They will be ineligible for payment of Medicaid covered NH services but will be in the Medicaid program if the state determines a penalty. Yeah, total double-speak!!
If when you apply for Medicaid for NH, the state has concerns based on the financial documents provided and required within the Medicaid application or information they discover from state records (for real property like homes, land, vehicles), then the state can do a transfer penalty inquiry. The inquiry will be pretty specific as to the time, the property and amounts that mom/dad or their family have to provide details about.
If you don't provide to the state documentation or information requested that makes plausible sense, then the state can do a "transfer penalty". This is totally sticky to get into. The state isn't going to kick mom to the curb per se. But the NH can use the contract you or someone signed when mom entered the NH to go after you or whomever for payment while there is a transfer penalty. This could be a whole lotta money.
The penalty is based on whatever is your state's daily Medicaid for NH room & board rate. Like for Texas, it's about $ 145.00 a day. Which is low. The transfer penalty has a whole formula in how it's done and it's totally loco to try to figure out. The details will be somewhere within your states Dept of Health & Human Services website. But whatever the case, what the penalty means is that mom/dad, although accepted in the Medicaid program, is ineligible for the state to pay for their NH care through Medicaid. For even more fun, the NH will get a letter notifying them that mom/dad has a penalty.
If mom/dad are already in the NH and entered the NH Medicaid Pending, then the NH will require SOMEONE to either private pay for mom/dad for all the time and until the transfer penalty is paid up OR mom/dad will get the dreaded "30 Day Notice". If that happens you are totally toast on getting in another NH too. Like Much Hated said, they end up back living with family. Or if it gets really bad, they can be made a ward of the state and then the state takes over their care and decides where mom will live. And it won't be the place she was at but more likely get moved to a NH in another county where they are desperate to fill beds. Family has no say as mom is now a ward of the state. Not pretty. This is pretty extreme and most of the time, someone in the family does private pay and works out something with the NH or mom moves in with family till the penalty runs out.
You don't have to pay it back. Medicaid will delay approval of your mom/dad for a period of time. During that time, if mom/dad has no money then the family who received the money should be taking care of her/him.
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If when you apply for Medicaid for NH, the state has concerns based on the financial documents provided and required within the Medicaid application or information they discover from state records (for real property like homes, land, vehicles), then the state can do a transfer penalty inquiry. The inquiry will be pretty specific as to the time, the property and amounts that mom/dad or their family have to provide details about.
If you don't provide to the state documentation or information requested that makes plausible sense, then the state can do a "transfer penalty". This is totally sticky to get into. The state isn't going to kick mom to the curb per se. But the NH can use the contract you or someone signed when mom entered the NH to go after you or whomever for payment while there is a transfer penalty. This could be a whole lotta money.
The penalty is based on whatever is your state's daily Medicaid for NH room & board rate. Like for Texas, it's about $ 145.00 a day. Which is low. The transfer penalty has a whole formula in how it's done and it's totally loco to try to figure out. The details will be somewhere within your states Dept of Health & Human Services website. But whatever the case, what the penalty means is that mom/dad, although accepted in the Medicaid program, is ineligible for the state to pay for their NH care through Medicaid. For even more fun, the NH will get a letter notifying them that mom/dad has a penalty.
If mom/dad are already in the NH and entered the NH Medicaid Pending, then the NH will require SOMEONE to either private pay for mom/dad for all the time and until the transfer penalty is paid up OR mom/dad will get the dreaded "30 Day Notice". If that happens you are totally toast on getting in another NH too. Like Much Hated said, they end up back living with family. Or if it gets really bad, they can be made a ward of the state and then the state takes over their care and decides where mom will live. And it won't be the place she was at but more likely get moved to a NH in another county where they are desperate to fill beds. Family has no say as mom is now a ward of the state. Not pretty. This is pretty extreme and most of the time, someone in the family does private pay and works out something with the NH or mom moves in with family till the penalty runs out.
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