Mom was placed in NH rehab after a fall. Hasn't recovered and needs longterm skilled NH. She is still in the NH that she was placed for rehab - on a status of medcaid pending. I just got POA and will be moving her to a private pay (to spend down for a year bc doesn't look like she will qualify right now)... the medcaid NH is facing law suits / not a nice place but costs 600 / day. Private pay will be 150 / day. Am I going to have to back pay the current NH at the 600/day rate for time from when rehab ended and we were in medcaid app pending status ...we never signed anything, they've just allowed her to stay while the app is pending...we have paid a 1k a month "copay"
In order to have been “Pending”, an application to State LTC Medicaid program as well as an admission agreement with acknowledgements and signatures was done. As you were not her POA at the time, the facility did not have to come to you to get any of this done. What likely happened is your mom signed off. There was no “we” needed as mom did the whatevers needed. That a 1K mo copay has been getting paid establishes that mom was aware of, understood and acknowledged LTC Medicaid regulations and the Terms on her residing as a custodial care resident at the facilty. LSS she owes the $.
Fwiw the copay is technically a Share of Cost that is required by Medicaid to be paid to the facility by the applicant starting date of application of almost all of the applicants monthly income less the State set personal needs allowance.
None of the “at need” State programs are run casually. Ditto for facilities. There’s applications and documentation needed. Somewhere someone signed something. There’s reason(s) why mom is now deemed ineligible and the NH gets notified of this. Fully expect the NH to have a private pay bill less the required “copay” that is due in full usually on receipt. If the NH wants to - and they think favorably of your mom and you - they could bill much lower State set LTC Medicaid paid day rate rather than the full tilt private pay day rate. But they don’t have to.
Your mom owes the NH exactly how JoAnn described.
I can’t tell by your post, but if somehow you think you can just stroll out with mom and then ignore the bill, her current NH can make life difficult. Really please you don’t want to go there as stuff like this can snowball and get ugly. Also if they are currently in litigation, they have attorneys on retainer.
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A NH / SNF charging only $150 a day so abt $4,500.00 a month?
Where is this magical place?
$ 4,500 is more what a more no frills Assisted Living charges.
The only I can see a NH / SNF able to be profitable to stay open on $150 a day would be if it’s all a La carte on billing….. $150 daily bed use, AND medication management 2K, AND specialty nursing services 3K, every PT / OT session billed independently, etc. So that this place can get it to the 8K - 15K monthly cost of a skilled nursing facility. OR there’s a bunch of old school nuns running a place with no debt service on the building and doing almost all the care without drawing a paycheck.
$150 a day is kinda the rate paid to an agency for hospice care.
bottom line someone will be paying her bill for the time she was in there.
Get expert advice before you do anything.
Medicare pays 100% for only the first 20 days. 80 to 100- 50 %, meaning if Moms supplimental does not pay Mom owes $300 a day while on rehab from day 80 to 100. She can be discharged anytime within that 100 days. They did not "just allow her to stay" Mom is paying big time. If Mom had rehab for the 100 days Medicare allows and Moms supplemental paid nothing, she owes 24k. at $300 a day. Once that 100 days is done the person is now private pay. Since it seems Mom has money, she should be paying privately. Medicaid applied for about 2 or 3 months before money runs out. If she had no money, then its Medicaid pending and her SS and any pension would have been requested to help offset the cost of her care. If Medicaid is refused, she will owe the NH the full payment of $600 a day. I would wonder who thought a Medicaid application was needed if she can afford to spend down for a yr of private pay? The NH she is in now deserves that money first.