Looking for advice in New Jersey
My 93-year-old mother was admitted to a nursing home initially under Medicare to recover from Covid. After three months she came off Medicare and onto self-pay. For the next four months I paid out-of-pocket for my mother's room and board before Medicaid accepted her into their program. They accepted her into the program back-dated two months of which I paid.
So there were two months that both Medicaid and I paid the nursing home.
How might I receive a refund for the over-payment?
Should I expect to receive a check from the nursing home or will it go into her PNA (Personal Needs Account) trust that the nursing home manages which I think becomes part of her estate upon passing and then I have to go to court to obtain these funds.
1. a- takes her over the 2K asset max for LTC Medicaid. The NH do tend to monitor residents on LTC Medicaid as to their PNA balance because
1. b - if over 2K they should report it to Medicaid. And what a NH can do to avoid dealing with this is asap order an expensive piece of DME, like a wheelchair or walker, to get the PNA under the 2K max. Done by NH to keep them ok for Medicaid. But you will be most unhappy if this is done, just sayin’.
and
2. - $ in the PNA totally becomes moms ownership so any “transfer” to you looks like gifting which spirals into its own problems as gifting not allowed by Medicaid.
Fwiw a PNA balance statement should be sent out every 90 days from the NH to the POA and should pay a small amount of interest (it did for my mom in Tx as per State law and I’ve heard from others their States do the same).
You do want to do as others have suggested and send the NH a very detailed letter as to just how the NH were paid by you and that you personally are owed for the overpayment of two months. Send it as a certified letter with the return registered receipt from USPS.
if Nh is part of a chain, could take them 90 days to process the overpayment. Glacial.
I would send the business office of the NH documentation and ask when you can expect a check.
Do ALL of this in writing: CC your elder care attorney if you have one.