My father needs nursing home care. He came from the hospital to have rehab then the plan is to keep him in the nursing home. There were no beds avail in the rehab side so they put him in the long term side while doing rehab. The sales guy at nursing home says I need to sign the admission agreement right away. I'm going to the medicaid office today to apply for dad.
I want to have an attorney review the document prior to signing. Can they kick dad out if I take a few days to have it reviewed? Dad was admitted to the facility on Thurs. Fri, I received the papers and asked to have the weekend to review and he wants them signed today (Monday).
Thank you for all of your advise!
If dad is being discharged from after a 3 day hospitalization with MD orders for rehab, then dad is fully qualified for the MediCARE rehab benefit. That is a pretty hard & fast rule and the facility knows that. If you want to hear this on your own go to the CMS (Centers for Medicaid & Medicare site) and google or call CMS.
The facility will be paid 100% for days 1 - 20 by MediCARE. I would NOT sign anything until at least dad is there for that period of time and AFTER you have discussed dad's "progress" in rehab. The "progress" determination is a big deal - it is a determination IF dad can continue in rehab. Medicare will pay 80% of the rehab from day 21 - 100 as long as dad is progressing. The therapists have some degree of discretion in doing the determination too (like is dad trying or is he stubborn and won't do the rep's) so you want to do whatever to work with the PT OT's and dad to keep him as "progressing" as much as possible.
BTW Medicare payment to the facility is like more than double what Medicaid would ever pay - so a facility wants them to stay in under Medicare benefit. I'd be concerned that 1. the admission guy is clueless on this & 2. that you are being essentially forced under duress to do sign something asap. Now after day 21, dad will need to pay the 20% - most better secondary insurance policies cover this, so find out what secondary dad has. If he has none, then the 20% is private pay unless he qualifies for MedicAID.
Make sure this place takes Medicaid for all beds and takes residents as "MEDICAID PENDING" - this is very very important. If they don't - but they take Medicaid - they can bill at full private pay rate till dad has cleared and been accepted by Medicaid. You should get the overcharge once dad is cleared by Medicaid but with Medicaid application taking anywhere from 3mos to a year, that is a whole lotta funds in limbo. And if dad has a Medicaid eligibility issue, that $ is gone. Comprende?
The facility should have a page that lists what documentation is needed for the Medicaid application. For my mom's NH Medicaid admission, I pulled together all the items and it was close to 100 pages. Don't faint - a full 1/2 of this was all pages of her very old insurance policies (life and funeral) as the old ones are like 20+ pages each and legal…..Now the NH looked over the documents to determine IF they would take mom in as Medicaid pending. Mom was in IL for a couple of years prior to going into NH (she bypassed the AL stage too) & still had her home, so her "pattern of spending" was pretty clear as to just where all her $ had gone to to get her to impoverishment for Medicaid. But if there is something that the NH admission saw that was an issue (like mom had 85K 4 years ago, gets $ 1500 in SS and lives with family and now has only 1K so you know that's totally off), the NH can choose not to accept the resident as "pending". You want to get that list to get this stuff together and figure out if there is likely to be any issue with where his funds went the past 5 years.
Also I'd look about for another NH just in case. The pressing you to sign is not good, I'd be wary. You could use saying "all paperwork needs to be evaluated by counsel" to delay this as well (even if you don't have an attorney). That should put the admission guy on alert that you are not to be trifled with.
Good luck with the process you are starting. The care your father receives won't be the same as at home, but you might want to choose your battles. If they close ranks against you as a trouble-maker, it could be your father who suffers.
By paying an attorney and a Medicaid consultant, I saved more headache then I would have had I signed them myself.
Do NOT sign anything unless it's reviewed! The attorney I contacted (I didn't know her at all) was going to do it for free (first consultation) but I actually felt I had to pay her, so I did. That's how important this is.
If you look at some of those agreements, there are pages missing. That's the first thing the attorney saw, i.e., 1 of let's say 26 pages. Well, the next page was 5 of 26 pages, and the list goes on. The parts where they wanted me to sign were highlighted in yellow. I was strongly advised to have my mother sign these if she could. Well, she 'could' and she did.
See All Answers