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Tractor Asked February 2016

Do you have to pay facility $2000 Medicaid lets you keep?

Do you have to pay facility $2000 medicaid  lets you keep? Due to past bill accumulated during time money spent down & qualified for medicaid. My aunts Nursing home has turned me into Adult Protective Services, claiming I must pay the nursing home her whole $2,000 she was allowed to keep when she went on medicaid. I got cross wise with the medicaid facilitator there when she called between my uncles death and funeral. demanding I do my aunts recertification immediately. I did get up set with her and feel this being turned ion Adult protective service is a payback. Now I am being forced to provide bank statements and who knows what else to this case worker. Although my aunts recertification has come through fine and she will now be paying 3 times what she was due to my uncles SS. i am being told my aunt is not allowed to keep this $2000.. thought it is the $2000 medicaid allowed her to keep when she went on medicaid a year ago. They claim there is a $5000 bill due from the gray period when she was spent down to the $2000 and medicaid began to pay. I would love to find where in a law it stats she does not have to spend this, give this to the nursing home. And I wish there was some sort of recourse for me against this malisious act by one nursing home employee. thanks in advance to anyone that can help me!


 


 

igloo572 Feb 2016
Medicaid differentiates between income & assets.
They are allowed to have an asset of usually 2k for individual.
Their income should be used to do required by Medicaid co-pay or SOC ( share of cost is Medicaid speak) less whatever your state has a their personal needs allowance. PNA varies from $ 35 -105 a mo.

Those are the basics for Medicaid. But what a facility can do is based on whatever the contract was upon admission. It sounds like she was private pay for a while, correct? If so, then if there is an outstanding from that period then the admissions contract is what counts. But if she was Medicaid Pending, then Medicaid rules apply.

Hmmmmm, I'd guess you'd like auntie to keep her 2k & tell them to stuff it, right?
my suggestion to perhaps get this done will depend on the answers on? below:
Has this NH ever sent auntie a 30 Day Notice?
Are you personally responsible for aunties NH as per your personal signature on the admissions contract?
Where is her income (like her SS) going?...direct to the NH?
Or is her income direct deposited to Aunties bank account and you or the dpoa is sending a check for the exact amount of her required SOC to the nH?
What is aunties PNA balance?
If auntie has been on Medicaid for a few months, has NH sent you a ledger or statement on debits from PNA? With or without interest?
Does auntie have a preneed funeral or burial policy?
And finally, does this NH work well for auntie or do you envision moving her to another Medicaid facility...like closer to you or with different religious orientation or because this place is a buttrash. & Is moving her a feasible option?

Oh About APS, keep it nice as you likely want to use APS in backing the retention of the 2k in the near future. Most APS inquiries are pretty proforma so if you have good legal preexisting & her bank statements make sense, it's all ok. APS when they are still in the home is lots more invasive and subjective, but that not your situation.

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