$500/day for nursing home while Mom is in hospital. Legitimate Medicaid spend-down? - AgingCare.com

$500/day for nursing home while Mom is in hospital. Legitimate Medicaid spend-down?

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Mom has been in the hospital for more than a week. To keep her room at the nursing home, we are shelling out almost $500 a day. Will these thousands of dollars be considered legitimate spend-down by Medicaid, or will they question this expenditure as extravagant? She will be going back to nursing home life in much worse mental and physical condition than when we took her to the hospital and we do not want to change her environment if we do not have to.

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Lolli47 is correct. As long as the money is spent for the benefit of the person whose money it is, it is not a gift and will not be questioned by Medicaid.
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Hopefully the facility has a Medicaid Coordinator of similar staff person with experience in these issues -- or call your local Council on Aging. However, I've been told that Medicaid is not concerned with "extravagance" during the spend down period ONLY THAT THE MONEY IS SPENT DIRECTLY FOR THE CARE OF THE APPLICANT. For example, the Medicaid Coordinator in my Mom's facility told me she could have taken a cruise and bought a sable coat during the five year "look back" period -- she just couldn't have taken a friend on the cruise at her expense or given the coat to me. My mother's facility also charges a "bed hold" fee; theirs is equivalent to their daily rate so $500 a day sounds like a lot to me but I agree it's definitely worthwhile to return her to a familiar environment. I suggest you raise this specific question with her physician AND WITH THE HOSPITAL DISCHARGE COORDINATOR. S/he may be able to predict how much longer will be the hospital stay and the discharge coordinator should be able to comment on both your state's Medicaid views of "bed hold" fees and the likelihood of finding an equivalent place when she is discharged. Good luck and angels watch over you on this journey!
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How long do you think she will be in hospital from start to finish? Also do you have a medicaid worker you can talk to about this? I would think it would be ok but I am not 100% sure. Wanting to bring her back to the same surroundings is wonderful of you, but I think I would get on the phone and just make sure how the state views that.
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I saved the room for my uncle because he liked his things and his room mate, best money ever spent because I wanted him to be happy and not go thru another transition. Ask the social worker from the hospital, they should be able to help you with this question.
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When my Mom was in PT rehab at a NH, she fell after 34 days & had to be in hospital 8 days. They stopped her charges at the NH for her room & kept her room for us (there were no semi-private rooms set up for client(s) so there was a difference that Medicare didn't cover that we had to cover). The NH said that Medicare cant be billed for the room while she is in the hospital. When she returned, they started back on the 35th day of PT until her 100th day came up & then released her from PT. After that you are responsible for relocating her or doing private pay. She doesn't qualify for Medicad but that is the experience with Medicare. I do wonder how to do that spend down. I thought someone said there was a 5 yr period to do that. My Mom is 88 & struggling day to day now. I'm not sure how that would work. In 5 yrs she would be 93. I'm just now getting the Judgement of Possession for my Dad. It will be a year on the 29th. Everything is about money even though the people are really nice that are helping you.
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$500 a day? $15,000 a month. Wow. When my mom was I. A rehab place after a surgery we just paid her regular rent at the AL until she came back. Her long term care insurance bumped up
Our reimbursement rate because she was actually living in a rehab even though Medicare paid for the rehab. $500 per day seems exorbitant
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Thank you for all the responses. Now that the physicians have turned my Mom into a miserable, sobbing vegetable in the process of slowing down her heart rate to within acceptable limits, they have decided to release her back to the nursing home, where we will put her in palliative care. The entire hospital stay was nine days, so I am not as worried about the Medicaid issue as I was before. Sadly, I'm not all that concerned about Medicaid at all at this point, as I do not think she will outlive what's left of her money, at this point.
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Don't know about Medicaid, but whenever mom has been in the hospital, we've always been advised by the NH (which has a low census) to relinquish the room.
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Boy, I sure wish I had proof-read that last statement before I posted it. Sorry for all the redundancies.
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It does sound like an exhobitsnt amount....but that is the cost of LTC, as he expert states, as long as the money is spent on her behalf, it is ok.....I would totally hold the room.
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