My mom has some money at the nursing home patient fund account for her use and is also on Medicaid. We recently moved her to a new nursing home in another state and the previous nursing home says she has a minimal balance (which, in my opinion, there should be no balance since they accepted Medicaid) and they are refusing to release her money to her until that gets sorted out. It has already been 3 months since she was moved and they are still holding her money. I am not sure what else to do. Her balance is roughly $1700.00 and her patient fund account is roughly $700.00. Can they keep her money like that since she was taken as a Medicaid patient? I keep calling and don't get much information. They said they have been talking with Medicaid and it is under review. Any ideas? I don't want to contact a lawyer since their fees will likely total more than what this case is worth and also, I don't have the money to get a lawyer right now. Any thoughts on this are appreciated.
You know Medicaid (well at least Medicaid in TX) pays the NH on a daily fixed reinbursement rate (about $ 145 a day for TX) and if they are on Medicaid can move from 1 NH to another with no penalty and the state only pays the NH for the days there are actually there. So if you know you are going to move your mom, just pay for the days she will be in the old NH based on whatever her co-pay is for the # of nights she will be @ the old NH. The old NH might not like it but too bad as it's within Medicaid regulations that this is allowed.
I would send a registered letter to the old state's Medicaid program on this and included a timeline of your numerous requests to the NH. You want to include the NH state registration # too - you can find this on-line. If the amount is $ 1,700 plus $ 700.00, that's $ 2,400.00 and could have taken mom out of Medicaid compliance
for assets. Could be a delay as this is worked out. Or the NH is a POS.
You know your mom does NOT have to have her "personal needs allowance" set up in an account @ the NH where it goes automatically and deducted from her SS check. My mom's old NH was pretty insistent on this and I was pretty insistent that it wasn't gonna happen. They cannot make you do this as the Medicaid recipient or their DPOA can self-direct the PNA. To me if the NH doesn't tell you this or insists it has to be then this a big red-flag signal that this is NOT a NH you want to be in. Lesson learned for me.
I write a check each month from my mom's checking account to my mom's NH based on whatever the latest state of TX letter states is my mom's co-pay.My mom's checking account gets direct deposit of her SS ck and retirement annuity. My mom gets about $ 1800 a mo. In theory, the NH should get about $ 1,740 a month as TX PNA is $ 60 a month.So every month her checking account grows by $ 60.00. I do have to make sure that her base amount in her bank account stays under 2K so she is totally OK for Medicaid asset limits. Her state does an annual recertification on Medicaid in which I have to send copies of the last 3 months of her bank statements, so keeping it below 2K is important to do.
What I have found is when there is a cost of living increase, there will be a lag time in the paperwork about increase in monthly amount due to the NH. Maybe 2 - 3 months, and you are not responsible for paying the increase until the month that the NH get's the notification that the increase is due. So right now my mom actually get's about $ 30 more this month and probably next month too, as the increase is still being processed by state. Hey $ is $ and that is about the cost of a pair of those hideous SAS shoes my mom loves and looses regularly. If my mom's checks were going straight to the NH, well, it likely would be a different story and I wouldn't be aware of the extra money.
Oh another thing, some NH have it so that if there is cable in their room, the cable cost is "billed" to the PNA. This is totally chickens*** to me, but totally legit. So you have to ask about any fees for incidentals, like cable or phone, and how it needs to be paid. At my mom's current (her 2nd NH), there is no in their room cable and they all have those converter boxes if they have their own TV.There is cable in the dining rooms and community rooms.
I do have a personal trust @ the NH for her. I keep it at about $ 200.00 for the hair salon and canteen where she can buy candy, magazines, stuff. It will never go above $ 200. Now when she dies, I have already directed & signed off that whatever is left to go to the activities directors fund @ the NH. This is just a personal thing for me as the activities gal is just amazing and the type that I know goes to Big Lots, $ Tree and spends her own money on things for NH projects. They also have an "at-need" fund for residents that a deceased PNA $ can go into. You don't have to do this, but you can to help out residents who maybe don't have family or really really are poor. If they do this, it's probably a good NH.
Contact your local Office of the Aging and see if they know of any in your area.
I had a problem with my mother's debts when she went into the nursing home. My Office of the Aging hooked me up with a senior law service center that sent letters on her behalf to the debtors and got those debts forgiven.
I don't know what they will be able to do for you but this will be a means for you to get access to unbiased advice and have the law on your side.
Good luck.