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KROGER123456 Asked January 2017

Can a nursing home release someone because they can't pay the new cost while on Medicaid?

Hello I have a friend who dad is in nursing home he had dementia 24 ho  Under Medicaid And she was told  that her dad cant stay there anymore. care wandering And is doing good in the nursing home And now the nursing home Is going to release him Because she cant pay the extra income there added on When she put in The nursing home is was 1.600 And now they said they owe 2.000 What are the medicad laws And can they do that She is very upset Doesn't know what to do Thank you Carolyn

zythrr Jan 2017
They drain his account to pay for his care, esp if he is on Medicaid. Outside expenses, too bad so sad, unless relatives/friends want to foot the bill.

ASusan48 Jan 2017
Pam is exactly right. If for some reason, Dad's entire SS check is not being turned over to the nursing home (except for the small amount they allow you to keep for his personal necessities, about $60 per month), they can and will evict him for non-payment. There is no law that says they have to keep him if he is not in compliance with the financial rules that apply to Medicaid residents in a NH.

Let me give you a scenario:
My mother was in a local NH and I was in charge of paying her bills. They tried placing her with a few roommates, but none of them worked out. The first was yelling at mom all the time and very angry, which was depressing to Mom. The second was near death and non-communicative, and Mom was on the non-window side of the room, closed behind a curtain all day and couldn't even see sunlight - again, depression set in. Finally, I decided she needed a private room until a more suitable roommate became available. Mom was very happy in her private room, but the added expense was $450 a month that had to come out of my pocket, because her entire SS check was already going to the NH to pay her portion of the Medicaid agreed cost - the "patient pay" portion. Siblings would not help with the expense, and it quickly became more than I could handle. I set up a payment arrangement with the NH administrator and finance manager, and they worked with me. Unfortunately, "corporate", the owners of the NH, didn't see it that way. They assumed immediately that I was on the take and running off with Mom's money every month, even though I was making weekly payments on the balance to pay it and get ahead of the balance. "Corporate" wanted to attempt to take guardianship of my mother over this, believe it or not. The kind folks at the NH stepped up to bat for me and explained to the corporate jerks that I was not doing anything illegal or even remotely unethical with my mother's money - that out of 4 children, I was the only one paying the bill, and they needed to give me time to take care of it.
If I had not had someone in my corner at the NH level, Mom would have been taken from me and I would have been powerless to stop it. If I fought them on the guardianship thing, they were simply going to kick Mom out with a 30-day notice.
That's how fast these things can spin out of control.

Make sure your friend understands that Medicaid requires that the entire SS check be turned over to the NH for the patient pay portion of the bill, except for the small amount allowed for personal need. That's something that is absolutely non-negotiable and is grounds for eviction if not complied with.

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Sunnygirl1 Jan 2017
Usually, the recipient keeps a modest amount, like $60., but, all of their other income has to go to the facility and then Medicaid adds more to it, so that it totals the Medicaid rate. The recipient can't pay any other bills. They can only use that modest amount they keep for personal things like out of pocket meds, clothes, toiletries, personal items, etc.

pamstegma Jan 2017
Kroger, her dad can't stay there if she does not give them his entire SS check. She cannot hold money back to pay other bills.
I recently had a patient whose Medicare ran out; she refused to apply for Medicaid because "they take my whole check". She was given a 30 day eviction notice. She is now living in a shelter.

Sunnygirl1 Jan 2017
I don't know her dad's particular situation, but, it's my understanding that if a resident is on Medicaid, and the facility accepts Medicaid patients, the facility is required to accept as full compensation the Medicaid rate. So, that the facility cannot come after the resident for anything additional.

I don't understand what you mean by extra income. With Medcaid most all, except for a modest amount of the resident's income goes to the facility with the resident keeping a small some, usually under $100. per month. So , how would the resident be getting more income? I don't get it.

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