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Nursing Home payment plan
Old 07-22-2015, 08:41 AM   #1
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Nursing Home payment plan

Hello all,

I'm bringing my 90 year old father to a nursing home later today. We've taken care of him and reached the point that it's necessary.

He'll be paying his own way, he has Long Term Care Insurance that will pay $100 per day (for up to 3 years) after a 90 day waiting period. He has just enough assets to sell to pay for his own way and allow mom to stay in her apartment. I'm not even going to try to apply for medical assistance.

I have a question for the board. Do you think it's possible to negotiate with the nursing home on the pricing ? I realize that they need to make enough to keep their doors open, but can a cash paying customer negotiate a price that would be more similar to what they are receiving from the majority of the residents who are on some type of assistance ?

Thank you.
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Old 07-22-2015, 08:42 AM   #2
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It never hurts to ask if they'll take less, but don't get your hopes up.
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Old 07-22-2015, 09:29 AM   #3
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It never hurts to ask if they'll take less, but don't get your hopes up.
+1
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Old 07-22-2015, 09:40 AM   #4
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Nursing homes in this state require you to do a net worth statement before admission, I think so there is a record in case someone does eventually apply for MA..

Since your Mom is still living and you say there is "just enough" be sure you know the threshold the state allows for income and assets for the non-nursing home spouse. Because you just never know what the future holds, the government does not expect the other spouse to end up with nothing to live on.

Rates are usually by care level and I don't believe people get a price break on anything. In fact I think the "full pays" are used to offset the price of MA residents. We looked at a great place for my MIL and they made it very clear that it was private pay only and if she went on MA she was out.
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Old 07-22-2015, 10:32 AM   #5
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Originally Posted by REWahoo View Post
It never hurts to ask if they'll take less, but don't get your hopes up.
+2

Here are some bargaining tips from Genworth:

Quote:
Assisted-living facilities often charge a one-time move-in fee. But if facilities have high vacancies, they may discount or waive the fee. They may also let you choose a more expensive room at a lower price.

Nursing homes generally donít discount rates, which are influenced by what Medicare and Medicaid pay. But you may be able to negotiate for extra amenities, or a private-room upgrade, if paying out-of-pocket or with long-term-care insurance.
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Old 07-22-2015, 10:43 AM   #6
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I'd ask them.
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Old 07-22-2015, 11:09 AM   #7
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It's a bit late, but the first thing I'd do is find an "elder law" attorney.
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Old 07-23-2015, 12:18 AM   #8
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I have consulted in many nursing homes in Texas and they do not negotiate their private pay rates.


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Old 07-23-2015, 07:32 AM   #9
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If someone gets a price for their Aunt Betty from a nursing home will that price be affected by Aunt Betty's net worth? I guess, reading this thread, I am wondering if some people get a price based more on their net worth than on the services they are purchasing - so, my rich Aunt Betty gets charged $125,000K a year and your middle class Aunt Betty get charged $105K a year at the same nursing home for the same services. (Assuming neither Aunt Betty receives government assistance.)
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Old 07-23-2015, 07:41 AM   #10
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Quote:
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If someone gets a price for their Aunt Betty from a nursing home will that price be affected by Aunt Betty's net worth? I guess, reading this thread, I am wondering if some people get a price based more on their net worth than on the services they are purchasing - so, my rich Aunt Betty gets charged $125,000K a year and your middle class Aunt Betty get charged $105K a year at the same nursing home for the same services. (Assuming neither Aunt Berry receives government assistance.)
Not based on my experience. Both my parents and DW's parents spent their final days in private pay nursing homes and the daily rate for everyone not getting govt. assistance was the same.
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Old 07-23-2015, 08:14 AM   #11
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Thanks all, we got him checked in and we're working on the paperwork.

I didn't even ask about the rates, I don't think the rates they're charging for private pay are much different than what they're receiving from residents on assistance. My goal wasn't to try to beat them down like we're buying a used car, I've just never been in this situation. I'm glad there are facilities available to help our elderly and their families.

I am going to contact an elder care attorney, my concern is that mom has enough to live independently in her apartment. This is way more complicated than an average person can figure on their own, I learned a long time ago that if you think you might need an attorney - You already do need an attorney.
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Old 07-23-2015, 08:18 AM   #12
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Thanks all, we got him checked in and we're working on the paperwork.

I didn't even ask about the rates, I don't think the rates they're charging for private pay are much different than what they're receiving from residents on assistance. My goal wasn't to try to beat them down like we're buying a used car, I've just never been in this situation. I'm glad there are facilities available to help our elderly and their families.

I am going to contact an elder care attorney, my concern is that mom has enough to live independently in her apartment. This is way more complicated than an average person can figure on their own, I learned a long time ago that if you think you might need an attorney - You already do need an attorney.
It's not a bad idea to meet with an elder care attorney at least once. You want to make sure your father's care does not leave your mother without enough to support herself.
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Old 07-23-2015, 08:41 AM   #13
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Quote:
Originally Posted by Tadpole View Post
If someone gets a price for their Aunt Betty from a nursing home will that price be affected by Aunt Betty's net worth? I guess, reading this thread, I am wondering if some people get a price based more on their net worth than on the services they are purchasing - so, my rich Aunt Betty gets charged $125,000K a year and your middle class Aunt Betty get charged $105K a year at the same nursing home for the same services. (Assuming neither Aunt Betty receives government assistance.)
The net worth sheet you have to do in this state is to do an asset accounting in the event you do need to go on MA... They want to be sure some of your assets haven't "vanished" ie... been given away to try and get on MA...you must do a spend down of your unprotected assets first. Protected assets might be a base level for a spouse or living expenses for your spouse.
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Old 07-23-2015, 09:18 AM   #14
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Agree on seeing an elder care attorney. The rules are complex, especially with respect to the spouse not receiving care.

My mother is in a nursing home. She started as private pay, spent down her assets and is now on Medical Assistance. While private pay, my mother had to pay extra for laundry, syringes for her insulin injections and a whole host of other charges, above and beyond the daily rate. It can get ridiculous! The rate sheet will list the prices for those items.

BUT, when Mom went on MA, all those charges (except phone & cable) went away. Her payment is based on her income, less health insurance premiums.

This can be a stressful time for the family, but it will get better. Best of luck.
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