What if the nursing home signed my mom up for Medicaid without my approval and then hid it from me?

I will definitely keep everyone updated. Sorry I have been so quiet lately. I have an upcoming OIG court date, and have been dealing with the Federal Postal Police and FBI Fraud department, along with numerous other departments. It is absolute chaos, and I can't find an attorney to help me.

Medicaid is helping, but pressing charges has proven to be very time consuming and financially horrible.

Thanks for everyone's support!

She has no funding, which is how I found out the Medicaid because I tried to apply for her. There are pending cases now with all of the correct departments. We got lucky because an employee signed her up. Not us as her POAs and Guardians. We got lucky to get our hands on those papers before they disappeared too.

I need to post the number of departments to call for all of this kind of stuff. I did not know there were so many people to report to. It's a long list. Once I get done with my first preliminary hearing next week, I will post some helpful information for everyone.

It does sound awfully complicated and confusing.

The NH has been double billing. I pay for a Long Term Care insurance policy on her. I was getting those receipts because it is a plan that I provided to them. They were collecting over $7,000.00 per month from that policy, and then applied for Medicaid on top of that and collecting another $6,000.00 from them, on a Private room. Yesterday I just found out that they were also billing for Physical Therapy visit through a BCBS BCCHP plan they signed her up for, and she is completely immobile and incontinent. They are actually reporting that she is walking in the NH Physical Therapy department. I about fell over when I got those bills. I was on the phone with more Fraud cases today. I have never in my life thought that one NH and Managment would ever do something so criminal in my life to a woman that has the onset of Dememtia. Talk about a Hot Mess.

They have not filed for Guardianship. We have the State filed Papers. We are the State Filed Durable POAs, Healthcare POAs, and Guardians. That is why there is an open Fraud case going on.

The Ombudsman is new to her position, so she can only answer so many questions.

That would answer a number of questions.

Irregular admission paperwork, so maybe no copy of POA on file, and a spouse that won’t pay the bill.

But wouldn’t the new guardian have gathered control of the income and assets that the (old?) POA has been using to pay legal bills?

Thank you so much. I'm so frustrated and angry at this facility. I tried to get them to help me and answer some questions, and their Corporate Legal team sent me an email that they have nothing to say to me.

I tried to talk to them. Their Legal Team at Corporate sent me an email stating that they did not have anything to say to me.

It took more 4 months, $10,000.00 in attorney fees, and the Illinois State Ombusdmen to even get her medical records, because they found out their computer program had a safety net, and all of their records that they thought they had deleted were still able to be retrieved.

Now as her Healthcare POA they won't even communicate with me, and I can't get another facility to take her because I'm literally in limbo with her Medicaid. I'm sorry for the long rant. I really just don't know what to do.

OIG knows that she doesn't qualify, and no, the facility didn't have me sign her application because they were in lockdown because of Covid. I have the original application and it says that my Mom is Married and that she is a Private Pay. OIG isn't concerned about the Fraud in this department. Someone else is looking into that mess, but why do the look back when I know that she is just going to get denied. When her and her ex husband got divorced 4 months ago, they were still bringing in over $8,000,00 a month from Social Security and their Pension accounts, and he had over $500,000.00 is 401Ks, Pensions, Stocks, etc.

I'm not sure why I need to do the 5 year look back when I can give them all of this information showing that they illegally signed her up. The insurance Medicaid care plan coordinator even filed fraud charges against them. I just don't understand or know what to do.

She was deemed unable to make an Financial, Legal, or Medical decisions by a doctor, 3 years after the POA documents were done, and the facility was aware of this also. The Administrator of the Nursing Home knew that my Mom was married, and did not qualify for Medicaid, but got tired of fighting her husband for her Private Pay Room Rate. The Admin. signed my Mother up leaving all of her Admin information on the application that my Mom didn't sign. They have admitted to the Police that they have been illegally opening all of my Mom's mail and shredding all EOBs and Insurance cards, so I never found out that she was on Medicaid.

It's been an absolute nightmare. I have all the proof, but why do the 5 year look back? I know that she isn't going to qualify because of her husband's income. But she put on the application the My Mom was Never married, never owned a home, hadn't filed taxes in 5 years, and didn't own a vehicle. All of which was completely untrue, and have email back and forth about Mom's Long Term Care insurance and no payments from her husband. I even asked them once about Medicaid qualifications once they got divorced and they said that we could discuss how to get her signed up them. SHE ALREADY WAS. Now I can't move her and OIG is wanting a 5 year look back. She isn't going to qualify, and I never signed a single document, and neither did my Mom.

Do I just tell OIG there's no reason for the financial look back and apply from the date her divorce was finalized, or what? It's such a mess.