I am a disability advocate-doing some senior advocacy for my wife's friend. Jim- placed his mother in a PA based N-home app. 6 months ago. He had & has been taking care of her finances prior to her residency. The NH is claiming that he has "stolen" money from them since they were not notified of his ability to access her accounts before she was accepted to the home. Jim has only used mom's account for things she wanted. The NH intends to charge him a large fee-- to recover what is owed. However they are also including as part of their calculations-- a large chunk of time BEFORE she was ever a resident there.
Now I am primarily an advocate for younger disabled folks, but I've dealt with NHs before. This sure sounds like a Rights violation- either as an illegal backdoor pre-admit fee (mom was already receiving medicare when admitted to the NH) or as a denial of her right to designate someone besides the NH to care for her finances. I just wanted to get some feedback from some of ya. Has anyone ever heard of this tactic before? Some Pennsylvania based resources would be welcome. some strategies for advocacy would be great too
Medicare does not cover nursing home costs. (They cover rehab services which are sometimes housed in a unit of a nursing home, but for a limited number of days for rehab only.) Do you mean that Mom was receiving Medicaid? That does cover nursing home costs.
The 5-year lookback period pstiegman mentions occurs when someone is applying for Medicaid. It is the business of the state agency. Nursing homes do not have lookback periods. Nursing homes have no authority to say who can be in charge of Mom's money or what it has to be spent on.
Has the NH not received their monthly charges? I guess I'd start by looking at the contract between the NH and the family.
Somehow I get the feeling that application for Medicaid is involved in this. Is Medicaid being denied or delayed, because of payments made by the son? For example, did Mom give a large amount to a charity or to a family member? It would not have mattered if son wrote the check or Mom did, if it happened in the last 5 years it could impact her eligibility for Medicaid. If the NH was counting on Medicaid and now knows they aren't going to get it as soon as they thought, they may be claiming that is the son's fault. Does the contract specify she must disclose who had authority to handle her finances?
This just seems so muddled. Is the NH trying to administer the application process? I think your friend's mom would be better off hiring an elder law attorney to handle that for her.
Meanwhile, the NH is entitled to be paid for what they have provided. Whether the son is responsible for the amount is a legal matter. The claim that the son stole from them sounds absurd.
There are a some folks on here who are very experienced with Medicaid applications. Could you provide some additional details, such as whether Mom was on only Medicare or also Medicaid when she entered the NH, and whether there is a Medicaid application pending at this time? Perhaps you'll get some more helpful comments.
In response to Psteigman- there are no past fees due.
Jim's mother has been on medicaid for the last few years prior to her admission to her current NH. She has been a resident of this particular NH for about 9 months or so. All bills due to the NH have already been paid for from the time she became a resident going forward. From what Info I can get apparently they want to charge her (or Jim) for money PRIOR to her ever having lived there. This includes time when she resided in her own home.
Also FYI- medicare can in some instances pay for a NH. This is taken from http://www.medicare.gov/nursing/payment.asp
"Medicare
Under certain limited conditions, Medicare will pay some nursing home costs for Medicare beneficiaries who require skilled nursing or rehabilitation services. To be covered, you must receive the services from a Medicare certified skilled nursing home after a qualifying hospital stay. A qualifying hospital stay is the amount of time spent in a hospital just prior to entering a nursing home. This is at least three days"