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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?
The only heartburn I would have with this is if I had just placed my mom, I would want to wait 2-3 months at least before changing rep payee for SS because what if we found out that the facility wasn't appropriate for her or that she hated it, or any other reason why you might want to move her to another facility? Then how does the new facility get paid? These are good things to get ironed out BEFORE placing someone so I'm glad this thread was resurrected.
Speaking as a Business Office Manager, yes this is legal. No, they do not need your signature to do it. Medicaid mandates that a Medicaid resident's income is to be used for their stay (minus the personal needs allowance allotted by your state). Medicaid then pays the difference. It does not matter to me whether a person chooses to turn over their Social Security themselves monthly, or whether we are the representative payee. However, this is standard operating procedure in many nursing facilities due to non-payment. Contrary to popular belief, WE ARE PROFESSIONALS DOING A VERY DIFFICULT JOB. This thread just shows how underappreciated Business Office professionals are. If you do not feel comfortable with the answers given to you by the nursing facility, a Medicaid worker or the ombudsman can assure you that this is the correct process.
micalost, I don't know about the "no warning" business, but as you can tell from previous posts in this thread, it is pretty standard for SS to go directly to nursing homes IF the resident is on Medicaid. Is your loved one on Medicaid?
This just happened to me with NO warning - I have been paying her bill on time for a year ! today I get a letter saying "you are no longer her payee" WHAT? Now what happens to the Payee account??? Her pension still goes in there - what the heck?
I have an elder attorney that I signed a no pay waiver three yrs ago when another nursing home tried to sue us for twenty five grand..then they found out we have nothing in the bank..so they dismissed the suit..I went to ss twice last wk. But I am not disclosing the results. Worse comes to worse..he w have to be home again w me and w have to work it out again
This must be really scary for you. I hope you can help yourself a little each day, as you seek the professional help you need. Take care of yourself, Stefani, even if you have to rearrange your visiting schedule to see your husband. For example, you may need to forego paying the debt in order to see that attorney. Even a bankruptcy attorney wants a bundle of money up front. Then, there are consumer credit counselors for free, but that is later. See the elder law attorney first, especially if you have not yet sat down in front of the social security office to get the money back. When this happens, you need to fight or get help to fight.
I dont have $124,000.00 in the bank. Right now today there is 700.00 in mine and his.He spent j is whole retirement money. Thirty five grand on lottery tickets...there is no savings. I am living on my ss check of 1300.00 a month and a small 700 pension.. I rent an spt as nd lease a car. I have to pay bz/c for the nn other of us $400 per month..he is not a vet. We have no assets just his funeral 6000$ term ins policy for burial mine the same..I w have to declare bankrupt cycle so I can buy food pay rent electric and car and renters ins..need that one since a pipe broke in one of the s pts above us and ruined all in the nxt . Apt..it broke since this winter the pipe ss froze. I am going to gave th o get food stamps too
Stefani - you are the "community spouse" and as such should be getting enough $ from either your own resources or his resources (his SS & retirement) to enable you to live in your community. You should be allowed MMNA - monthly maintenance needs allowance OR CSRA - community spouse resource allowance. Just what it's called depends on your states Medicaid program.and each state sets a cap on the $ amount. And you as a CS can have up to $ 114,000.00 in liquid savings plus home & a car as the basics for a CS. You souks not, never, be impoverishing yourself to have an spouse in a NH.
Your attorney needs to do whatever to get your MMNA CSRA increased to the maximum. And if this means the NH gets zero as his coPay, well too frickin bad fir the NH.
The rules for CS are very different & more complex than for a widow or widower applying for Meducaid. If the NH is telling you that all has to be paid to them, that is wrong. Have your eider law attorney get on this both to get the whole SS check snafu dealt with and to get your MMNA CSRA maximized. You or the attorney may have to be a pit bully but need to as you could outlive hubby by yearsc& years. Comprende? Good luck
Not everyone who is a representative payee for handling the funds of a social security recipient is a lawyer and does not have to be. The fact that you were unaware of this transaction with the NH is worrisome. While you may have signed an admission agreement and not read the fine print, you would have had to initiate the transfer of funds yourself, and been aware this was happening. If you have family, take them with you to the soc. sec. office when you sit down to get the money transferred back to your bank. Don't allow this technically illegal transaction to stand. Have them show you the documentation with whose signature on it to have made this transaction.
Yes I am my husbands POA ..health care proxy and his SS responsible payee given to me by our elder lawyer and the Brigham/Womens psychiatrist who diagnosed him..but the nh rerouted his ss check to the nh bank account and did not even tell me ..I had to delete all our checks I had written out for our bills and call all our bills and told them I what h as ppened. I only have my ss check with a small pension check to live on..I rent an apt and lease a car..no money in the bank..I don't know why medicaid can't pay the nh bill in our case..I will have to go bankrupt..I have no other monies..what a mess
According to S.S., only the Responsible Payee should receive the check. If the nursing home is not the RP, then they do not have the legal authority to receive the check directly. I went through the same thing with my mother who is in a NH in NJ. The check is deposited into my mother's account and I write a check to the NH.
Since Medicaid is a government entity, and Social Security is a government entity, the two work hand-in-hand. The nursing home wants their money first so your loved one will get the care he/she needs. Don't get angry, go discuss the process with the administration at the nursing home and they can explain it. If there is any money left over, as Representative Payee, you are responsible for accounting for any expenditures you make on your husband's behalf. I am a RP too, and I put his funds in a separate account (per Chase Bank" requirements), and then pay only the mortgage, and car payment from that account. The other monies are in another account so I do not co-mingle funds and I have a paper copy to show how the money was spent.
You as his spouse or as a DPOA have the fiduciary duty for the person. A facility may press upon family that signing over the residents SS, retirement, etc is what is done but that is bogus, you do not have to do it this way and they cannot compell you to. Just because it's easier / simpler / better for the facility isn't not your problem.
if they somehow got resident to sign a paper to allow for this, it will be done by someone coerced or lacking the cognitive ability to sign as they have dementia. I would contact the NH ombudsman at your area on aging to get a letter off on this. ASAP. If NH persist, then get a lawyer to send a letter.
Also since your a community spouse, your MMNA or CSRA is very much interdependent on his income stream and so you need to be in control of it. Now you have to pay the facility his required copay or his SOC (share of cost) but other than the nH getting paid his copay the NH should not be involved in any of his finances. About the PNA - personal needs allowance - that too you can determine what the amount is in his kitty at the facility. If your states PNA is $60 a month, you can place it in his PNA trust account@ NH but you do not have to.
For my mom, I paid her NH by check each month for the copay and let the PNA build in her bank account rather than go into the kitty ( personal trust account) at the NH. The NH personal trust account, I'd keep at about $100/150 max. Moms first NH gave grief on this approach but just too bad. Her second NH was fine on this and like clockwork a statement every 90 days as to all activity on her trust account & interest paid on balance. When mom died, balance paid with a sympathy card 90 days after death.
If yiu do end up seeing an attorney on this, I'd suggest you also on the visit have them review your MMNA or CSRA situation. You want to get the maximum allowed by your state. Some states have it pretty high - like TX is about $2700 - so you want to get the max. If that means the NH gets zero as a copay from his SS check, well just too bad. good luck.
I took my husband out and got home help and he is not going back unless I am in one I am older then him but if possible every minute home and with family is worth thousands in a nursing home and as to your ss ? Yes they can its legal in a lot of states sorry they get your loved ones body and bank account but like they will tell you the medical worry's are there's and you only have toolove them you real only get two choose them or home care and they gave me a fun time getting him out when he went in they said I could take him home any time but they held me up till I had to trow a hissy fit and kid nape him just about be smart have your lawer if you decided to try home care handy mine was in ct I live in r.I our places are better about releases
Ohio Medicare will pay up to 100 days in a nursing home before they take checks unless the patient is doing continual physical therapy and improving. If the patient has topped out of therapy and has reached a level where their condition will not improve then the nursing home will contact the family when the patient has only 10 days left on their time to not exceed 100 days. If the patients family decides to take the person home then the nursing home doesn't take their check but if the patient had to stay then the nursing home takes the check because Medicare has stopped payment. I just went through this last week with mom. She was to come home Thursday but she passed on Tuesday unfortunately.
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.
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 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.
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.
Stefani - how are you paying for the nursing home? If you are paying for it each month in cash/check according to an agreed upon contract, then it should not be possible for the nursing home to obtain the SSI. As indicated above, if the monthly rate you are pain is less than $8,000 to $10,000, it is likely that the payment is being subsidized by Medicaid. Regardless, they should not be able to do this without giving you some written notice. Do you have your admission paperwork for him? Such a disclosure is usually included, along with a lot of legal language. in my experience, the admissions officer at a facility can be very helpful. There may also be a social worker available.
if your husband is covered by Medicare, Medicare only covers up to 100 days of Skilled Nursing. Medicare does not cover custodial care.
You do not mention your age, but you may wish to check with your local office on aging, or your local social services department to see if they can help you review the paperwork. If losing his income creates hardship for you, go as soon as you can to one of those agencies to find out how to qualify for help.
People will tell you that the nursing home or Medicaid cannot take your home, but if you are now unable to keep it up or to pay the taxes, you need to plan how to meet those obigations or make more affordable living arrangements. Do not wait.
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.
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.
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.
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Now what happens to the Payee account???
Her pension still goes in there - what the heck?
For example, you may need to forego paying the debt in order to see that attorney. Even a bankruptcy attorney wants a bundle of money up front. Then, there are consumer credit counselors for free, but that is later. See the elder law attorney first, especially if you have not yet sat down in front of the social security office to get the money back. When this happens, you need to fight or get help to fight.
Your attorney needs to do whatever to get your MMNA CSRA increased to the maximum. And if this means the NH gets zero as his coPay, well too frickin bad fir the NH.
The rules for CS are very different & more complex than for a widow or widower applying for Meducaid. If the NH is telling you that all has to be paid to them, that is wrong. Have your eider law attorney get on this both to get the whole SS check snafu dealt with and to get your MMNA CSRA maximized. You or the attorney may have to be a pit bully but need to as you could outlive hubby by yearsc& years. Comprende? Good luck
if they somehow got resident to sign a paper to allow for this, it will be done by someone coerced or lacking the cognitive ability to sign as they have dementia. I would contact the NH ombudsman at your area on aging to get a letter off on this. ASAP. If NH persist, then get a lawyer to send a letter.
Also since your a community spouse, your MMNA or CSRA is very much interdependent on his income stream and so you need to be in control of it. Now you have to pay the facility his required copay or his SOC (share of cost) but other than the nH getting paid his copay the NH should not be involved in any of his finances. About the PNA - personal needs allowance - that too you can determine what the amount is in his kitty at the facility. If your states PNA is $60 a month, you can place it in his PNA trust account@ NH but you do not have to.
For my mom, I paid her NH by check each month for the copay and let the PNA build in her bank account rather than go into the kitty ( personal trust account) at the NH. The NH personal trust account, I'd keep at about $100/150 max. Moms first NH gave grief on this approach but just too bad. Her second NH was fine on this and like clockwork a statement every 90 days as to all activity on her trust account & interest paid on balance. When mom died, balance paid with a sympathy card 90 days after death.
If yiu do end up seeing an attorney on this, I'd suggest you also on the visit have them review your MMNA or CSRA situation. You want to get the maximum allowed by your state. Some states have it pretty high - like TX is about $2700 - so you want to get the max. If that means the NH gets zero as a copay from his SS check, well just too bad. good luck.
"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.
Regardless, they should not be able to do this without giving you some written notice. Do you have your admission paperwork for him? Such a disclosure is usually included, along with a lot of legal language.
in my experience, the admissions officer at a facility can be very helpful. There may also be a social worker available.
if your husband is covered by Medicare, Medicare only covers up to 100 days of Skilled Nursing. Medicare does not cover custodial care.
You do not mention your age, but you may wish to check with your local office on aging, or your local social services department to see if they can help you review the paperwork. If losing his income creates hardship for you, go as soon as you can to one of those agencies to find out how to qualify for help.
People will tell you that the nursing home or Medicaid cannot take your home, but if you are now unable to keep it up or to pay the taxes, you need to plan how to meet those obigations or make more affordable living arrangements. Do not wait.
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.