Just transferred my mom into nursing home. Not sure their business office Medicaid person is giving me correct info. Any advice? - AgingCare.com

Just transferred my mom into nursing home. Not sure their business office Medicaid person is giving me correct info. Any advice?

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Had to pay one month out-of-pocket. Spending down to allotted amount for the county ($15,150.00). Not sure the person sending in the Medicaid application & paperwork I gave her (5-year look back, etc.) knows what she is talking about. She sent the info to Medicaid before we could spend down my mom's bank account. I still have one more payroll check to her home health aide and an Amex bill. This person said not to worry about the Amex bill: 'the doctor at the nursing home will send a letter to Amex, stating my mom is Medicaid-pending in a nursing home, and Amex will forgive the payment.' No one I asked ever heard of that before. I know they help with the last 3 months of unreimbursed medical bills, but this is not the case. If my mom has $15k in the bank, why would Amex let her skate on a $1600 balance??

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If the billing / admissions gal at the NH is wrong, the fallout is on your mom & therefore on you as her DPOA not her.

It it sounds like your states Medicaid program uses the system where the facility is the middleman for the intake aspect of the LTC Medicaid application. This is the format we dealt with for TX but not so much for LA. But whichever way, there’s a Medicaid caseworker assigned to your mom’s case who you can & should speak with regarding any questions or concerns.

You may may find that Medicaid wants all income & assets once a elder is a resident in a facility and in Medicaid “spend down mode” to ONLY use their $ for needs &/or care. Paying the home heath aide should fall into that category (& make sure you have a bill or invoice as to this so not looked upon as “gifting” to a person). The AMeX bill does NOT fall into that category as it’s debt. It’s in my experience, expected that the elders default on any pre-existing debts from their old before-living-in-a-NH life, whether it’s paying credit card debt or property taxes on their old homestead they continue to own ONCE Medicaid spend down is placed. Please try to find out as your gonna be some kinda peeved if there’s a penalty placed on that $1600 and you have to private pay an extra month for her....

I think the system of using the NH as the intake for LTC Medicaid applications are done so that it allows the NH to do a review of the documentation to determine IF they will accept the resident as “Medicaid Pending”. If the NH accept the elder as Pending and it’s goes wrong, they are ineligible for Medicaid, the facility has no beef with the state for payment. It’s just too bad from the states perspective. Facilities don’t necessarily have to do Pending.
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Reply to igloo572
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Yes, I would be dealing directly with the Medicaid people. If they are anything like the Medicare people they will be very helpful. You are more likely to get correct answers. Pay that caregiver and the credit cards right away. If there is money to pay, I see no reason to not pay. How would it be ethical to buy thing on a credit card and then say oh sorry not paying for that? Please keep good records of what you are doing. You should have a copy of all of the paperwork these other people sent in to Medicaid. I recommend good record keeping since you are responsible for what is done not this person at the NH. Good luck. Let us know what happens so we can all be efit for your experience.
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Reply to Toadhall
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If Mom has 15k in the bank, this is too much for Medicaid. In NJ ur only allowed 2k or less. You will need to pay another month or so to the NH to help spend down the money. I would pay the Amex bill and her Caregiver. Would help with the spend down. This is why I don't understand people filing thru the NH. There is no way they know the ins and outs of Medicaid, Filing has to be done so when private pay is gone, Medicaid starts. You only have a certain time from filing to get into a NH. With Mom, it was 60 days. I paid two months, 18k, then Medicaid started. Call Medicaid and run ur concerns by them.
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Reply to JoAnn29
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