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I have a parent who was in a nursing facility which we were not happy with at the time. Dad contracted sepsis and was hospitalized after our family insisted on having a transport take him. We have moved dad to another facility and the previous facility is asking for a debt owed. My father is Medicaid approved and Social Security has been received by the nursing home without authorization. My father does collect a pension but he does have a living wife. Does anyone know if this is protocol for nursing facilities to ask for debt being owed? My father was receiving a VA benefit while he was at home but since he was taken to a nursing facility, the benefit ended. The PR1 form discloses that he receives this benefit from VA which he does not since he was admitted. Very confusing but any insight would help at this point.

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The government is VERY DIRTY when it comes to money and Medicaid will not tell you things that will later come to bite you. In reality a person is better off not owning anything so the government can't seize it. I do know once a person dies everything that goes into probate will be owned by Medicaid. Estate planning, establishing POA, are very important making seeing an eldercare attorney a necessity; Medicaid laws also vary from state to state. I know a lot of people who avoid Medicaid due the confusing quagmire of laws. I never put my mom in a nursing home, but I thank God I seen an eldercare attorney before she fully declined. POA was established already many years before her Alzheimer's.
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Contact an who specializes in nursing home abuse and malpractice. Also nursing home injuries. I believe a single letter from such an attorney suggesting they cease and desist attempts to collect money, and alerting them that the family has engaged him as their attorney to discuss damages if they were to decide to sue the facility for putting their loved ones life at serious risk. That should be enough to get them off your back, and not raise the cost everyone else, since all sides usually want to avoid a lawsuit. My father was an attorney involved in such cases defending the institutions. His focus was always to identify the problem, solve the problem to be sure it doesn't happen again, and make a reasonable out-of-court settlement. Regarding personal matters, like when I got sepsis as a child, he went straight to the top, found out what mix-up happened, how and why it happened, and set a plan with the head of the hospital to make sure it never happened to anyone else. After reaching those milestones he agreed not to file a lawsuit, and that they would not send him a bill.

Whether you decide to file a lawsuit or not, is another matter. Medicaide would get any monies they paid out of any settlement, and the attorney can address losing Medicaid because of too much assetts.
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Had to cut my other post short.

If Dad was getting Aid and Attendance, no he can't get that and Medicaid too. A member has mentioned that he could receive $90 for his Personal Needs Account from A & A but that is all.

Was Dad in the NH for rehab at one point and then transitioned to LTC? Was he Medicaid Pending?

I just found out a friend, who is in LTC, was placed the last few days of August. Medicaid did not pick up his care until Sept 1. He owes $800 for the days of August.

Like I said, you need to sit down with the NH and find out why they owe. Then go from there. Come back when u find out someone maybe able to help.
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Yes, it's protocol. - Medicaid or not.
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I’m not sure I’m folllowing exactly. If I’m understanding, your Dads social security check went directly to the 1st nursing home. When admitted the paperwork must have said the NH is the “payee”? So they got his check(s) but he has since moved. Is your question that if he moved sometime during the month, that some of that money should be reimbursed, for days not there? That would seem logical to me, but the NH contract may say you pay for the whole month. Maybe others on the forum can chime in on how they write these things.

Also, make sure SS/Medicaid knows he has moved, and the date.
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Yes I would think the NH would be entitled to be paid for the days your father was a resident there prior to when he was transferred.

You specifically shouldn’t be charged but your father would have been.
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Care02: When the individual applies for Medicaid, they must do a "spend down." They are allowed to own $2,000 in countable assets. Be prepared for the 5 year look back, where they will want to examine 5 years' back of financial records. The spend down can include such things as a pre paid funeral for him, but be on the cautious side with other spending or Medicaid will deny.
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Care02 Mar 2019
Thank you for your help. My dad hasn’t owned anything in over 10 years. He does get a ck for social security for right at 2000, maybe a little more but not much. His car is in my name but he does make the payments but he is no longer driving. We just use it for his Dr appts and running his errands. He pays 180 for Medicare and has a supplemental policy through United Health and he pays for a policy to cover his funeral expenses monthly. Would this affect him getting on Medicaid? I am looking into a private pay for either assisted living or a small apartment in a Sr community. I think he would be happier and it is much more cost effective rather than a nursing home. He can still do things for himself so he’s really not ready for a nursing home so I’m hoping I can find something affordable where he can have a better life. Do you think this is a good option? Thank you so much for your help!
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Yes, they can ask for debt owed. Was Dad on Medicaid at the time? How did they get permission to receive his SS. The resident or a POA has to authorize the home to become payee?

You need to sit down with the former NH and see if things were done correctly. Takes a while for Medicaid to start paying if Dad qualified.
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Everything depends on the state he lives in. With that said, typically mediciad does request an income contribution. In New York, the well spouse can typically keep $3161.00 per month of there joint income. The balance should go to the nursing home. So if he was only there for a few days, the income may be owed to them. You should get something in writing from the VA as to the cut date of the full benefit. That may help too
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We haven't had to go this route yet, but it always pays to be informed, so I do read up! That said, I did a quick check online.

From https://www.aarp.org/health/medicare-insurance/info-08-2011/paying-for-nursing-homes-ask-the-experts.html:

"If you receive a monthly Social Security benefit, it would go directly to the facility for your care once you are on Medicaid. However, you would be allowed to keep a small allowance for personal items."

So, the "authorization" to receive SS income is built in.

Other results I clicked on implied that once you are approved for SS, you are "approved" for Medicaid (however that may just be SSI, not SS.) Regardless, Medicaid has to be applied for and assets spent down (or split with spouse) per your own state's requirements.

One other thing to note: I had to sign up as rep payee for mom's SS. Among all the paperwork and information they sent along with the approval is notice that if the recipient dies, that month's SS will be TAKEN BACK! In mom's case, if that were to happen after they facility cashes the check, there won't be anything there to take! I suspect I would get a call or notice by mail that it must be paid back... :-( In your case, it is possible that SS took back the funds for the month that he moved.

I would certainly take the time to have a face-to-face discussion with the old NH, where they provide you with DETAILS. No details, no $! The VA benefits, from what I also read, go away when Medicaid is approved, so they are wrong there. If they say no, here is the proof you can give them:
https://www.veteransaidbenefit.org/aid_and_attendance_pay_nursing_home.htm

"Retaining VA Benefits and Imputed Income
VA will not pay anything more than $90 a month if a single veteran or single surviving spouse is eligible for Medicaid covered nursing home care. State veterans homes are exempt from this ruling."

If the SS funds were withdrawn, they should be able to show that (or you could contact local SS office to inquire) - if it was taken back, it should be applied to the new NH.

I really don't understand how they can take back the whole month's payment though - what if the recipient moved or died near the end of the month?? They should be able to keep most of it!!!
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rocketjcat Mar 2019
"If you receive a monthly Social Security benefit, it would go directly to the facility for your care once you are on Medicaid.” Just for future information, thats not necessarily true. The person applying for Medicaid chooses whether to continue to receive their SS payment (and pay the NH themself) or have the check go directly to the NH (make the NH the payee). My Moms SS still goes into her checking account and I pay the NH from her account.
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