I'm the SS payee as the C.S.. for my husband in a nursing home. The NH rerouted his SS check from me as his payee from SS..to the nursing home bank acct. Is this legal?
When a nursing home resident is also a Medicaid recipient, the nursing home is limited to the lower state rate vs their usual private rate. The Medicaid recipient's income is first paid to the nursing home and then Medicaid pays the difference between the lower state rate and the income. The amount the patient pays is worked out by Medicaid and is called the patient's "share of cost." Note that the facility may not charge the patient MORE than the state rate if the patient is on Medicaid.
It is standard operating procedure in our state for someone on Medicaid who is in a nursing home and will be there long-term (ex. secure dementia unit) to sign a document having the SS check sent directly to the nursing home. A personal care allowance, $105 per month in our case, is placed into the resident's account for things such as hair cuts.
My mom is in long term care in a nursing home. So is my best friend's mother. Both on medicaid. In both of our cases, our respective nursing homes gave us the option of writing them a check every month or having them take the check directly from social security. My friend writes them a check, less $50 for her mom's personal needs allowance, and I have the nursing home take it directly and deposit her $50 into her "resident bank account," which I will access when I need to buy her things. The person at my nursing home didn't care which option I chose. I am the last person who would trust a nursing home, but I don't think this is a case of them being malicious. If your husband is on medicaid and medicaid is paying for him to stay long-term (not just for rehab), the nursing home is legally entitled to his ss check, minus the personal needs allowance, which varies according to state. I'm in NY; we get $50. If your husband is there for rehab, they have no right to his ss check; medicare will pay for 100 days. What should have happened is that they should have spoken to you and given you the option. When I released my mom's check, I had to sign papers. Funny that they were able to get this without your signature. However, if your husband is mentally sound, and you are not his POA, they can do this without you. However, either you or your husband should be informed. I would walk into the financial office and talk with someone about this. Don't call for an appointment; that's not the way it works. These people are NOT professionals. Just walk in and ask to speak to the "medicaid coordinator." This person should explain how payment works with medicaid. You should be given the option of writing them the check or having them take it. If you have them take it, you should get information on your husband's "resident account," and how to access it. It should be a simple conversation. And the person in the office shouldn't care one way or the other. I suspect that's how it will go. If it does NOT go that way, call the ombudsperson immediately.
Sounds a little sickening to me, did they communicate with you about it, don't let them walk all over you, these people would take advantage if given the chance.
Meanwhile get legal advice, sue them if they are out of order, don't let them get away with anything because they will take advantage.
Medicaid does not reimburse the facility for the normal rate it charges to private pay residents or generally even as much as private insurance would pay. It would be difficult for most facilities to survive and provide a level of care you would want for your loved one if they only received what Medicaid provides for each resident. They accept Medicaid because they also can receive the SS check and potentially other forms of income such as a pension. The facility my MIL is in charges $8100 per month for a semi-private (shared) room with two hospital beds and a curtain divider. Medicaid reimburses them far less than that amount.
It is common for Nursing Homes to have SS payments sent directly to them, however the resident must provide authorization. Often times the Nursing Home Admissions Agreement will have a section that refers to this--here is a sample directly from an agreement:
"C. Assignment of Benefits. You hereby direct all payment made on Resident’s behalf by third party payers, including payments from Medicare and Medicaid, to be made directly to Facility for any services furnished by Facility. If Resident is or will be a Medicaid recipient, then in addition You hereby direct all resource payments made to the Resident or on Resident’s behalf, including payments from Social Security Administration and pension benefits, to be made directly to Facility in order to satisfy the Resident’s Patient Liability. You agree to take any steps necessary to implement this assignment of benefits such as redirecting the direct deposit of Social Security Administration funds or filling out an application to make Facility the Resident’s Representative Payee."
A good start would be to review the admissions agreement and additional forms to see if there was authorization provided. It is also important to see who signed the agreement and if your husband signed the agreement then he would be presumed to have the ability to sign other forms.
Many people prefer to have SS sent directly to the facility as it makes accounting easier but again it is a choice. As far as who to speak with, I would start with the business office.
Contact your local area agency on aging and ask for the long term care ombudsman. The ombudsman is an advocate for those in nursing homes. If you were the rep payee and you were paying his cost of care, the facility would have had no need to request his check come to the facility account. You should have been informed prior to their actions.
Meanwhile get legal advice, sue them if they are out of order, don't let them get away with anything because they will take advantage.
"C. Assignment of Benefits. You hereby direct all payment made on Resident’s behalf by third party payers, including payments from Medicare and Medicaid, to be made directly to Facility for any services furnished by Facility. If Resident is or will be a Medicaid recipient, then in addition You hereby direct all resource payments made to the Resident or on Resident’s behalf, including payments from Social Security Administration and pension benefits, to be made directly to Facility in order to satisfy the Resident’s Patient Liability. You agree to take any steps necessary to implement this assignment of benefits such as redirecting the direct deposit of Social Security Administration funds or filling out an application to make Facility the Resident’s Representative Payee."
A good start would be to review the admissions agreement and additional forms to see if there was authorization provided. It is also important to see who signed the agreement and if your husband signed the agreement then he would be presumed to have the ability to sign other forms.
Here is a link to the SS website that has great information regarding both:
http://www.socialsecurity.gov/ssi/text-repayee-ussi.htm
Many people prefer to have SS sent directly to the facility as it makes accounting easier but again it is a choice. As far as who to speak with, I would start with the business office.
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