Is there an appeals process I can go through to help my father and his $200 shortfall in share of cost he is to pay the nursing home? - AgingCare.com

Is there an appeals process I can go through to help my father and his $200 shortfall in share of cost he is to pay the nursing home?

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My father is an Airforce Vetran and resides in an amazing nursing home here in the state of Nebraska. He has been there for 1 year. I had hired an elder law attorney to help me with this entire Medicaid application process. I personally discovered that my father has a shortfall of $200 every month for his share of cost to the nursing home. Medicaid calculated his full pension amount even though my mother gets $200 of that pension. This is a divorce obligation that had been set over 30 years ago. When I gave all requested documentation to Medicaid I also included the military statement of that pension that shows the $200 garnishment and Medicaid still took the full amount of pension to determine his share of cost. I am in the first renewal process and talking directly to the case worker is impossible She actually told me in a voice mail message that maybe go back to court and have it amended???? Meaning so my mother would relinquish her monthly $200? There must be something that can be done. My father has no more money and I as POA and daughter can’t afford to pay his shortfall in share of cost to the nursing home.

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Was this $200 for alimony or child support payments? Is your mother working, getting SS, or have any other source of income? If it was for child support, I would think the children are grown and that deduction would have been quashed through a FOC action.

Is your father getting assistance through the VA? If not, contact them and get an appointment ASAP. I don't know if the VA could help with the shortfall, but if your father has a service connected disability and it's documented by a VA selected physician, there probably would be some level of compensation.
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The atty should have dealt with it. The $200 would be some sort filing attached to his Medicaid application like what is done for CSRA - community Spouse resource allowance or MMNA - Minimun Monthly Needs Allowance / Assessment. CSRA, MMNA are set asides to enable spouse to live in the community. Dad has a court ordered required set aside which is similar.
But that’s another problem......

If your in appeal stage, it’s NOT calling the local / initial caseworker anymore. You need to mail uspo a letter (certified with the return registered card) to whatever address is for the appeal. Keep the letter short, like 1 page, state just the facts... “there’s an error of the calculation on dads copay determination (put in the amounts) due to the NH each month due to the existing, legal requirement by divorce decree.” I’d include a copy of the DD; dads awards letters from VA, SS or other retirement monthly income. I’d include a copy of the dpoa for you as well.

If you want to be ocd, you can fax it all over as well. If you fax, you need to do it from a FedEx Kinkos type of place, where you get a transmission report print out that states date, time, fax # and successful delivery.

So dads $200 short.... what type of blowback is he / you getting from the NH? This is a pretty tiny amount overall. If the NH likes dad, he’s an easy care resident, NH might be ok is floating this while his appeals run through. I would though suggest that you allow NH to move dads PNA ( personal needs allowance) to go towards the shortfall each month. If they are being obstinate hardball, then I’d look to see what possible VA LTC facilities are out there and get dad on a waiting list ASAP.

Atty should be dealing with this but as he’s MIA, you need to just get on it as appeals have tight timeframe and if you miss it your toast. Once you get through this, you can go after atty.
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Is the nursing home demanding payment, or telling you that they will evict him due to this shortfall?

It seems like the lawyer who took you through the Medicaid application should be the one to fix this. 
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