I’m in NY. My aunt is an SNF and was approved for chronic care Medicaid. Her admission was quite chaotic during COVID last fall and communication with family has been poor. The nursing home’s head office in NJ contacted us directly and as she owes NAMI (about 350 a month) we arranged to have it paid via debit out of her bank account. This is happening, no issues with that part.
I am confused though why her social security monthly payments are still showing up in her bank account every month (she has direct deposit). I thought she loses her social security because she is on Medicaid? (With a tiny $50 per month stipend or something.) No one is touching this money because we assume it is not supposed to be there. What gives?
Will the nursing home ask for this money with a big invoice at some point?
My problem is this: we would like to move her into a home based PACE Medicaid funded program, which will require a separate certification process. I guess she has to apply all over again? My worry is that this SS money piling up in her bank account will make her ineligible for Medicaid if we try to get her out of the nursing home into PACE.
Who should I be speaking to? Her Medicaid caseworker seemed confused by my question and said “we don’t take her social security” whereas I assumed it would be automatically garnished or something.
Confused, should I call the nursing home head office?
P.S. What is NAMI? (I think of it as the National Alliance on Mental Illness)
the stroke. She never had the same social worker from week to week - they were constantly shuffled or reassigned or they just quit. Staff turnover at this NH is insane. That was why they wouldn’t offer services of a notary. Due to COVID I could neither take her out to see a notary or have a traveling notary come see her. I fought to have her cognition reassessed by a speech therapist who understands aphasia. The therapist ran different tests and she agreed the original assessment was too low. The corporate office just sort of rolled their eyes and said yes we’ll accept her signature, they know this particular NH is poorly run. Upshot is, she is her own responsible party. A lawyer advised me at the time (COVID hell) that guardianship might take months and they might not even rule her incompetent. He advised us to just have her sign her own checks. (And she isn’t, though she has mild cognitive effects from stroke. She asks all the right questions about her bills and even says no sometimes.)
long story short, the NH seems to accept that she is her own responsible party but they talk to me about medical matters and routine paperwork issues.
anyhow, I believe this is a social security matter and tomorrow I will be with her so I will begin making inquiries with SSA. I believe she is being overpaid by mistake because no one properly changed her address or let them know of her nursing home status. (Although I THOUGHT the NH would do that?)
Yep, that monthly SS money she is still getting is not real, so it is not being touched. It probably has to be paid back to the government. The reason why this is an issue (aside from being not legally correct) is that we want to move her into a PACE program funded by Medicaid and I was advised by her Medicaid caseworker that she would have to go through a new approval process. I don’t want her to look like she has more income than she really has. That income she is getting right now is not real, it seems to be an error.
I have a question…. If she / you are thinking about her going onto PACE, have she/you looked at in detail how PACE is set up for where she is? We have a PACE center by us. I’m very much a fan of PACE but it’s not geared for everyone as how ours are run. One by us is essentially a M-F day center with everyone as a “dual” so on MediCARE & Medicaid for health insurance and also enrolled in community based Medicaid. Between all 3, costs for health care and day program costs are dealt with. Transportation is provided to/from the center as well and for the rare trips to hospital if needed. The # of days you go is dependent on your assessment and most get 3 days a week. The 1 by us is essentially a mini clinic and has seriously equipped vans (from State Dept of Health or from the hospital group this PACE is affiliated with) drop by on a regular basis for when certain screening/ procedures are needed. PACE is the hub. However, participant will need to be able to be on their own or have family there to deal with whatever oversight or care needed for nonPACE time. So if they are on M-W-F Pace then on their own all the other days & nights. On weekends - if deemed necessary- they might have a health provider do a in-home stop. But at no time will PACE ever provide for 24/7 oversight or care. To get 24/7 they need to be in a facility that is staffed for that.
Please, please pls before she moves out of current NH, look in detail as to just what this Pace does and if it’s at all feasible for her. If she needs others to be there to help her make it through her day, if she cannot do her own medication management, and she’s going to be alone she may not be a good fit for PACE.
Also look as to if there is a waiting list and what the list is drawing from. The PACE by us is run by Catholic Charities health facility administration group. Now CC also has a facilities group with market rate senior apts, income dependent apts, communal living places AND 202 housing. And church has senior groups within their parishes. All of these feed the waiting list for enrollment at PACE center, especially the 202 group. It’s hard for a random individual to get into this Pace, bc of this. There is a CC owned senior apt building by us, that on a regular basis has the PACE van picking up several residents regularly to whisk them over to the PACE for the day. If there’s an event, like Covid shut down or hurricane evacuation, the individual is kinda on their own to deal with it as the PACE will shut down. It’s not a NH that technically due to Medicare compliance has a legal requirement to provide for safe transfer to a comparable NH facility. Just in detail look into all this BEFORE she moves out.
Sounds like she’s still competent & cognitive but her aphasia keeps her from being able to communicate so she can seem incompetent, is this kinda happening? Its so hard to have the time or patience to understand one with aphasia (I have a dear with primary prog) as it takes forever to get a sentence out (my friend does excellent mime). You might want to have her look into 202 supportive housing program, that might be good fit. Good luck in your quest!