Follow
Share

Nursing home wants private pay, while resident (who is already admitted) lists house for sale for money. Resident can't apply for Medicaid, until house is sold (it has a mortgage) and money is spent down. No other funds available- Nursing home says POA has to pay or resident will be discharged. There's no one to care or take in resident.

This question has been closed for answers. Ask a New Question.
Find Care & Housing

32 Answers

Most
Helpful Newest
First Oldest
First
1 2
Nursing homes expect and need to get paid, and demand assurances that that will happen.

You can own a home and still apply for Medicaid. Who told you that you have to wait until it is sold?

What other assets need to be spent down? Is there enough to private-pay while waiting for Medicaid?

Unless you signed something making you responsible you do not need to pay the nursing home out of your own funds. But they don't have to keep the resident indefinitely without getting paid. How long has the resident been there?

How certain are you that the house will sell reasonably soon? How confident are you about the price? How many months of NH costs can be paid with the equity you expect from the sale?

I wonder if it might be worthwhile to consult an elder law attorney to get you started on the Medicaid application process and advise you on options for dealing with the NH in the meanwhile.
Helpful Answer (7)
Report
I agree with consulting an elder law attorney. I've been working with one and they are great as they know all those Medicaid rules .
Helpful Answer (4)
Report
Yup, Elder attorney is the way to go, no doubt. You can't blame the NH for wanting to be paid. If not Medicare, then it has to come from somewhere. They are not a charity, and have bills to meet just as we do. They are not obligated to keep your mom without pay. But, along the same lines, as Jeannie says, if you did not sign anything, then they can't hold you responsible for the bills. If you did sign something when you put your mom into the NH, perhaps as a backup if you're mom can't pay, then you could be held responsible for the bills. So best to talk to an Elder Care attorney on behalf of your mom as her POA. The fee might be able to, ultimately, come from the proceeds of the sale of the house, since attaining the services of an attorney for your mom can be counted as being used for her benefit.
Helpful Answer (3)
Report
Yes. You are not responsible as POA for mom unless you personally assured payment Being a POA means you "stand in the shoes" of your mom to deal with the business-side of her life. Always be sure to sign anything, For example, "Mary Smith, POA for Amanda Jones." That makes it clear you are signing on mom's behalf.

I agree with the others here, 1) you shouldn't have to sell her house to apply for Medicaid and 2) the nursing home is a business and has a reasonable expectation to get paid. However, before paying for an attorney, you coud start with your local area agency on aging / county senior services for information. They can direct you to free advuce regarding Medicaid etc. Hope this helps.
Helpful Answer (3)
Report
As POA, you must help resident pay out of her own funds. They have no claim on your assets. I will echo what everyone else says; it's worth it to consult an attorney and the sooner the better. He/she may even tell you that mom can keep the house or somehow shelter it. They have many options to get medicaid and preserve as much of the estate as possible.

I know Medicare pays for x number or days (200 or 365) at 100%. They may consider keeping her as Medicaid Pending status, but for that, medicaid needs to be pending. There is also community medicaid, which is a lot easier to get and takes less time. Once you're on community medicaid, you can be converted to institutional medicaid in the facility. Good luck, and please note, nursing homes are required by law to give 30 days written notice of intent to discharge. You are allowed to appeal that discharge. Worst case scenario, that will buy you some time.
Helpful Answer (0)
Report
contact an Elder attorney asap. when my dad was pending Medicaid, it was 6 or 7 months before they got their money. but with the help of the elder attorney we got things situated so that things worked out. good luck
Helpful Answer (0)
Report
To Christine73
POA is not responsible for bills incurred by the person. Apply for Medicaid and list the house. Some states only allow you to keep the house for a certain number of months.
You cannot apply for Community Medicaid if you are already in a Nursing Home, it has to be Institutional Medicaid.
Call your local Medicaid office and ask if she can apply while her house is on the market and Medicaid will place a lien on the property. They will take back the money that they have paid out before the resident gets any money. The remaining funds will have to be spent on her Nursing Home Bills until she gets below $2000. Then she will be eligible for Medicaid again.
Medicare is not an option Christine73 unless she is coming directly from an INpatient Hospital stay of 3 or more days.
Please don't give inaccurate advice about public programs, it just confuses people.
If a person comes to a nursing home after inpatient hospital stay of 3 or more days MEDCARE ONLY PAYS 100 DAYS. not 200 or 365.
Helpful Answer (4)
Report
lamama, If you refuse to apply for Medicaid, they (NH) want private pay. So apply for Medicaid. If you previously applied and were assessed a penalty, selling the house will not remove the penalty.
As POA, if you moved money or assets out of her name, you could be liable for nursing home costs, as in HCR v. Pittas in Pennsylvania.
Work with a benefits counselor. Most NH facilities can refer you to one at no cost.
Helpful Answer (3)
Report
Good advice above. Lots of it.
BUT...the NH already accepted the person into their care.
While I totally respect they want to be paid for services rendered, they HAVE taken on that person.
So, they will also need to help find a place where the person can be transferred to, if they opt to move them out. They cannot simply dump the person on the sidewalk out front--that is "patient abandonment".
And, they cannot tell the POA to take the elder home with them, either.
They can bill the estate.
The assets up for sale, could be legally liened, I think. Need proper legal advice on how to do that. IF that can be arranged, the NH might be satisfied to wait for the completion of the sale.
Some people in the past, used to sign over their ownership of a house, for instance, directly to the NH, and the NH would then sell it off, and take what is due them. That gives the NH control of the asset, so they might feel more secure about being paid from the money, once it's sold.
Would this place do that?
Also, talk with DSHS and Social Services.
IS there some special arrangement, which would allow assistance for the NH care, while the asset is being sold?
Like, maybe, signing some papers to show that the money gained from the sale of the asset, will go to the NH to pay for care, and anything beyond that would go to the State, to repay Aid? Then after that, IF there is anything left, the residual left over would go to family?

And nope, a POA is not themselves financially responsible to pay the elder's bills out of their own pocket.
The elder, and/or the elder's estate, and/or sale of assets, and retirement funds, SSI, etc., are what is used.
Beyond that, State Aid can help.
A combination of SSI/MediCaid, are commonly used to pay for NH care. There are loads of elders who get stuck in this kind of limbo though, trying to sell off assets, and there being a gap between needing NH care and getting assets sold.
There surely must be ways to resolve it.
Helpful Answer (0)
Report
Unless Medicare made a huge change in how long they will pay for rehab/nursing home, my Mom was only allowed 21 days under Medicare at 100% last year. A few years ago my Dad had the same 21 days.

Then after the 21 days it depends if the patient is improving with rehab or not. If the patient isn't improving and needs to stay in the nursing home, then it becomes either self-pay or Medicaid. If the patient is improving, then Medicare will pay a certain percentage of the care, with the secondary insurance kicking in to help for a limited certain amount.... for a certain set number of days.
Helpful Answer (5)
Report
agency on aging / county senior services for information. Stay away from lawyers.
Helpful Answer (0)
Report
I am seeing some rather incorrect statements here. I think its important for people to avoid writing things that they don't know for sure to be true. Good sources consistently are pamstegma and freqflyer for the record. The poster suggests there is private money which has to be spent down in this case (in addition to the home) before Mom gets down to the Medicaid qualifying amount...so yes POA is supposed to be paying the nursing home for those bills from the patient's money...although not from her own assets. Make sense?
Helpful Answer (4)
Report
Lamama, you said in November that you signed for her unpaid bills when she was admitted. There is also some question about the house being put in the childrens' names. I think you know that is why Medicaid will not pay and why you are stuck with her bill. At this point you need a really good attorney or else you take mom home with you.
Helpful Answer (1)
Report
freqflyer you are correct, rehab stays are different than the 100 days that Medicare pays for ongoing Nursing Home Care. My Dad used the VA for medical so he didn't have any supplemental insurance. During his 100 days he paid out of pocket for the not covered portion of his stay.
He was no longer living in his apartment or needing his cell phone or other expenses so I just canceled everything and paid the Nursing Home with his money. Luckily his income was high enough that there wasn't a large amount he couldn't cover. He lived in GA and it took me years to get him on Medicaid because there was one bank account there that did not have a POA assigned. I froze the account because some young people had his debit card and were taking his SS $ as soon as it was deposited every month. The Nursing home was able to get the SS check transferred to them but I couldn't get the bank to send a statement or close the account. Finally when the NH was threatening to throw him out on the street I got a Bank Executive on the phone and said if they didn't fax the statement to my Dad at the Nursing Home or to the Medicaid Worker I was going to have the NH deliver my Dad to his office and he could figure out what to do with him.
What do you know the bank finally sent the required records to the Medicaid office!!
What a headache!!!!!!!!!
Helpful Answer (0)
Report
Families are often overwhelmed by numerous nursing home admissions documents. Rest assured that family members cannot be required to sign as a “Responsible Party” for payment, 42 USC §1396r(c)(5)(A)(ii), although some facilities have asked family members to “volunteer” to act as a responsible party. The federal law says: “a nursing facility must (ii) not require a third party guarantee of payment to the facility as a condition of admission (or expedited admission) to, or continued stay in, the facility.”

Why do you think that: “Resident can't apply for Medicaid, until house is sold (it has a mortgage) and money is spent down.”? Who provided you with this misinformation?

Medicaid regulations allow eligibility if the applicant is taking steps toward selling the real estate. When the property is sold, the proceeds can be immediately deposited into a pooled trust account that will benefit the nursing home resident, or into a trust that benefits another disabled person. You may miss out on many options if you decide to try to go it alone through this difficult time of transition. An elder law attorney in your state can give you good advice and services that protect you and the nursing home resident.

To read the nursing home law:

https://www.law.cornell.edu/uscode/text/42/1396r

Scroll down to §1396r(c)(5)(A)(ii)

A nursing facility must have identical policies and practices for transfer, discharge, and services, regardless of source of payment. 42 U.S.C. §1396(c)(4). In my state (Massachusetts) state law prohibits nursing homes from discriminating based on a person’s source of anticipated payment. 940 CMR 4.03(1).

Medicaid reimbursements to the nursing home will probably be lower than if you privately pay, but the nursing home cannot require a resident to waive their right to Medicaid benefits.

A nursing home may be motivated to give preference to people who can pay privately, but they are not permitted to require a resident to give up the right to Medicaid benefits by requiring private payment for a time before the resident applies for Medicaid.

http://www.mass.gov/ago/docs/regulations/940-cmr-4-00.pdf
Helpful Answer (0)
Report
Just to set the record straight, POA is never responsible to pay any debt or bill of the person they are serving as POA for. I think my message might have been misunderstood; sorry about that.
Helpful Answer (0)
Report
There are so many conflicting comments on this thread it is a bit confusing. When someone goes from hospital to skilled nursing facility medicare will pay if they have stayed inpatient in hospital for 3 midnights or days. The amount of days they cover is as follows day 1-20 covered 100% day 21-100 covered with copay of 161.00 per day. Day 100 and over not covered. A person must be in need of skilled nursing care or rehab and must be showing progress for coverage to apply. If a person has medicare supplement policy they may cover the 161.00 per day copay as my mothers ins did. Now that being said of a person goes to a nursing home without a qualifying hospital stay medicare pay nothing. It is either private pay or medicaid in that case. We just went through this twice last year with mom so I know the journey all to well.
Helpful Answer (2)
Report
I thought she meant the money from the sale of the house would have to be spent down and I thought she said it had a mortgage, still not sure any of that's accurate; a friend just put her mom in and she was able to apply for Medicaid and her house had a mortgage, question I have if it has a mortgage, who's paying it?
Helpful Answer (0)
Report
debdaughter, in other posts lamama reveals that the house was put in other names. Bad move #1. She also signed as responsible party when mom was admitted. Bad move #2. So she is stuck between a rock and a hard place.
Helpful Answer (0)
Report
pam, think I did see where you had mentioned that, as also thought I saw where you're one our resident experts - do understand where you're coming from, I think, I guess, depending on when it was done? - I'm still wondering about life estates - but especially signing as responsible party - but I was just addressing this post's issue but especially what I felt was a misunderstanding regarding the spend-down funds
Helpful Answer (1)
Report
If you live in one of the states where the state can come after you for the care of one or both parents, then you can be found responsible for their bills, even out of your own assets. I wouldn't just "volunteer" to to be responsible though, and a nursing home can't make you. Even in such a state, they'd still have to go after you under through a lawsuit. It's an unpopular law in most places and I understand legislation is pending to change it in many states.

Whatever you do, don't commit in writing to be responsible for your mom's costs. If you have already done so, then you really should see an elder attorney to see if anything can be done.
Helpful Answer (0)
Report
Does anyone know what states have those laws, and what such a law is called?
Or how to find out if they pertain to your particular family?
Helpful Answer (0)
Report
Filial responsibility laws. Enter term in search box and articles will come up.
Helpful Answer (0)
Report
Other issues that may arise are gifting and look backs. As long as you are in compliance with those state/federal regulations, POA is not financially responsible. Sounds like the NH is just trying to bully someone for payment. If so, the NH should be reported to the appropriate agency. NHs take payments from the state via funds residents have paid in taxes to the state during their working years. Resident is not getting a 'free ride.'
Helpful Answer (0)
Report
My mother was moved from I NH in Mass ton another in NY, I cannot get a
Decent answer. By brother is/was POA, he refuses to let me get a copy of her med records.
She died a week after she was moved.she had a fall a month before the. Move.
Her hea;lath was bad, weak-wasn't in good condition when she arrived at new my. Brother has cut me off,even thought I was her caregiver in my for 13 yrs.
How can I find out about the move- why-the financial situation etc.she was private pay and that ran out,she was at the 1st NH for 2 yrs, but they claim she wasn't a resident. They also said it had something to do with property and assets in nyc. Non one will tell me about this.
I feel something was not right in the whole situation. Can u help?is it impossible form me her daughter, to find outs about her situation up in mass?why am I not allowed to see her medical records?i want to know what happened, I love/loved her and feel like I am being denied info because my brother may have not done everything according to legal standards,please help me-I will wait for your reply.
Helpful Answer (0)
Report
careinhome, what would be the appropriate agency? just read on here somewhere I thought nursing home had to give at least 6 mos. before they started pressing for sale of resident's home; just stopped by a neighbors - never dreamed get involved in yet another situation - she was placed in nursing home, last fall, hasn't been 6 mos. - fell, broke hip, rehab, then long-term, had dementia already - nh telling them they at least have to list house whether sells or not - which then that makes me think and son, who's living in the house, had moved home - when his unemployment, from quitting, other issues won't go into yet - to take care of her, may have said they're saying they're being told that - by Medicaid? - but already is the point, when hasn't even been 6 mos.
Helpful Answer (0)
Report
I am still so surprised that many persons believe that because an individual paid taxes in the past, the state should pay for their nursing home care. That would be a nice world I agree, but the laws are not this way. Government only kicks in at poverty levels...and I mean POVERTY (Your last $2000 in assets or so).
Helpful Answer (0)
Report
I think people are confused about the difference in Medicare and Medicaid.
Helpful Answer (0)
Report
Retain an elder law attorney.
Helpful Answer (0)
Report
where was the post about 6 mos.?
Helpful Answer (0)
Report
1 2
This question has been closed for answers. Ask a New Question.

Recent Questions


Popular Questions


Related Questions

Ask a Question
Subscribe to
Our Newsletter