Typically the nursing home will absorb the bill (minus the Social Security contribution of the patient) while the initial Medicaid application is pending. They won't evict the patient for non-payment.
6 months isn't that long for a review to be done. My mom's was slightly more than 5 months. Is it such that in your state, it takes 6 or more months OR could there an issue or concern with the paperwork submitted as to her being in compliance with Medicaid's requirements? I'd try to find that out and then base your worry on that.
How it runs in my mom's state is that each NH has a specific state caseworker that get's that NH's applications. You can get their name and then send or fax them a letter asking to be contacted regarding the status of the application. Fax is better than a phone call as a fax establishes a legal papertrail for contact which a phone call doesn't do. My mom's Medicaid application (over 100 pages) was submitted by me to the NH with the documents based on the 1 page list of required items from the NH. In turn the NH submitted my mom's application and her 100+ supporting documents ALONG with their NH invoice to the state for Medicaid reinbursement for her daily R & B costs. This is set by the state and each state has a different rate. For TX it is about $ 145.00 a day the state pays the NH for the elders care - yeah it is low. Some states day rate is much, much higher. You need to know what the rate is BECAUSE if you run into a problem with the application, it will be that rate the NH can bill you if mom was admitted "Medicaid Pending."
Is the facility she is in and was she admitted "MEDICAID PENDING"? If so, then she (& you!!) are OK for her staying there till the Medicaid review is done. If she was not a Medicaid pending admit, you could be on the hook for paying @ private pay rates if there is a Medicaid decline or transfer penalty. Really you should go to the business office and have a detailed sit-down with them. How does it read in the admissions contract as to how they deal with Medicaid acceptance? If you do not have a copy of the admissions contract and her Medicaid application, you need to get a copy which the business office should have.
I'm assuming that mom is fully paying her co-pay to the NH each month less whatever is mom's states "personal needs allowance". You need to know what that is and how it is being handled (you or other family is managing her banking and keeping the PNA, OR is such that the NH getting her checks and they have a PNA trust for her set up). In TX the PNA is $ 60 a month, and I pay my mom's NH from mom's bank account that get's her SS and annuity BUT keep the $ 60 a month in it. Now what is the situation for your mom? and are you or whomever in your family is dealing with mom's stuff paying the NH regularly each month her co-pay less her personal needs allowance? You have to do this to be in complaince for Medicaid admission. I have know of situations where the sibling who is still living at mom's home was keeping the SS check to live on and NOT paying the NH, which is not kosher for how Medicaid works. You want to make sure the NH is being paid their full co-pay each month & check w/business office on this.
The NH does not have to keep them per se, they can have them discharged to another facility. What I've seen happen is that if there are payment issues, the NH will send the resident and whomever signed the contract a "30 Day Notice" - also the state DHHS gets the letter too. In it, it requires that someone has to come to an arrangement with the NH regarding the outstanding bill or mom will be issued a discharge from the NH. No, mom won't be kicked to the curb but it starts the system to have her moved to another facility probably within the next 60 - 90 days. IF you get this it is a total panic situation and the social worker can help you sort it out. Sometimes it takes this point for the state to move the application review into high gear too.
Now in the admissions contract it will probably state how delinquent accounts are dealt with. If the elder signed it, then there isn't much that can be done to collect on the debt if they have nothing. BUT if family signed their name and did not sign it only in their capacity as DPOA then they can be held responsible for the debt. At my mom's old NH, one lady's son (imho a real a-hole) refused to pay or come to an agreement on his mom's debt @ the NH. There seemed to be issues with a big transfer penalty that kept her from being accepted on Medicaid. Anyway it went on for months and she was made a "temporary ward of the state" and transferred to a NH in another county that had a super low occupancy rate and needed residents. He still had to deal with the debt from the NH too, which I assume got turned over to collections as it was big enough $$$ to be worth doing that as he was yelling about it one day I was there. What a charmer, he was.
So find / get the documents and review them carefully. Contact the caseworker to see what might be missing and if it is something that you needed to submit, then fax it over to them asap. Keep open communication with the business office and the social worker at the NH. Good luck and keep a sense of humor!
In addition to the wise commentary by Mr. Heiser and Igloo, I just want to warn you: do not use your signature on any documents in or about the Nursing Home. Let the patient sign. Why? Guess.
I suggest calling your Medicaid caseworker, if they do not respond talk with their supervisor. Also stay in good contact with the nursing home liaison that works with Medicaid sometimes it is the social worker. Start keeping a file and make notes on each person called, date and time for proof regarding your loved ones Medicaid. You can not expect them to stay on top of it, you must be the one to follow up and through.
Yes, LovingMom, I can explain. Life Insurance is a private product, owned by the insured ( most of the time), and sold to consumers with the beneficiary in mind. When the Insured dies, the company who holds the policy will send the to the beneficiary or to his/her estate the proceeds according to contract. No one else can sieze the proceeds. It is no one's business other than the parties involved. Now, if you answer the question on the admittance sheet at the Nursing Home, that this resident does have a life insurance policy, they will try to find out who, what, when ,where and how much. Leave it blank. Contact the insurance company and let them know that you have a death that is imminent, and that you wish to have the beneficiary compensated. The death certificate should go directly to the life insurance company. No middle men, nor any kind of annuity program. Medicaid, a government program, is at the forefront of taking monies for it's recipients, and you need to know the law, in your state, and, as it applies to the beneficiary. Keep in mind that anytime you get free money from the government there are consequences. Keep in mind also, that the government-paid caseworker works for Medicaid, not you. A good elder-care attorney should be on your Rollodex ( old), or your Speed Dial..
Check online for your state's long term medicaid program, Grammyj16. It will provide all the details and it will not be near as bad as you might have heard, if even bad at all. They will not make you go without or kick you out of your home. I know this for sure. But you have to check your state's program to get the details.
Everyone should be advised to let the parent sign themselves into nursing home if possible. I did not as my mom had had seizures and had been in the hospital. I signed as her POA but be careful.
Today I had a nursing home Admission person come to the house to see if mom would qualify. Mom has dementia and has to be shown and told what to do almost every minute of the day. The Admission person called me back and said she had a meeting with the head nurse who told her that Medicaid had made some changes and now Mom needed( 2qualifiers) because Dementia was not enough. Then she asked if mom needed wound care or was she on oxygen,or was she a diabetic. I am in shock. Since it is Friday and after five I will have to wait till Monday to try and find if this is true. I can't take much more I am ready to go to sleep and not wake up. I just can't do it anymore.
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How it runs in my mom's state is that each NH has a specific state caseworker that get's that NH's applications. You can get their name and then send or fax them a letter asking to be contacted regarding the status of the application. Fax is better than a phone call as a fax establishes a legal papertrail for contact which a phone call doesn't do. My mom's Medicaid application (over 100 pages) was submitted by me to the NH with the documents based on the 1 page list of required items from the NH. In turn the NH submitted my mom's application and her 100+ supporting documents ALONG with their NH invoice to the state for Medicaid reinbursement for her daily R & B costs. This is set by the state and each state has a different rate. For TX it is about $ 145.00 a day the state pays the NH for the elders care - yeah it is low. Some states day rate is much, much higher. You need to know what the rate is BECAUSE if you run into a problem with the application, it will be that rate the NH can bill you if mom was admitted "Medicaid Pending."
Is the facility she is in and was she admitted "MEDICAID PENDING"? If so, then she (& you!!) are OK for her staying there till the Medicaid review is done. If she was not a Medicaid pending admit, you could be on the hook for paying @ private pay rates if there is a Medicaid decline or transfer penalty. Really you should go to the business office and have a detailed sit-down with them. How does it read in the admissions contract as to how they deal with Medicaid acceptance? If you do not have a copy of the admissions contract and her Medicaid application, you need to get a copy which the business office should have.
I'm assuming that mom is fully paying her co-pay to the NH each month less whatever is mom's states "personal needs allowance". You need to know what that is and how it is being handled (you or other family is managing her banking and keeping the PNA, OR is such that the NH getting her checks and they have a PNA trust for her set up). In TX the PNA is $ 60 a month, and I pay my mom's NH from mom's bank account that get's her SS and annuity BUT keep the $ 60 a month in it. Now what is the situation for your mom? and are you or whomever in your family is dealing with mom's stuff paying the NH regularly each month her co-pay less her personal needs allowance? You have to do this to be in complaince for Medicaid admission. I have know of situations where the sibling who is still living at mom's home was keeping the SS check to live on and NOT paying the NH, which is not kosher for how Medicaid works. You want to make sure the NH is being paid their full co-pay each month & check w/business office on this.
The NH does not have to keep them per se, they can have them discharged to another facility. What I've seen happen is that if there are payment issues, the NH will send the resident and whomever signed the contract a "30 Day Notice" - also the state DHHS gets the letter too. In it, it requires that someone has to come to an arrangement with the NH regarding the outstanding bill or mom will be issued a discharge from the NH. No, mom won't be kicked to the curb but it starts the system to have her moved to another facility probably within the next 60 - 90 days.
IF you get this it is a total panic situation and the social worker can help you sort it out. Sometimes it takes this point for the state to move the application review into high gear too.
Now in the admissions contract it will probably state how delinquent accounts are dealt with. If the elder signed it, then there isn't much that can be done to collect on the debt if they have nothing. BUT if family signed their name and did not sign it only in their capacity as DPOA then they can be held responsible for the debt. At my mom's old NH, one lady's son (imho a real a-hole) refused to pay or come to an agreement on his mom's debt @ the NH. There seemed to be issues with a big transfer penalty that kept her from being accepted on Medicaid. Anyway it went on for months and she was made a "temporary ward of the state" and transferred to a NH in another county that had a super low occupancy rate and needed residents. He still had to deal with the debt from the NH too, which I assume got turned over to collections as it was big enough $$$ to be worth doing that as he was yelling about it one day I was there. What a charmer, he was.
So find / get the documents and review them carefully. Contact the caseworker to see what might be missing and if it is something that you needed to submit, then fax it over to them asap. Keep open communication with the business office and the social worker at the NH. Good luck and keep a sense of humor!
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Medicaid, a government program, is at the forefront of taking monies for it's recipients, and you need to know the law, in your state, and, as it applies to the beneficiary. Keep in mind that anytime you get free money from the government there are consequences. Keep in mind also, that the government-paid caseworker works for Medicaid, not you. A good elder-care attorney should be on your Rollodex ( old), or your Speed Dial..
They will not make you go without or kick you out of your home. I know this for sure.
But you have to check your state's program to get the details.
I will have to wait till Monday to try and find if this is true. I can't take much more
I am ready to go to sleep and not wake up. I just can't do it anymore.
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