If my mom was kicked out of a nursing facility due to non-payment, can another facility refuse her?

Asked by wiglett  |  Nov 8, 2011

She has been waiting on Medicaid for months and felt it was close to approval. After 9 months of paying out of pocket, we have simply run out of money. They are kicking her out. Can I get her in another facility? Can I keep them from kicking her out? We applied for Medicaid through the facility over 7 months ago. They just recently told us that Medicaid doesn't have it in the system and asked for original application as it would be easier for Medicaid to "scan" it into the system. Apparently, they couldn't do it with a copy. Unfortunately, all this time has gone by and now, they have asked that we remove her by the end of the month because we are beginning to pile up a bill. I feel that Medicaid could have been approved months ago, if they had not dropped the ball. What can I do?

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Carol Bradley Bursack, Nov 9, 2011

Over the span of two decades author, columnist and speaker Carol Bradley Bursack cared for a neighbor and six elderly family members. Because of this experience, Bradley Bursack created a portable support group, the book "Minding Our Elders: Caregivers Share Their Personal Stories."

 

Eddie, you are a gem!
Wiglett, this is awful! It does sound like your mom's paperwork "got lost." The nursing home wasn't following up, or didn't do it right. Work directly with Medicaid and listen to what Eddie says, since he really knows how this works.
Hang in,
Carol

 
 

Eddie

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Nov 8, 2011

W:

Sounds like somebody lost the paperwork and you're going to have to start from scratch. Most facilities won't fuss about a pending Medicaid as long as they're getting paid some other way. (Mine is like that.) The moment they sense $ won't be coming in the easiest thing to do is discharge the person.

Go straight to Medicaid and reapply for that "American Express to Medical Services" card. Mom might not yet into another facility without it.

 
 

Bryn

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Nov 9, 2011

And also get in touch with Ombudsman in your area.

 
 

pablambert

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Nov 14, 2011

Our experience included following up constantly by phone every step of the way and still I had to complete the paperwork three times and transfer ownership of two life insurance policies before my mother was approved. This process is too important to depend on others to do it for you. When your mother is approved, they will pay her back to the date on which she qualified. Whatever you do ... don't give up ... it's better to start from scratch and redo the application if necessary and keep copies of everything. Mother got "lost" in the system when I added documents through our local department on aging office but persistent phone calls got us back on track. Find out who your case worker is and call & e-mail to ensure that all is going smoothly. That approval letter WILL come if you are persistent.

 
 

pablambert

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Nov 14, 2011

Short answer ... sorry, I didn't address your main point ... our nursing home tolerated an unpaid balance, but were getting very antsy after the 4-month mark. Be in touch with the new nursing home and ensure that the medicaid case worker will help you. I don't see them taking her without private pay funds or medicaid in place.

 
 

coach

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Nov 14, 2011

In most cases like this Medicaid will close a file when they have not been provided requested documentation within a given time frame. It could be bank statements, value of life insurance policies, unexplained withdrawals from a checking account, CD's value, pension amount, and the list could go on and on. It is your responsibility to provide all requested documents. Most nursing homes Business Office Managers and the Administrators meet weekly to monitor all Medicaid Pending applications that are being processed. They certainly don't want to have someone staying there for months with no one paying the bill and then suddenly find out that the resident will not qualify for Medicaid and have an unpaid bill of $40K and no way to collect.

But to answer your question, yes the nursing home can request you find an alternative facility. However, they have to give you at least a 30 days notice of discharge, they must assist you with finding another facility and they must make sure it is a safe discharge (they can't just discharge your mom to your house if she requires 24 hour care). I would contact your local Ombudsman and challenge the notice of discharge. That might add another 90 days. In the mean time get all the required documents for Medicaid and don't try to hide anything. Medicaid will find it.

If your Mother is above the Medicaid caps you might want to get the assistance of and elder law attorney or a professional medicaid planner.

Good Luck

 

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