Nursing home business offices or their business associates will file Medicaid applications for free, but it can cost you a lot of money. We were contacted recently by a client whose wife is residing in a long-term care in a nursing facility.
The facility’s business office filed the Medicaid application for free, telling the couple that benefits would be approved retroactively to the date of the wife’s admission to the nursing facility. This was inaccurate. After four months, of the application pending with the Pennsylvania Department of Human Services, the family eventually received a determination notice stating that benefits were denied due to excess resource.
The nursing home was rewarded for this failure with private payment of their invoice for those four months. Had proper planning occurred with the help of an elder law attorney, the excess resources would have been identified immediately, and mostly protected in this case, without having to lose money to pay for four extra months of nursing home care at $14,000 per month.
The nursing facility blamed the denial on “the law” and “the County Assistance Office” but the real problem was that the person with the nursing home who filed the Medicaid application did not know the law. If the person did know the law, they would have realized that in fact there were excess resources, and the County Assistance Office would deny the Medicaid application in the absence of proper Medicaid planning.
Nursing homes are not in the business of protecting assets for their residents. Their job is to provide quality care. Perhaps they properly view part of their job as making sure they get paid, fair enough, but they do a disservice to married couples with one in a nursing home by not advising them to seek the counsel of a capable elder law attorney to do proper and legal Medicaid planning.
Our job, here at the elder law offices of Gerhard & Gerhard, PC, is to make sure the above situation does not happen to you or your parents. Elder law attorneys provide advice that can protect the “excess resources” for the benefit of the spouse at home, legally. There are many different planning strategies to explore, and the nursing will likely discuss none of them with you, apart from maybe suggesting you pre-pay irrevocable burial reserves. There is often so much more that can be done.
Please review the Medicaid planning articles on our website. We set forth various strategies that may be helpful in your situation. These articles are for general information, so you as a consumer are aware that there are things that can be done legally to protect assets and prevent the spouse at home from being impoverished by nursing home costs.
Medicaid planning should only be accomplished by securing the ongoing legal advice of a qualified elder law attorney. Don’t go broke saving legal fees.
Disclaimer: We recommend that you receive ongoing legal advice from an elder law attorney before attempting to navigate the Medicaid planning process. If you have questions or wish to secure our services, please contact Gerhard & Gerhard, P.C.
