Medicaid nursing homes and payment

[bmcgonig]

This will/might be a real situation sometime for someone I know so Im hoping someone here might know.

If you end up in a nursing home on Medicaid because you don't have any assets, and later you inherit a 100k or so, would that money be owed to Medicaid?

Thanks everyone.

 

[MichaelB]

IANAL, but my understanding is beginning the month the inheritance is received, Medicaid eligibility is lost and the patient is fully responsible for all charges until all the money has been spent.

 

[ERD50]

It is also my understanding , from posts on this forum, that if you have moderate resources, consider the following: Get into a higher quality, higher cost home, and when you run out of money, I don't think they can kick you out, they need to accept the Medicare/Medicaid rates going forward (but won't accept them for new patients).

It sounds like this person could run out of funds either way, so best to get into the best place they can, while they can afford it.

But check this info yourself, and for the state this person is a resident.

-ERD50

 

[gerntz]

It is also my understanding , from posts on this forum, that if you have moderate resources, consider the following: Get into a higher quality, higher cost home, and when you run out of money, I don't think they can kick you out, they need to accept the Medicare/Medicaid rates going forward (but won't accept them for new patients).

-ERD50

I thought states assigned Medicaid beds such if you're in a home w/o any, out you'd go. No?

 

[athena53]

I thought states assigned Medicaid beds such if you're in a home w/o any, out you'd go. No?

I think it's up to the individual nursing home and I'm sure there are some that don't accept Medicaid, period. There are some that will accept you if your have enough assets + LTC insurance for a few years and promise to accept Medicaid if you outlive all that and I know one woman whose mother was still kept on when Medicaid kicked in. I'd be really paranoid that their lawyers would find a way to get out of that promise when you really needed it.

 

[ERD50]

I thought states assigned Medicaid beds such if you're in a home w/o any, out you'd go. No?

I am not sure, just passing it along for consideration - that is why I closed with:

"But check this info yourself, and for the state this person is a resident.".

-ERD50

 

[Teacher Terry]

A SW told me that here the homes can't throw you out once you go on Medicaid. Now some very fancy ones don't accept it period so you want to be sure you get into a nice one that does accept it when you run out of $.

 

[misanman]

This is only a single example but I have a friend that is a nursing home owner and he tells me that their home does not accept Medicaid and that a resident who is running out of their own funds will need to find other accommodations. If they (the home) are given advance notice then they will help find a Medicaid bed in another facility and "smooth the transition". This is in Iowa.

Not sure what happens if someone refuses to leave.

 

[joeea]

This will/might be a real situation sometime for someone I know so Im hoping someone here might know.

If you end up in a nursing home on Medicaid because you don't have any assets, and later you inherit a 100k or so, would that money be owed to Medicaid?

From https://www.medicaid.gov/medicaid/eligibility/:

"Estate Recovery: State Medicaid programs must recover from a Medicaid enrollee's estate the cost of certain benefits paid on behalf of the enrollee, including nursing facility services, home and community-based services, and related hospital and prescription drug services. State Medicaid programs may recover for other Medicaid benefits, except for Medicare cost-sharing benefits paid on behalf of Medicare Savings Program beneficiaries."

 

[Helios]

As I understand medicaid, if you receive money after being in a nh, you go into whats called ,spend down,. The money is used for your care until its gone, then you return to regular status.

 

[Walt34]

IANAL, but my understanding is beginning the month the inheritance is received, Medicaid eligibility is lost and the patient is fully responsible for all charges until all the money has been spent.

State laws vary of course but in MD that is what would happen. We learned more than we wanted to know about Medicaid dealing with FIL's issues several years ago.

 

[Ed B]

It is also my understanding , from posts on this forum, that if you have moderate resources, consider the following: Get into a higher quality, higher cost home, and when you run out of money, I don't think they can kick you out, they need to accept the Medicare/Medicaid rates going forward (but won't accept them for new patients).

It sounds like this person could run out of funds either way, so best to get into the best place they can, while they can afford it.

But check this info yourself, and for the state this person is a resident.

-ERD50

Adding to what ERD50 said....

[FONT=&quot]This can be true but it depends on the policy of the individual Nursing Home, aka Skilled Nursing Facility. As others said some skilled nursing facilities don't accept any Medicaid patients, but some will. One of the facilities we looked at for my mother back in September only had about 6 Medicaid rooms (semi-private) out of about 50 total rooms split up between private and semi-private. We were told that when my Mother's resources ran out and she transitioned to Medicaid, they would only be able to keep her if a bed in one of those 6 rooms was available. That facility is well thought of enough in the community that people only give up those Medicaid rooms if they pass on, or have to be moved to the memory care wings. Plus, they had a waiting list for Medicaid rooms at that time. She also mentioned that people move up the queue for those rooms if they had been a private pay resident for a while, and weren't just hiding money from the state to save an inheritance. This wasn't personal, it was corporate policy. The person that we visited with at that facility from their admissions department was a family friend.

At another facility which we eventually chose they assured us that residents are almost never sent out once they transitioned to Medicaid, but my mother would have to move to a different type of room ... semi-private. There were a few other reasons why we liked this facility so that is where she is now. She went in on Medicare Rehab after a terribly botched back surgery that nearly killed her in the hospital twice and again in a rehab and left her paralyzed in her left leg. Once her 100 days of Medicare rehab were over we transitioned to private pay because for her a semi-private room would be torturous. Since the army of physicians treating her said she would never recover and even discussed hospice with us, we sold her house to help fund her private room at that skilled nursing facility.

As time as gone on, she is slowly but surely recovering, to the amazement of all. We are all thrilled that she has improved enough that she is getting ready to move to an assisted living facility around June 1st. This will drop her cost from $200/day to $110/day which will make a huge difference in how long her money will last. There are so many remarkable twists and turns in my Mother's story over the past year. I have barely scratched the surface.


As the poster I quoted said, check this out in your area and with multiple facilities. If this is a real scenario playing out in your life, also check with some attorneys who specialize in this stuff and perhaps a minister at your place of worship. The attorney(s) has a profit motive and they can be fast talkers, the minister shouldn't. Balancing the advice of the two sources can help you make the best decision for your situation. After talking to two attorneys my siblings and I decided "we didn't have a single crap to give" about preserving our mother's home as an inheritance asset, which was really all they had to offer at the time as she appeared to be near death. We were happy to sell it and use it for her. Now, she will be able to live in that assisted living facility for about 12 years before she runs out of money even if her money from the house sale sits in a mason jar under her bed. [/FONT]

 

[bingybear]

from link

You have it right. When your mother receives her inheritance, you or whoever is representing her will have to inform the Medicaid agency for your state. Medicaid coverage will then end until she has again spent down her money to the countable asset limit, $2,000 in many states. The money can be spent for anything that will benefit your mother, including prepaying her funeral, travel, dining out, clothes, television, DVD player, and paying off any debts she may have. In most cases, your mother cannot make gifts with her money. However, there are some exceptions to this rule and in some states good planning techniques that may permit some gifting. To be sure, you will need to consult with a qualified elder law attorney in your state.

 

[Walt34]

One more thought. DO take the time to talk with an elder law attorney in the state where your mother lives. Expensive, yes. But in MD at least there was a rather complex method of shielding about half of FIL's estate from Medicaid. He passed on just before the first half of his assets were spent on care so it for us it was a meaningless exercise. But had he lived just a few months longer it would have been well worth it.

 

[ivinsfan]

A SW told me that here the homes can't throw you out once you go on Medicaid. Now some very fancy ones don't accept it period so you want to be sure you get into a nice one that does accept it when you run out of $.

In this state that in not correct...Some places say right up front that they are private pay only and if you can't pay you have to move.

 

[MBSC]

You may be interested in the following post if there is a spouse.

My FIL was on Medicaid after he'd exhausted his assets. His small pension check and SS covered all but a small portion of the monthly fee at the modest nursing home where he lived for nearly 7 years before passing away a few months ago.

I consulted several times with an elder law specialist attorney in his state of residence and was grateful for her experience. FIL received a small and unexpected inheritance, many years after the benefactor had passed, due to a lawsuit settlement. It was enough to upend his Medicaid eligibility, but not enough to cover a month of care. Having completed the annual eligibility forms for him for a number of years, I considered it money well spent to have the attorney advise us on an annuity that was payable to his spouse (MIL) to avoid his ownership of the inheritance.

 

[Ed B]

You may be interested in the following post if there is a spouse.

This is very good advice if there is a living spouse. There are rules that protect the spouse, as there should be. And this isn't gaming the system, it is a way to take care of both of them.

 

[bmcgonig]

Thank you everyone for all the information. I learned a lot.