My mother is in a nursing home and when medicare ended, we decided to take her home and do the best we could. Several times we were approached by the social worker at the home to apply for medicaid. Several times, I declined because I really didn't want her to remain in the home indeinitely. After much prodding and even a subtle threat of reporting me to the SPA, I relented and applied for medicaid. Every day it is something new with these people. They assured me that it would only be a short stay and since my mother has not assets, she most likely will qualify. Now it seems as if they have "jacked" up the bill and I have asked them, with no clear answer, so I am in stress. What if she doesn't qualify for medicaid? What happens with the bill at the nursing home? She has no assets, property -- nothing. How do we pay for that bill?
If the Nh has not been clear on all this, I'd be on full-alert that this NH may not be in your or mom's best interests financially. Or that someone in the biz office it totally incompetent. My mom's first NH did not ever send out a trust account statement, her current & 2nd NH sends out a trust account statement every 90 days even if it is a zero balance.
Realize that the Medicaid application although done @ the NH & reviewed by the NH, it HAS TO BE determined by the state Medicaid program for acceptance. The NH's review the required set of documents to see if they anticipate any issues to accept the resident as "pending" and then in turn the NH sends the application with the required documentation with their NH bill to the state. Has this been done - ask the NH when the application was turned into the state.
Now for both my mom & my MIL, the NHs provided a list of documents they required to accompany the Medicaid application. My mom;s was a 1 page list and MIL was a 2 page list - both for TX Medicaid. Why? because the NH can base the list on how they do their internal acceptance for "Medicaid Pending" review. Yeah it is loco & for us especially crazy was that MIL had been on Medicaid in Louisiana so was already vetted for being "at-need". For my mom, it was over 100 pages of documents to accompany the application, really truly due to mom's old-school insurance policies that run 20 -30 pages and each & every page front & back needed to be submitted. I turned all the pages in at one time and had the admission gal sign off receipt of it and i did not leave the NH till or pay the first co-pay till I got a copy of each & every page of the contract too - I am a totally bad witch on stuff like this. All in all for my mom it was a 3 year & 6 month review of all her financials plus insurance and documentation on all her real property for 5 years and took about 6 months to be approved and I did have a transfer penalty issue on her car (which came in at month 5 and I got waived on appeal); for MIL she died before being accepted and SIL dogged the application and it was approved retroactive about a year from initial application and then slightly less than a year after than BIL got a check from NH which was the balance of her personal needs allowance trust account.
It can take months. You have to turn in whatever specific documentation is needed initially. No way around it. Did the NH give you a list of what was needed? If they didn't that to me is a big red flag that this NH is not going to be ever in your favor.
My thought is that this NH has not yet turned in the application to the state. Since mom was initially in and being paid by Medicare, they were all OK on having her there…I bet they even though that they could have her Medicare paid stay extended beyond the initial 20 or so days and that would be good as Medicare pays so much more and then family or the resident just pays the co-pay and does this as a part of their spend-down for Medicaid. So the Medicaid application was on the back burner but not anymore and now the NH is concerned about if she will qualify for Medicaid. They (someone in the business office which may or may not even be at the facility if they are part of a chain) are looking at the application and notice that there is yet another thing needed - insurance card, some banking month missing, info on the spouse, whatever. You need to find out who is the state caseworker assigned to this NH and speak to them directly to see if the NH has turned in the application & what is still needed by the state to process the application. You should be able to speak to the state caseworker and can fax whatever is missing to the caseworker directly too. (Faxes are great as they get it immediately, is legal and you can get a transmission report that it was sent)
If the NH won't give you the name & phone #, then you contact your Area on Aging to get the number of the Medicaid office for your area. The AoA also has an ombudsman who can help for issues between the NH and the residents & their family. AoA is your tax $$ so use it. Good luck and try to keep a sense of humor in all this mice-maze of NH and Medicaid.
Medicaid can be a pain in the neck but if you keep providing them with what they ask for her application process will continue. And while you're going through the Medicaid process the NH will allow your mom to stay as long as you continue to prove to them that you are still in the process of getting Medicaid for your mom.
Does your mom have social security and/or a pension? That should be going to the NH monthly to pay for your mom's expenses.
The only hope you have of not getting a bill for tens of thousands of dollars is to get your mom on Medicaid. I know it's a confusing process, I went through it with my dad, but it has to be done. Make sure you keep in touch with your Medicaid caseworker. I used to call mine every week just to see how things were going.
Please tell us you have a copy of all the paperwork, if not, you can ask for a copy from the facility. They can charge you a copy fee for this too. If it is part of a chain, you may have to request it from corporate office.
Here in Arkansas, so far, the laws only protect those in the mental health system. Parents/Children/Spouse can not be abandoned into the mental health system and the family wash their hands of them. In Arkansas, immediate family is responsible for the bills if the state pays out.
And all recovery laws are not equal. There are states that don't have to go after the children, or parents or spouse equally. They can sue only the ones with deep pockets to assure they get reimbursed.
"How did mom sign into the facility? If she signed herself in then, she is responsible for payment. If you or other family signed her in and signed every document as something like "Jane Smith Jones as DPOA for Mary Smith" then you are acting as her DPOA and are personally NOT liable for the bill. But if you signed everything as Jane Smith Jones, then you could be well on the hook to private pay for everything for mom if she is declined for Medicaid."
Is there a legal reason to have to sign? What if you resist the facilities pressure to sign.