The terms of the contract of her admission matters as to what her legal and financial obligations are.
So where was mom on September 15th? like… Did she move to another facility, or move to a family members home? & for either did she move according to a discharge order/plan? or was she hospitalized as of 9/15? or is she deceased as of 9/15?
And from 2018 to Sept 14th, exactly how was her monthly bill for her to be a custodial care resident in this NH paid? You posted she was on Medicare and Medicaid. This would mean she was a “dual” for her health insurance coverage. Neither of those 2 will in & of themselves pay for custodial care costs in a NH as they are health insurance. Custodial care would be covered by her State’s Long Term Care Medicaid program if she was low income & basically impoverished.
I’m guessing she was on LTC Medicaid & it was paying her monthly NH bill. Was there any change in her LTC Medicaid eligibility and was she 100% current in paying her required Share of Cost (SOC) of her income (like her Social Security) to the NH? Did she have a change in status, like she became hospitalized or inherited $?
It’s important bc if she wasn’t current on her SOC, or had a change in eligibility or left the NH without discharge orders or left the NH to be hospitalized past whatever timeframe her State LTC Medicaid allows for bed holds, she could become ineligible for LTC Medicaid. If that happens, the old facility can bill her till the end of the month or even till whatever is the time frame on their standard contracts. The NH will bill whomever they can affix the debt onto.
This is how it works when on Medicaid. Moms SS and any pension go towards her care then Medicaid pays their share which is not much.
My Moms Medicaid recovery amount was 6k over 3 months. 1700 she paid with her SS. So her monthly total to the NH was 3700. Her NH at the time cost $9300 a month, private pay, about 300 a day.
In 14 days the cost of your Moms care was $4200 at $300 a day. Was her SS less than $4200? If so, her SS payment paid for her care. NHs do not profit off of Medicaid. Medicaid does not pay close to what someone pays for private pay. Thats why NHs only have a certain amount of Medicaid beds.
What is in the contract? Is your mother a self pay or have Medicaid long term care.
When my uncle was 100% selfpay his contract read that a daily rate would be refunded should the entire month not be fufilled upon death only. If we chose to discharge or move him there would be no refund.
He is on Mediciad long term care and I am assuming there will be no refund if he should leave or die. I do not know the terms when MLT is in effect.
Read the contract. Anywhere you rent, no matter when you leave, you need to pay the full months rent. Just my opinion, you should not have to pay the care amount since she is not getting care.
I read Midkids response. I don't think they can move someone into the room if the month has been paid for, its double dipping. IMO, the roombis still being rented.
Like all places for rent, payment is usually month to month. New tenants also move in at the beginning of the month normally. What is expected is spelled out in the contract signed at admission.
Now, if you have a really stellar place, they may refund some costs to you once place is emptied, cleaned and in good condition. My brother's place did, though his contract did not stipulate that they had to.
Only the rental portion, not the care portion, should be charged for.
My MIL died in a NH 1 week after she moved in. In the contract, it stated that she would be responsible for the entire month even if she had passed on DAY into the4 month.
It was kind of nit picky, esp b/c they had her room rented out the day she passed and they were leaning on the family to get her stuff moved. She hadn't settled in, by any means and the day after her funeral the apartment was completely empty. She never even took a shower there. Nor ate a meal.
Being an in law I had no say, but the 'kids' were kind of upset--the origination fee, the cleaning fees, the whole month of care, of which she got 1 week--I think they were out close to $12K for zero care.
That's what a contract usually does--protect the owners. It is what it is, we just went along with it all. Not worth it to fight, as we would have lost, for sure.
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So where was mom on September 15th?
like… Did she move to another facility, or move to a family members home? & for either did she move according to a discharge order/plan?
or was she hospitalized as of 9/15?
or is she deceased as of 9/15?
And from 2018 to Sept 14th, exactly how was her monthly bill for her to be a custodial care resident in this NH paid?
You posted she was on Medicare and Medicaid. This would mean she was a “dual” for her health insurance coverage. Neither of those 2 will in & of themselves pay for custodial care costs in a NH as they are health insurance. Custodial care would be covered by her State’s Long Term Care Medicaid program if she was low income & basically impoverished.
I’m guessing she was on LTC Medicaid & it was paying her monthly NH bill. Was there any change in her LTC Medicaid eligibility and was she 100% current in paying her required Share of Cost (SOC) of her income (like her Social Security) to the NH? Did she have a change in status, like she became hospitalized or inherited $?
It’s important bc if she wasn’t current on her SOC, or had a change in eligibility or left the NH without discharge orders or left the NH to be hospitalized past whatever timeframe her State LTC Medicaid allows for bed holds, she could become ineligible for LTC Medicaid. If that happens, the old facility can bill her till the end of the month or even till whatever is the time frame on their standard contracts. The NH will bill whomever they can affix the debt onto.
So what’s the backstory on all this?
My Moms Medicaid recovery amount was 6k over 3 months. 1700 she paid with her SS. So her monthly total to the NH was 3700. Her NH at the time cost $9300 a month, private pay, about 300 a day.
In 14 days the cost of your Moms care was $4200 at $300 a day. Was her SS less than $4200? If so, her SS payment paid for her care. NHs do not profit off of Medicaid. Medicaid does not pay close to what someone pays for private pay. Thats why NHs only have a certain amount of Medicaid beds.
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It makes a difference depending on why she was there. Can you let us know?
When my uncle was 100% selfpay his contract read that a daily rate would be refunded should the entire month not be fufilled upon death only. If we chose to discharge or move him there would be no refund.
He is on Mediciad long term care and I am assuming there will be no refund if he should leave or die. I do not know the terms when MLT is in effect.
I read Midkids response. I don't think they can move someone into the room if the month has been paid for, its double dipping. IMO, the roombis still being rented.
Now, if you have a really stellar place, they may refund some costs to you once place is emptied, cleaned and in good condition. My brother's place did, though his contract did not stipulate that they had to.
Only the rental portion, not the care portion, should be charged for.
It was kind of nit picky, esp b/c they had her room rented out the day she passed and they were leaning on the family to get her stuff moved. She hadn't settled in, by any means and the day after her funeral the apartment was completely empty. She never even took a shower there. Nor ate a meal.
Being an in law I had no say, but the 'kids' were kind of upset--the origination fee, the cleaning fees, the whole month of care, of which she got 1 week--I think they were out close to $12K for zero care.
That's what a contract usually does--protect the owners. It is what it is, we just went along with it all. Not worth it to fight, as we would have lost, for sure.