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My mom has been in a nursing home for over a year. She just spent a week in the hospital and will need rehab for two months so she is back on Medicare. The nursing home says she now will have to spend down. How do we do that?

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Did you tell the rehab facility that she is already on NH Medicaid?

Does she have any assets to "spend down"?
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So mom was not placed into rehab at her old NH?
Any idea why she didn’t go back & do rehab at the old NH?

The rehab is it purely & only rehab or rehab/LTC facility?
When mom is discharged from rehab, do you think she & you want her to go back to her old NH? If so, then I’d suggest that ASAP like today you contact admissions at her old place to see if she can transfer back to old place and do her rehab there. They know her, she knows them, Medicaid application/eligibility all known to them, to me it’s the most ideal. Medicare (not Medicaid) pays for rehab, so the rehab facility is getting like 3 times the $$ for rehab than what Medicaid pays for daily room & board. I’d rather that $ go to someplace with a history of caring for her and that she’s familiar with. She’s going to do better in a place she knows.
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Confusing...Mom is on Medicaid at a nursing facility, correct. So, she has no money of her own, SS and pension is used to offset the cost of her nursing home. Now she is is going to rehab that Medicare only pays 100% the first 20 days. 50% the next 21 to 100 and after that your on your own. So, Mom will need Medicaid to pick up the balance because...She has no money. I have no idea where the NH feels because Medicare is paying there is a spend down involved. Medicare is always primary in paying medical, even in a NH. Medicaid picks up the rest of the cost. The only thing I can think is that the NH Can't guarantee her room. So, you will need to hope they have a room available after rehab or find a new place. And, since there is a lapse in Medicaid, you will have to refile. There really will be no spend down since you have already done that. Call your Medicaid caseworker and talk to them. Why do they feel Mom needs rehab for 2 months? Please, make sure the rehab is aware of there being no money. Medicaid should pick it up.
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Does she have income coming in that will not go to the nursing home while she is in rehab. Maybe they are talking about that money will have to be spent down to no more than $2000 in assets when she is ready to go back to nursing home?
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Good point Vickie
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