My brother handles this end of things with our Mom's care so I don't have the paperwork in front of me.
He recently got a bill from the nursing home for $3,000 for my Mom, who is a permanent resident there. She has been there two years, was self paying for 11 months till her money ran dry. She did NOT even get to keep her $2,000 that Medicaid allows you to keep. She has been on Medicaid since Jan. 2020. Why on earth have they waited until this point to say something??? The bill is in her name, and when he called they suggested that she only keep $5 of her personal needs allowance and start paying the balance back with the rest.
My brother and I *think* Medicaid is not adjusting correctly for what Mom is paying for her prescription drugs and/or her AARP supplemental insurance THAT THEY TOLD US TO KEEP. We asked more than once about dropping it because it's not benefitting my mom and each time they told us not to. The nursing home filed for Medicaid for us, all we had to do was bring mom's bankstatements, etc to them and sign papers. She was approved right off the bat with no problems.
A telephone hearing is scheduled for later this month with Medicaid. They sent my brother a letter with an access code that does not work, so he could view her information online. It's impossible to get anyone on the phone at that DFACS office and they don't seem to be interested in returning calls. And of course you can't get inside right now.
All we definitely know is that the nursing home is getting every penny that my mom has, except her personal needs allowance. I told my brother not to start turning that over to them until they threaten to kick her out or sue us. We have been mostly pleased with this facility.
Has anyone been through this? Any tips or advice?
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We could find another one, but my brother and I would have to pay for it, so we are hoping to straighten it out ourselves.
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From an article I have
More specifically, the regulations provide a “partial” list of unacceptable uses of the PNA:
1. group activities or entertainment which occurs within the facility;
2. facility-organized parties;
3. medically-necessary drugs, medicines, or medical supplies;
4. funeral expenses, up to $5,400;
5. room and board to the facility;
6. non-customized wheelchair purchase, rental, or repair;
7. physical restraints;
8. transportation to necessary medical treatment;
9. gifts to relatives in excess of $25.00; and
10. medically necessary treatment normally paid for by Medicaid.
We actually paid an attorney to do the Medicaid forms for us, but he never did. He had done a great job on some other legal stuff so we thought he was trustworthy. He is in jail now on several felony charges, for threatening his wife and shooting at police. Pretty sad.