We thought all of this was wrapped up for our aunt since we started the process a few months ago only to find out today that her application was never processed by NH staff, and they have since contracted with an outside agency, Medicaid Done Right, to help them process these applications. We met with an attorney a while ago as well since we did not have POA but helped with as much of the paperwork as we could and at that point we could not get her sign off on anything since she basically ignored our requests. Long story short auntie has since gotten much worse with her dementia and they are requiring she sign the paperwork to move forward with the application. We’ve called the NH administration the business office and no one will return our phone calls but we cannot afford nor hire another attorney at this point and not sure what our options are. It seems like the NH staff dropped the ball and now we are left to try and pick up the pieces. We don’t see how they can even think of letting her go as she is wheelchair bound and can barely do any of the daily essentials without help
How does this even happen?
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On the “on her behalf”, having a POA may not be enough to do things needed. The banks are especially loathe to let someone who just strolls into the bank with a POA to access an account. If the POA isn’t already a signature on the account, has some sort of prior use on the account, a bank can say sorry but this POA seems to be a springing POA so once you have medical documentation on physician letterhead & notarized that the elder is incapable then we’ll let you do stuff. Then after that hurdle, bank will want you to have your own account at the same bank and synched for dealing with overdrafts. And if there is any type of Social Security items to be dealt with, for more fun! SSA does not recognize POA; SSA needs the elder to themselves do what’s needed in some fashion. I mention all this cause if y’all are not POA or are POA but never really involved in her life and unsure if landmines out there, do not get involved. A POA can resign by sending elder a certified letter. The NH owns this, it’s their problem to resolved.
A NH is getting payments from Medicare (MediCARE not Medicaid) in some way to deal with fees & charges for health care. (Not custodial care costs as those are LTC Medicaid). MediCARE requires facility to do a continuity of care and provide for a safe discharge.
SO….
NH cannot just put Auntie out. They cannot send her to a homeless shelter as there is no continuity of care, not a safe discharge. They may call y’all repeatedly to come & take her into your home, so be forewarned. But what NH will more likely do is call EMS to obstensibly take Auntie to the ER as Auntie seems to have had something that appears to need to be seen outside of what the NH can do. The easiest would be to say she appears to have had a TIA, aka transient ischemic attack as they are very much subjective in how TIAs “present”. LSS NH does a ER dump. Auntie now hospitalized and is the discharge planner at the hospital problem now. They will contact you to come and get her, so again you have to stand fixed and firm that you cannot.
State Medicaid programs all are very time limited as to how long an application will stay open and will need documentation in within the “window”. It can & will time out and then have to be reopened and may need an appeal filed for this to happen. It sounds like this NH & or their new outside contractor clusterF this in a lot of ways, but unless you personally signed off to be financially responsible for the Aunt, there is zero the NH can do to make you responsible now.
fwiw Medicaid Done Right is based in FL and started by a couple of guys who had been in the mortgage industry till the real estate meltdown. They contract with facilities & tout themselves as a way to streamline the process and capture earliest payment from a states Medicaid program. Read the reviews…. toxic seems to be the overall takeaway.
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I know this is hindsight but this may help someone else applying for Medicaid, you never allow a NH to apply for Medicaid. Help, maybe. But I never trust people to do their jobs. I always keep on top of things. There's a turn over in office staff and I doubt any of them are qualified in all Medicaid Procedures.
Yes, the NH dropped the ball big time. If u do not want the State to take over, I would ask the NH if the application had ever been sent to Medicaid. If yes, there should be a caseworker. Find out from the NH if they received any communication from the caseworker. If so, you want copies of all communications, letters and emails. If they won't give u the info or they never received any, ask for the office they applied to and call there. If info was inputted into their system, Aunt should be in it. If so, the caseworker assigned should be on the info. Ask to speak to them or anyone who can help you. You then explain the situation and see if you need to reapply or can continue with the first application. If Aunt has no assets, it should be an easy application. A house and a car are exempt. If they actually never applied, then I would go to Medicaid and apply. I did it and it was not hard.
No, Aunt cannot sign a legal document. And you sign nothing for her unless you can put POA behind your name, This is why allowing the State to take over maybe a wise decision. The process will go quicker with them involved.
The NH cannot discharge Aunt, IMO. First it would be an "unsafe discharge". Second, they dropped the ball. In my state you have 90days from the date of application to get the caseworker all the info he/she requests, spend down assets and find a place for the recipient.
You should definitely not spend any money but her own for her care.
It might also be helpful to see if the Nursing home has a social worker to give you resources.