My mom was in a nursing home October 1 and discharged to a Medicaid Assisted Living October 2. When the application to transfer her from nursing home to community Medicaid was approved, it says it is effective as of November 1. When I called Medicaid to ask them to change to October 1, they said since she wasn't discharged from the nursing home until the 2nd, they cannot. They also said that the assisted living shouldn't think they are entitled to her income for October (meanwhile, they wouldn't even allow her to move in without me paying first). They said the nursing home is entitled to all of my mom's October income minus the $50 personal needs allowance. This doesn't seem to make sense considering she was only in there one day.
When I had called the nursing home billing department, they said it was easier to just bill her private pay for the day she was there and refund the rest. They sent the check. I told Medicaid this and asked if I could use that to pay her October rent at the ALP. She stated that she couldn't tell me what to do with the money if the nursing home wanted to send it. This also didn't make sense. I just want to do what is right and not have my mom's eligibility ever questioned. If the money needs to go back to the nursing home, fine, but it doesn't make sense that her entire social security check goes there when she was only there one day.
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To respond to Samantha, she never stopped being covered by Medicaid. Here in NY there are a few kinds of Medicaid coverage. She was covered under chronic care (or nursing home) Medicaid through October. She was then converted and covered under community Medicaid at an ALP (an certified state Assisted Living Program who are the only ones allowed to take Medicaid for Assisted Living.) She does have a spend down under the ALP, but that didn't start until November and she has a pooled trust set up for her spend down that pays her rent.
The type of facility she was in was a nursing home. No, it wasn't for therapy. It was for nursing home care. The primary payer when she was admitted there was Medicaid. Her social security check went directly to the nursing home, less $50 for personal allowance. The rest was paid by Medicaid.
As far as paying rent for a month... what type of facility was it before she transferred to the AL? Was it for therapy? Who was the primary payer when she admitted there? Our admission agreement states a daily rate and that we would refund any amounts owed if patient discharges within 30 days. I suppose each facility's contract is different.
Ugh.. clear as mud?