The nursing home says my sister owes over $9,000 and is giving her 100 days to pay. Is this legal and what can she do?

Thank you for all your help, it is in the hands of an Ombudsmen. To answer igloo, already took care of daughter this is a problem with home/SS/Medicaid but thank you for your help.

It sounds like Sissy is competent & cognitive, so her reason to be in a facility is physical as she's a quadarpleic, that's it right? If so, this will be somewhat easier...

Actually a 100 days notice is a good sign. Most places do a 30 day notice. I'd bet she is liked and a participating type of resident. Her issues are physical and she can tell staff what her needs are. So to me, a 100 day notice shows they want to work with Sissy. I'd bet her daughter was supposed to do or have requested all sorts of documents from PA for Sissy's OH Medicaid application.... And squat was done. and daughter is now MIA from her moms life.

Here's my suggestion:
- First & foremost, Sissy must pay the facility whatever income she gets each month. I'd see if this has been done, ask billing. If not and her daughter took the funds for some months, Sissy will flat have to file charges on her daughter as the $ will be looked at as gifting and keep her from getting into Medicaid unless there's a police report.
- speak with billing to see what's what with Medicaid application. if you & Sissy can actually speak with the Medicaid caseworker via a conference call at the facility to see what's what that would be ideal.
- if this is about supporting documentation needed, then you draft up letters written by Sissy to SSA, PA retirement & insurance companies (if that's a factor); IRS; and you certified mail these for her. These needs to be done ASAP. This is all about being able to show what she has for income & assets.
- what's Sissys banking status?. Can you sit with her to go online to access and print out a year or two of statements? Again if any of her $ was co-mingled with her daughter, and daughter took $, there's going to need some sort of police report to get around gifting penalty from Medicaid.

Daughter probably needs to be shut out of Sissys finances. It may be that sissy needs to just have the NH be her SS representative payee. Personally I don't like letting an institution becoming the elders payee (as I'd prefered to control how my moms needs allowance got spent), but this is such a mess it could be easier plus show that you all are doing whatever to get her OK for the NH & Medicaid.

If all this becomes too complex, Sissy could petition to become a ward of the state of Ohio. Now that could result in her moving to another facility as everything is determined by the court appointed guardian. You could ask to be named by the court, but I'd bet judge will go with appointing a temporary one from a list of vetted guardians as there's a lot of convoluted issues which her family has not dealt with for 9 months.......

So if you don't mind, what's the backstory on the daughter?

Actually they told my sister that she is responsible for it. I am going to talk to billing and social worker and also thinking of just getting her an ombudsmen.

So are they basically saying that if Medicaid doesn't come through in the next 100 days, she'll be responsible for the payment? Why don't you discuss this (calmly) with the billing department and find out exactly what it means. Also read the contract. Also inquire as to where they are with the Medicaid application.

yes

You don't "transfer" Medicaid from one state to another, you start all over with the application process, so, yes, it can take some time. Was Sister admitted "Medicaid Pending"?