How do I work out with the nursing home my mother's financial problems?

Since she is on Medicaid, call the wefare office and explain the bill you got. I think that medicaid does back pay a month or two from date of approval. I wouldn't go into detail about financial things in the past. Just keep it simple to what is going on right now. Only discuss her financial business and try not to throw out to much of your financial situation. Because you don't want to be held liable to pay this. . So how can she pay if she has no money. That's how she qualified for medicaid in first place. If the welfare office won't help ask them to direct you to someone that can.

You are not responsible for your mother's expenses. I think at issue here is that you had control of her SS checks. The nursing home claims you should have paid them with those checks. You used them to pay other expenses of your mother's. Is that correct?

I think yellowfeever is on the right track. If Mom has a case worker or a social worker who helped with the Medicaid application talk to that person. Leave your own finances out completely but explain what you did with the SS checks and the situation you are in now.

Coach is spot-on, There are really 4 issues here:

1. From the month she is accepted into Medicaid, her resources less whatever her state deems as monthly personal care allowance - which varies from $ 30 - 60 a mnt - all must go to the nursing home. SO if she has 800 SS & 1000 retirement
then $ 1,740 - 1,770 must go to the NH from the month she gets there. Some NH will prorate the first days to the actual date but don't have to if they take privatepay.
Sadly that means the $ you spent on other things for her you shouldn't have and it should have gone to the NH. If you signed her into the NH AND signed your name rather than "Jane SMith as POA for Ann Smith", then you signed off as legally responsible for the debt. Which did you do?

2. If her monthly medicare payment is being deducted from her SS - that amount is usually paid by the state if she is poor enough. This is about 88 a month - this can take 1 - 12 months to get resolved as the $ for it comes from different state resources. There is nothing you can do to move this if your state is slow on this reimbursement. So she will be in a minus catagory for that amount. The NH know this but again if they are not a non-profit, this can become an issue

3. If she has a supplemental insurance policy, like BCBS, that is automatically taken from a retirement account then that is usually exempt from being included in her resources. It depends on each state how this is viewed. You may have to write to have this reviewed/appealed. While it is under appeal, the NH cannot enforce billing you for the outstanding difference under federal compliance with the state run Medicaid program. Must be in writing

4. Filial Responsibility - 30 of the 50 states have filial responsibilty laws, which means children can be responsible for the debt of their parents. It's based on old English law from the 1600 & 1700 when there were still poor houses. Now most states that have "filial" on the books have it written weak and it is not enforced. But a couple of states have NH that use the law to "encourage" family to pay for NH charges. This has happened in Pennsylvania with actual judgements against family members.

I bet your mom's NH is for-profit and views every action from meds ordered to physical therapy as a profit center for them (through companies they own) so the $ they get for Medicaid for her room & board is just the start of what they can bill.
This is totally legal but it is a major conflict in my opinion.

GOOD NEWS: If you are just on SSDI then you are judgement-proof, That means that whatever they try to do to you legally they have no real recourse as the $ your get from SSDI cannot be seized. Not that this keeps you from getting collection letters as collection agencies are pretty ruthless.

My bet is that you will get the 30 day letter from the NH - which means you have 30 days to move her out or they will turn her case over to the local agency on aging or Medicaid ombudsman. This usually shakes $$ out from family. But in your case the $ isn't there. The NH doesn't know that. You need to let them know that in no uncertain terms.

Since you are disabled, I'd go to the meeting with a short letter saying you are not responsible for your mom's debts, you are only her POA and doing your best aftercaring for her for 2 years, that you do not have any disposable income as your only have SSDI. That the only option you see is for them to get paid over time by payment from the personal needs $ your mom gets every month to pay down the debt - say 50% of her personal needs allowance. If they are willing to accept that, then fine and you want it in writing. Also take a good friend to the meeting to listen & take notes for you. Good luck.

Then I'd still move her closer to you once that opens up.

Update!!

That lady at business office at that nursing home where Mom is was very nasty to me last Wednesday night. In front of other people in front desk! She demanded that I gave her 3361.00 right away. When I told her that I couldn't do that she got mad, said that I was stealing money from Mom's SS checks, threatened to turn me in to Social Security. I told her to go ahead! Due to my deafness she wrote me a page full, but grabbed it & crushed it before I could finish reading it so I left.

Next morning (thanks to this website) I called Ombudsman via relay service for Arkansas. Turned out she happened to have a deaf son & knew what I went through. She was very helpful. I told her the full story. She told me to go ahead and give nursing home a check of what's left of Mom's money in her bank from SS which is $1116.00. That Ombudsman lady in Little Rock said she will get in touch with Ombudsman in my area which is Hot Springs.

I emailed to Julia, an Admin. of Alzheimer's unit where Mom is & told her that I would not deal with that lady from business office, that I would now require them to provide me a certified sign language interpreter according to ADA (they'd have to pay for it.) I told Julia what I used Mom's money for, that I had paid for Mom's Blue Cross Blue Shield in advance for 3 months, that Medicare and Plan D took out money, etc.

I also requested to Ombudsman for a transfer for mom from that nursing home to the one close to me which is 5 min. away. She said that it would be so easy since Mom already had been approved of Long Term Care Medicaid which is transferable.

Anyway, to my surprise I got a check from Social Security office in amount of 322.00. It's a refund for Plan D (Prescription Drug Plan.) Got a letter from them.

How do I get refund from Medicare that still takes out 96.40 per month? I thought business office took care of it. I will call Social Security via relay service tomorrow to ask about it.

Amount has gone down from 3361.00 to 1923.00 so far. Still more to come from Medicare and Blue Cross Blue Shield (supplement to her Medicare) which will help more. Then the rest I will have to come up with from my own pocket.

To answer coach's question, Mom was admitted to nursing home on April 24. Medicare paid for it until July 22. I got confused, thought Medicaid would start to take Mom's SS checks in September when she was approved, but it goes back to July!

Again, warning: the moment Medicare stops paying Medicaid owns SS checks already, not later when approved. This was my mistake.

I forgot to add: that check in amt. of $322.00 from SS to refund Plan D. I thought that it was business office that arranged it, but it just happened that they reduced amount from 52.00 per month to $5.70. Just a coincidence! So it means more money owed back from Plan D even if it'd be small. I am bit confused in all of this.I will ask Social Security office tomorrow when I call them.

Thank you so much for taking the time to provide this update. Experience is the best teacher -- and it is great if it can be someone else's experience. :) You got some ideas from other posters and now you are returning the favor. I hope that your caregiving journey gets less bumpy and that having your mother close will be pleasant and convenient.

Your Mom was admitted to the Nursing Home on April 24th. Under Medicare your Mom was entitled to 100 days of care as long as she required what Medicare deems as skilled care. She apparently received her 100 days of Medicare and exhausted her Medicare benefit on August 1st. As she obviously did not have the funds to pay privately the nursing home put her in a Medicaid Pending category while they waited on the Medicaid approval. It is customary for the nursing to request a prorated amount of her Social Security check. In this case it would have been prorated less one day. How did you think the Nursing Home was going to be paid for the month of August for caring for your Mom as you already stated you had anticipated Medicaid approval as of September 1? I am sure the Office Manager attempted to explain this to you as she seems to be very aggressive when it comes to collecting money. Which is her job. I think the problem here is a lack of communication. The nursing home, under ADA, should have used the services of an interpreter to communicate with you. The nursing home accepted that responsibility when they agreed to admit your mother. They should also use the interpreter during mandatory care plan meetings. Of course you will be responsible for letting the nursing home know when you plan to be there to discuss your Mom's bill or her care or any other time you would like a formal meeting. I would say that you should provide no less than 48 hours notice. If you don't provide this notice, you should not expect an interpreter to be present. Remember the Nursing Home is going to be paying this interpreter $60.00 to $80.00 an hour. Most services require a 2 hour minimum once scheduled and have to be paid if you show up or not. They don't come cheap so please don't abuse this service.

As I understand it, here's how Medicaid works. First, it takes all of your mother's assets to offset the cost of her care. Then it empties your bank accounts and puts a lien on your house to pay for yor mother's care. Then, after you and your mother are both broke, the American Taxpayer will cover the rest of the costs associated with your mother's care. Medicaid sounds great until you get plugged into it. My MIL opted to die in our home rather than bankrupt her legacy to my wife. It was hard, but she successfully avoided falling victim to Medicaid. Good Luck. God Bless You.

Well, close, but not quite, JonathninOregon. Since Medicaid is a needs-based system, there is an upper limit on how much you can have in assets and qualify. If you have more than that, Medicaid does not take it to offset the costs of care. Rather they allow you spend down to the limit you are allowed. You can spend this on consumer debt, a delux wheelchair, repairs to your home, a new wardrobe, a prepaid funeral plan -- lots of ways to use your own money. You cannot give it away, because if you don't need it for other things, then you are expected to spend it on your care. Taxpayers aren't expected to subsidize your legacy to your children or gifts to others. The cap on assets impacts a spouse, but not children. You do not have to be broke before your mother will qualify. The home is exempt from being included as an asset, but by the same reasoning that doesn't want taxpayers to support legacies to heirs, the proceeds from sale of the house can be used to pay back Medicaid for expenses it paid.

I am glad for you that your mother was too wealthy to qualify for Medicaid, and that you were able to meet her needs in your home. That really is the ideal situation, isn't it? For the many, many people who do not have the ideal situation, Medicaid is a rescuer, not a victimizer.

Jeanne, you are probably right. My MIL had a teacher's retirement and SSDI, which was quite a bit of money. The nursing home wanted to take her, get $6,000 per month from her income, then her savings, then the principle on her 401K, and then the equity on our house. The program, like so many government programs, was intended to help the underfunded. The people who twist the system into something it was never meant to be so they can make money off it are the real problem. We were lucky that my MIL could stay with us under our care until she died. But we did feel that the hospitals and care facilities were trying to rake in all of her money that they could get their hands on, and they offered Medicaid as one way to help them help us help them.