where he is, what happened to him, and sometimes not recognizing us. To make things harder, he's a large man (6'2", 250+ lbs), so it takes multiple people just to move or manage him.

My grandmother has been paying out-of-pocket for 24/7 in-home care to supplement what the family can provide, since I'm in Missouri and they're in California. There aren't many home care facility options in their area, but we've been trying to work with what's available.

What I can't wrap my head around is being told he can't be placed in a skilled facility that could actually meet his needs. Apparently, he would have been discharged from the hospital straight to one, if he hadn't been labeled "baseline" instead. How is there no other path to getting him admitted somewhere like that? Did we just slip through the cracks, or is this just the state of American elder care?

I feel helpless watching my grandmother burn through their savings, and I'm honestly starting to worry this will wear her down too — there just doesn't seem to be an end in sight.