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Starting Medicaid Title 19 process for dad. He is not in a nursing home yet. Question is: If he gets in a Medicaid Pending facility which I know of in town, and he is there a few months and passes away before he is accepted on Title 19 am I responsible for the bill???

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No but you have to do all the follow-through needed with Medicaid. Make sure that the state has the correct address to send whatever is needed to you. you do NOT want the state to send any paperwork to your parent @ the NH - those seem to get lost or put in their chart which you don't have access to. Most Medicaid stuff has strict time-frames on getting items sent to the caseworker too. Medicaid will pay retroactively usually to the first day of stay in the NH if they are accepted.

he's not in the NH yet, correct? With the NH paperwork - if you didn't get a copy of all when you signed him into the NH, then you have to go to the business office and get a copy of each and every page. In it, it will read how they handle finances. Somebody will be asked to sign off a financial responsibility page. How this is done will be the key - imho - to how much panic you have. If the elder signs it OR if you sign it as POA and indicated that on each and every page, then it's just too bad for the debt if Medicaid doesn't accept. The debtor will have to go to probate to collect from the estate if Medicaid declines. But if you or whomever signed your name, then you kinda signed off to be financially responsible and the NH can bill you.

My MIL died before being accepted into Medicaid, and the NH billed at private pay rate to my BIL. The NH could bill at private pay rate (8K a month) as per the contract and not the $ 145.00 a day rate set by the state for Medicaid. MIL went from NH to hospital and then into a free-standing hospice. NH sent bill to BIL within the first week of her going into the hospice too. My SIL doggedly continued with the application and it took about 8 months after her death to have her approved for Medicaid. NH sent account to collections too - but there wasn't much they could do as nobody lived in the state of MIL residence and MIL had no assets so there never was going to be probate for NH to present claim. NH was paid retroactively by Medicaid. And it took not quite a year to have the collections letters stop from the outside vendors (prescription service, physical therapists) that the NH used too. All those vendors got a copy of the accecptance by Medicaid letter along with a big "X" through their bill which my SIL did.

The most single important things are:
1. never sign your name, have the elder sign or if they physically can't, make sure everything is done as " Jane Smith as DPOA for John Jones" or however it needs to read in your state to limit your exposure.
2. get a copy of each and every page of all documents. Not just the pages you sign off on but all pages. It will be a stack of papers too. My mom's first NH was about 50 pages, her current & 2nd NH came in about half that amount.
Good luck.
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Thanks for your help. So, am I understanding that even though your MIL passed away, your SIL still got your MIL accepted for Medicaid? I thought once you pass away that was it, everything stops. By the way, I am sorry for your MIL passing. It's so stressful going thru it all. Last year my dad went to a NH for another short term stay, they said he could stay because they accept medicaid pending patients. I signed Everything A's POA which I am for my parents. They social worker told me too.
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Oh I forgot to say that he had improved and came home again. He stayed home for 7months until now. He is back home again with some help but it is very difficult now. The NH is full and he is on a waiting list.
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I love, love, love by & large the social workers - they are a vast font of information and lots of knowledge of whom to go to for getting things done. Most states have it in law that there must be a BSW or MSW at facilities of a certain size, so the social worker is in a secure position and not necessarily subject to the whims of the DON (the director of nursing who is the god or goddess of the NH)

Thank you for your thoughts. MIL was a most difficult person and quite the financial terrorist (6 figure debt not including any NH/medical). Seeing how debt can overwhelm the elderly & their family was a real eye opener. I had been executrix twice before for "aunts" decade ago, and the whole debt collection process and marketing to the elderly is so much more aggressive & relentless now. So many bad & rushed decisions made.

As long as they were a resident @ a NH with an application Medicaid Pending the application goes forward. You kinda need to make sure that the NH has sent it in.
Once accepted it goes retroactively to either Day 1 (if their coming from home or IL or AL) that they got to the NH or to Day 22 or later of when their Medicare paid rehab stay is over if they came in from a hospital stay with rehab orders on discharge. If for some reason he should be declined for Medicaid, file an appeal.
This is important because as long as an appeal is out there, the NH has to continue to have him as a resident and Medicaid pending. I had a transfer penalty issue with my mom (her car) and filed an appeal. The hearing date was like 4 months out. I was able to get the issue resolved in a couple of weeks (easy solve as Blue Book was on wrong model). But if I had needed it, I would have had months to get whatever items needed to do the appeal.

Have you all considered his being on hospice?
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