What does Medicaid pay for nursing homes?

[Col. Klink]

Quote:

Originally Posted by tps7742 Luckily the administrator at the facility my mom lives directed me to this lawyer. From what I have seen all residents get the same treatment private pay or not.

Federal law requires equal treatment and amenities for residents of a Medicare / Medicaid enrolled nursing home regardless of payer source.

[Teacher Terry]

The nursing home handled most of the Medicaid paperwork and I just submitted bank statement so really easy.

[zippy2020]

Quote:

Originally Posted by Lakewood90712 IIRC MEDICARE will pay for a very limited time, like less than 30 days. Medicaid, for the long term indigent. As others have posted, very limited assets, usually a 2 year look back on assets, and claw of anything upon death , including home equity.

Medicaid changed to a five year look back on assets or asset transfers, quite a while back.

To the OP: Your best bet to find out what Medicaid pays is to talk to a local facility manager. Rates vary according to states because Medicaid is a 50-50 program: 50% Federal funds matched by 50% state funds.

[zippy2020]

Quote:

Originally Posted by ivinsfan This is true my MIL had dementia , she had money to pre pay for around 2-3 years but we had to select our second choice because our first choick told us very clearly that they didn't accept Medicaid. It was a difficult choice for the family because it was her third placement and everytime we switched her placement she declined significantly.

This is something that many people new to caregiving may not be aware of.

Change is very, very hard for people with dementia. Think of dementia as a "narrowing" of the visual world they see. As dementia progresses, more and more of those visual details begin to "lack sense".

Let's say there's a lamp on a table, between a sofa and chair. The sofa has a throw over it, as well as a few different decorative pillows. The chair has a seatpad on it, and somebody's sweater hanging on the back. There's tchotchkes on the table - a couple of photos, a few magazines, somebody's coffee cup.

Dementia turns this visual into a confusing, chaotic mess.

The clutter of so many details overwhelms the dementia-afflicted. Multiply that one visual by different angles/perspective - every time the person turns around, there are more shapes and colors and details crowding in!

Individual elements get "lost". Even something familiar may not be remembered, because there are too many things around it, and the dementia prevents being able to visually separate items into familiar/unfamiliar.

It all becomes strange and confusing.....which creates anxiety. The mind freezes up further under stress, and the anxiety continues to build.

The world becomes an unfamiliar, vaguely threatening, visual kaleidoscope every time the surroundings visually change. So routine is very comforting to dementia patients, greatly lessening stress.

Sorry to have gone OT, but the lesson we learned is, when you are caring for someone with dementia, you have to very carefully approach change with them. They don't take it well, so if you can avoid it, best to do so.

[NoiseBoy]

Quote:

Originally Posted by KM I think you’ll find most nursing homes don’t work this way. They either take Medicaid or they don’t. I don’t think you can “subsidize” Medicaid to get a “better place”? Maybe....but I don’t think so. 1) if a nursing home accepts Medicaid, once your in-laws assets have been drawn down to Medicaid levels (check your state laws for that level), Medicaid picks up the tab. What that amount is, is an agreement between the nursing home and Medicaid. You don’t “chip in more” to get a better room or better care at that facility. 2) if they don’t accept Medicaid, they don’t. Period. They don’t and won’t bill Medicaid. You pay the full amount and if you run out of assets you must move to a facility that does accept Medicaid.

This is how it works in my community, so I assume that it is the same for the entire state. We toured and filled out financial data for two different places and I had this conversation with their sales and marketing people. One place kept referring to a "fund" that they had to cover the gaps when a resident ran out of money, but when I kept asking for details, I learned that the fund was only enough to cover small gaps, like $500 a month. It smelled very much like they just wanted us to move our parents into their facility and then hope that they died before their money ran out. Very shady. The other place was a run by the Lutherans, and their marketing person was much more straightforward with me. It was 100% private pay (second best place in our community) and when my parent's money ran out, they would be moving out. Period.

It is my understanding that, in our state, if a facility takes Medicaid, like for when a resident's money runs out, then they are obligated to accept Medicaid only patients too. That is why most of the facilities near us are 100% private pay. There is no middle ground.

[marion10]

Our experience with my MIL was similar- she was a widow and went she entered a nursing home, she had enough assets to cover about 18 months of care ( at 8,000 or so a month). She went into a very good church run nursing home and stayed there for six more years! She had SS and a small pension and Medicaid paid the rest. My husband and his siblings did pay extra - maybe $200 a month to have her in a private room. We still give regularly to the facility- I know the Medicaid reimbursements do not cover the full cost and we are so grateful for the care she received.

[Dash man]

We put my MIL into a nursing home last year from an assisted living place. My FIL lives with us. The nursing home has a limited number of beds for Medicaid, but patients are treated the same. She is much happier than she was in the assisted living facility. Medicaid takes her social security and she gets an allowance. FIL takes her to get her hair and nails done. They keep her busy and frequently have singalong hours or other entertainment. FIL washes her clothes to avoid that additional fee, which we offered to cover. He’s there every day, so it gives him something to do.
The paperwork to start Medicaid was horrendous, but once done it’s been great. FIL could not have done it himself. DW did all the work, but the people in the home were great in helping. The county was helpful too.

[ncbill]

15+ years ago we were paying $120/day vs. Medicaid rate of $90/day at the same nursing home here locally.

[North Texas Cajun]

Medicaid laws vary by state. One important consideration is how much of a spouse’s savings must be spent before Medicaid will cover nursing home care. As I understand it, in many states almost 50% of combined IRA totals must be spent first, regardless of who owns the IRA. Furthermore, the maximum IRA allowed the spouse not receiving nursing care is as little as $126K.

https://www.elderlawanswers.com/medi...y-spouse-12019