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kaye99 Asked March 2016

Do they have to pay nursing home charges until she is approved?

My sis is in a NH for dementia. Her family applied for medicaid for her And does Medicade pay for charges from day they applied for it

igloo572 Mar 2016
Also for medicaid applicants, they MUST do the required co-pay or the SOC (share of cost) to the facility every month. The amount is their monthly income less whatever is your states personal needs allowance. The SS monthly income needs to deduct for medicare premium, usually that is indicated in their awards letters so its not included in the $ due but it could get left off - so check for that. The PNAvaries by state from $ 35 -105. Often the residents just pays thier entire income to the NH and the NH places the PNA in an NH trust account for them to draw from for incidentals (like beauty shop) but whomever is DPOA can instead pay just the SOC exact amount and let the PNA build up in their checking account and spend as needed.

If whomever is the DPOA did not get the admissions contract, then they need to get a copy from the business office at the NH. If its a multi -unit NH, this will likely come from their corporate office. For both my moms NH, admissions documents ran about 35 pages with about 7 signature lines.

Angelkw Mar 2016
If your mom was put into the nursing home under the status "Medicaid Pending" she would be able to stay while her medicaid claim is going thru the system. Once approved, medicaid will back pay to the date of application.

However, if your sister is in the nursing home with the agreement to pay out of pocket, or worse, someone signed her in and pledged to be responsible for the payment (look at her intake paperwork to figure out which it is) then yes she or the person who signed her in would be responsible...even if medicaid is pending.

This is very important because many nursing homes press the family to just sign things and get her in...and they don't realize they have actually accepted the burden of paying.

Angel

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