The facility that my Aunt is in is telling us that Medicaid did not pay for two months of her care. (She had Medicaid upon entering the facility and it lapsed while there and we did not know.) Now they are saying we have to pay her bill in full or she cannot be transferred to an assisted living home.
Is this true? Can they make her stay until she pays her bill or can they bill us or is it their fault for letting her Medicaid lapse?
So many questions!! And I have my grandmother in another facility who is pending Medicaid and her bill is now almost $60,000.00
If transferring from one facility to another, was Medicaid made aware of the change? I ask because, Aunts mail from Medicaid would be sent to the NH of record. I gave My Moms NH permission to open any info concerning Medicaid. They would then have made me aware of yearly updates, I guess. (Mom was only on Medicaid for 5 months) Pretty sure I would have been responsible for the info needed for this update. NHs do not have access to bank accts and other info. This is usually the POA, Guardian or family member involved with the residents care.
You need to contact Medicaid and talk to the Caseworker in charge of ur Aunt. Find out what happened to cause this problem. Do not rely on the NH to do their job. You may luck out that they retro Aunts payments.
You mentioned transferring Aunt to an AL. I would check with your State Medicaid and see if they cover ALs. Most States don't. In my state, for Medicaid to pay you must have paid at least two years privately in an AL. Then its if the AL has not met their % of Medicaid residents they allow. If that % has already been met, then the resident will have to be moved to LTC. Usually a person in a LTC facility needs more care then an AL can give. ALs are not skilled nursing. Its for those who need a small amount of assistance.
Once you find out how this happened we can help take you from there.
I am a person that doesn't rely on others. I applied for Medicaid for my Mom. I made sure that the caseworker received all the paperwork needed. I was the one who confirmed that he had it all. That Mom paid the 2 months privately to spend down and that he needed to set up the first payment for July. Not that he and the NH didn't help me a lot, but I made sure all the ducks were in a row. I did not rely on these people to do their jobs. I knew what Month I applied so would have been in touch with the NH a couple of months before that about the yearly paperwork. What I am saying is when responsible for someones care, you need to be Proactive. You can't rely on someone else to do their job. I have skirted a lot of headaches thinking this way.