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I had to pay balance at a non-medicare nursing home before.

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My Mom was started almost at once. It took about six weeks to put the paper work . After it was immediate.
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It took about 6 months for my mother's to come through. First they denied it, then said they looked at it again. But I had an elder lawyer too, which I think is almost a necessity.
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Medicaid is joint federal & state program BUT it is managed & administered by each state. So each state can set specific rules for their program but within the overall federal framework.

For my mom (NH in TX), it took almost 6 months from the date of the submission of all the documents to the NH to be approved. NH then in turn submitted my mom's documents with their bill to the Medicaid state caseworker for their facility.All this was done within the first week my mom was at the NH. My mom had a medical issue which took like 3 months to resolved with an appeal filed on that; for financial review she had an issue with life insurance at month # 2 which had to be resolved within a couple of days; then at month # 5 she had a transfer penalty inquiry regarding her car, which I got resolved within a couple of days. From start to finish, just short of 6 months. She did the required co-pay to the NH for every month too. NH accepted her as "Medicaid Pending" & admissions contract was signed off as Medicaid Pending by myself as her DPOA only.

For my MIL, when she was in a NH in LA, it took less than 3 months to get her approved as there was a small spend-down needed. It was the situtation where her bank account was like $ 2,600, so she had to spend $ 700 and had to wait a month for the next bank statement to show she was under 2K for caseworker to approve her. Pretty straightforward & simple. For when she moved to TX, she transferred to TX program under an emergency order so no issues. Then she moved into IL apt and off NH Medicaid. A couple of years later she needed to go back into a NH. The application this time was fraught with issues with the admissions office of the NH, like 4 months of all kinds of issues with them. She got hospitalized and then moved to a free standing hospice (Medicare paying) & before her Medicaid application was approved. NH sent a bill for her care at their private pay rate to BIL too. SIL dogged the application through and MIL was approved after death maybe 4 months later and the NH was paid retroactively for her stay at the much much lower Medicaid rate too. So 8 months for MIL.

You can contact the state caseworker directly too. I found that is the route to take rather than deal with the NH admissions office. Good luck and keep a sense of humor in all this.
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