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My Aunt is in a nursing home in NJ. She has Medicare/Medicaid for payment to the Nursing home. She was recently hospitalized for 10 days. My question is: Is the Nursing home entitled to her full Medicare/Medicaid payment for that month? Reason I am asking is...when she was in a nursing home in another state...she was hospitalized there too...and that Nursing home did not take all her full check for the time she was hospitalized. They pro-rated the payment...and the balance was placed into my Aunt's personal account...which she had to "spend down" by the end of that month. I don't know if things differ from state to state. I would ask the Nursing home directly ...but they have already given me incorrect information (ie: they can open all my aunt's mail...found that not to be true). If anyone has any information...would greatly appreciate it. Thank you!

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However, if you make the soc amt to the hospital then you would not pay it to the SNF.
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Medicae varies from state to state, but here in California if there is a share of cost or a co-payment, that must be met regardlless of the amt of days the person was in the hospital and away from the nursing home, so the SNF bills the state for a bed hold but still requires that the resident make the soc amt as the state does not pay until the soc is met. The amt you pay for soc also includes the bedhole.
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Thank you all for your help. I contacted the local Medicaid Office today and got conflicting answers. One agent said the NH gets the entire check...then another agent said to deduct the 10 days and pay that balance. Asking the NH is not an option..since they seem to not know the answer. They were opening up her mail and when I questioned that...I was told by the Asst. Adm. that she had the authority to do so. It was only after I did some research..I found out they can only do so with my Aunt's permission...which she never gave. Thanks again for your help.
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When my mother was living at a NH, she was hospitalized several times. Each time, I would make sure her room was held while she was there. In order for her not to lose her room, the NH had to be paid during her hospitalization.

As above mentioned, probably best to check what is written in the contract and also talk to the nursing home ombudsman. Take care.
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Look at the contract that either your mom or you signed off on for her admission into the NH. It probably details what their policy is in general. But whatever it says, IF they are on Medicaid, then the Medicaid rules top whatever is in the contract.
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It can be a bit different from state to state and I'm no expert in Medicaid. What I would do is call your county medicaid office or the area agency on aging. They should at least be able to point you in the right direction to get your question answered. Also, your ombudsman may be able to help if you have concerns about something the nursing home has done.
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