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Mother-in-law was in the hospital for 17 days in May. The nursing home deducted the whole month medicaid payment in May.

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OK - I'm pretty sure that Earl is referring to a "trust" account that is done @ the NH that and consists of the Medicaid residents monthly personal needs allowance. It's NOT a trust as one drawn up by an attorney trust...like a life estate or a enhanced benefit trust. THe NH "trust" usually happens when the resident has their SS check or retirement be mailed to the NH and then the NH deposits the whole amount as their required co-pay EXCEPT for their personal needs allowance which gets placed in the NH "trust", so each month their "trust" increases by the allowance amount. OR if the resident or their family writes a check for the required co-pay, the resident or their family can place a set amount in the trust for the resident to draw from to pay for hair salon or phone charges or candy, etc. It's funds held in trust for the resident for personal needs they can get cash from. For my mom, it's $ 60.00 a month personal needs allowance in TX (the $ varies depending on the state) & we write a check every month for her co-pay from her checking account which gets her SS & retirement direct deposit and put funds in the NH trust when it starts to get low.

The NH trust can get sticky in that if their $ goes to the NH and then the allowance isn't spent down, and just kinda forgotten about after a year or so, then the resident may find themselves with more assets than Medicaid allows. You have to spend it in some way, like a monthly hair salon visit.

Earl - Medicaid pays the NH a daily rate for "room & board" & the viewpoint seems to be as long as she is still a resident of the NH (like has her stuff there and is planning on returning after her hospitalization) then they can charge for r & b and she has to do the required Medicaid co-pay. Her bed is being held for her. Now you do need to speak to billing - usually if they are hospitalized for more than 4 days (3 full days & nights), then when they go back to the NH, it can often be considered a "rehabilitation" period. Rehab is a MediCARE paid for benefit for their R & B and medical needs, so MIL may not have a Medicaid co-pay for all the days if she is MediCARE rehab paid. But realize, that if she ends up with extra money from this, she has to spend-it down on her needs in some way so that she doesn't go over the Medicaid asset limit. I don't know how other states do this, but for my mom there is an annual recertification for Medicaid in which the last 4 months bank statements has to be submitted....just to make sure the assets aren't over the limit.
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I'm with Chimonger... I don't see how the patient even has a trust seeing as how the question involves Medicaid. It is my understanding that medicaid is given only if the patient has no more then a couple thousand dollars in assets and I don't think that would be in a trust. Perhaps Earl meant to say Medicare? If that be the case and they do have a trust, I don't see how they can simply deduct anything from the Trust. That is the job of the Trustee, which could be the patient (maybe it is and they gave permission while in the hospital) or a person designated by the patient.

I agree with everyone else in checking with the NH and seeing if they might have a provision for someone who has an extended stay in the hospital. Perhaps a partial refund might be forthcoming if you ask for it.
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Looks like 2 different questions here...

If an Elder has a legal Trust Account, might that be an "excessive asset" that Medicaid [Welfare!] is entitled to debit for services rendered?
DSHS stipulates a person can own very limited assets & still receive Medicaid or Welfare resources. If there are costs to the System, don't they usually require liquidating assets to pay the person's bills?

An Elder who is resident in a NH or other Care Home, sent to Acute Care Hospital for a time?
Unless they are discharged from the Facility they normally reside in, their bed, belongings, meds, etc. are still at their "residence".
Reporting is done each shift to account for the person, their meds & belongings. Staff may need to interact with other staff &/or patients there, relative to that persons' belongings while the person is absent.
That's people hours & paperwork x 3 shifts daily while the person is at the other hospital.
So, yes, they could charge for that....UNLESS, as someone mentioned, the facility gives credit for days the resident is not there.
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No. The only person or persons who have access to a trust is the trustee and the financial institution that set up the trust. No one else can "dip in".
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Only if they are holding a bed. Then they can charge the bed hold rate. Read the contract that was signed at admission to see what it says about hospital stays.
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Talk to the administrator of the nursing home to see if they offer a "vacancy credit" for the days your MIL was in the hospital. Some places do this since they are not providing food, care or supplies to the resident during the hospital stay. This credit is usually a small fraction of the daily cost because the facility is holding the bed and cannot be expected to get no payment if they cannot make the bed available to a new resident. Generally, health care providers get a greatly reduced payment for Medicaid patients versus private pay, so the nursing home may be trying to recoup some of that reduction.
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Interesting information. Since the nursing home is not an apartment or a hotel , they provide more than just a place to live. It's seem to me the the NH is also billing for medical services that are being duplicated during the patient's hospital stay. I can understand what a nightmare it would be to untangle the billing for those services but I am surprised to hear that this is legal since it seems to be an abuse of the taxpayer's money.
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Nursing homes are like apartments. One signs a "lease" and pays regardless of being there or not. Can you imagine what an accounting nightmare it would be to try and keep track of patients who went into and out of the hospital, came back, then went back into rehab, etc. It just is not cost-effective for the nursing home. They still have to pay staff who are there for others. I'm sorry your loved one is in the nursing home, but they are a business with profit margins. As a nurse, I have spent many hours in nursing homes. Take care...
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That sounds like "double dipping" to me but I am not an expert in their matters.
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