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My wife's skilled nursing facility is billing us one months charges for advanced billing claiming that this is industry standard. We are current with our account and do not want to give them these funds for what appears to be a deposit.

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My MIL's skilled nursing facility is one month advance pay. When FIL died they credited the remainder of his month to MIL's account.
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I'm assuming this is private pay or LTC insurance payment. If 1 month advance is the policy of the SNF, then you can either comply with it or move her to another place. Some AL & SNF require a "buy-in" for admission, so 1 month advance payment is reasonable for a private pay facility. Read through the admission contract to see what the terms were upon admission.

This is hard, but what to you anticipate your wife's long term care needs to be? and will you be able to private pay for the months and months or years of assistance needed? If you anticipate Medicaid will be needed to pay for her care, I'd start to look about now for a "tiered" facility - that would be one that does care from AL to NH to hospice and takes Medicaid. That way she moves along their system as her needs change. If her current place doesn't take Medicaid, I'd speak with the social worker at the facility to ask about what other places she could move to. The social workers are a font of information and deal with this all the time and are usually not the hard sell that admissions does. Also please see an elder care attorney to evaluate how to best use your $$ as you would be considered "the community spouse" for Medicaid and you want to spend down or spend on things that work best for a community spouse. Also you need to think about perhaps changing some things...like most couples have their life insurance so that they are each other's beneficiary, which can be a problem if 1 goes onto Medicaid. The attorney will know what to suggest that works for your state. Good luck.
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