Recertification. Any advice?

Igloo here and yes sirreeee!!! It was not quite at the 1 yr mark for eligibility / final approval but after the 1 yr mark for my moms application filing that I got the renewal letter with documentation resubmission list from State of TX LTC Medicaid program and due back within 14 from date of letter. Which for even more fun was postmarked abt 5 days later then the letter and I live in LA. And had put all mom’s paperwork into bins into storage. Sheer luck that I had it all with me and had almost all her mail addresses changed to a postal box in LA. Nevertheless was a long weekend followed by a long morning at a Fed Ex store as I faxed it over to Tx Medicaid office as I wanted a transmission report on each segment of the fax. I was oh so prepared for the next year…

Medicaid wanted the month of the renewal letter banking statement and 3 months prior. I remember this quite distinctly. & they wanted a copy of the NH trust account aka the personal needs account (PNA) at the NH that y’all may have set up for mom to use to pay for the on site beauty shoppe or pay for other incidental services at the NH. Your mom would have been given an exact figure from State Medicaid that is her required copay, that she has to, HAS TO PAY the NH. Imho what they are looking for is to make sure that your mom is for sure ending her month and starting her month at or under $ 2,000 (the maximum allowed for assets for most states) and that if she is still having her SS $ or other monthly retirement income going into her bank account that she is paying it to the NH as the mandatory copay to the NH and doing this in a timely manner. So no funny stuff happening with her income. ((NOTE: If you mom has the NH as her representative payee for SSA, she probably not longer does not have a bank account anymore, so perhaps only her PNA document needs to be reported for the renewal.)) But if she still keeps a bank account that get direct deposit of SSA, etc. and pays the NH the copay; her end of the month banking balance PLUS the PNA combined must be at or under $2K to be ok for LTC Medicaid or she can be deemed no longer impoverished so Adios! LTC Medicaid.

My moms initial application was abt 130 pages mainly due to her very old Term life insurance policy, house & funeral info; the renewal ran abt 25 pages.

It will be ok; really just fill out the renewal questionnaire & make a copy of it and all the documents asked for and submit them asap. If it the NH that is shepherding this, if you can at the bottom on one of the pages, make a notation: left at Whatsamatta NH business office 2/25/23 10:00AM with your initials, as POA for Mrs Florida.

Barb is 100% spot on that due to Covid, States suspended a lot of the processing on programs. One of my long time BFFs is with Medicaid and they were just rolling over all renewals systemwide as it was all they could do to even process new applications due to Covid.

I understand your confusion since no one has requested it of you before. Since you have never received notification from Medicaid, your moms mail is probably going to the NH. Ask them.

Igloo (Tx and La resident) long time poster, has written many times about how she got caught off guard on year two and had packed all her moms docs into a storage. Plus she got the notice w/o much lead time and had to scramble. The last thing you want is for the recertification to not be handled correctly and mom come off of Medicaid.

If the NH has taken care of this for you before or mom fell into the time frame of COVID on any recertifications, then you escaped that chore. I have never heard about the COVID exception but each state administers Medicaid in their own way and not all states were affected by COVID the same,

But do rest assured it is a normal request in normal times. The person who contacted you is trying to make sure they keep the state paperwork done correctly to keep the money coming in for your mom would be my take on it.
Is this a new contact for you?

Are you your moms POA? Did you receive your moms SSA-1090 and the summary of benefits or does it go to the NH? I’m not sure that this matters in regard to recertification but it might explain why you haven’t had to be involved before.
When I was last in the business office at my aunts NH I saw a stack of the residents 1099s sitting on a desk to be mailed to the NH corp office. My aunts comes to her home address. It is confusing. Most of us know nothing about these procedures from personal experience and I find each NH, Community and State can have unique to them nuances based on what I read here on the forum and in real life. Also the rules do change over time.
Let us know what you find out as it is helpful to others as well.

Medicaid usually asks for recertification every year. My Mom passed before I would have needed to recertify. I do know that I had to sign saying it was OK for them to go thru Moms mail to take anything from Medicaid out.

Do you pay Moms SS to the NH every month or are they payee. If they are doing the recertification than yes they need her bank statements to make sure she is under the asset limit. Just make sure this is what they are doing and give them the info ASAP because there is a deadline that has to be met and if not, medicaid will stop.

They cannot bill Mom extra fees when she is on Medicaid. The only money she should have is the asset limit allowed and the small amount of money for her Personal needs account which actually is part of the asset limit. So if Moms PNA takes her over the asset limit, you need to spend some money on her. You are not responsible to pay towards Moms care. The NH has excepted what Medicaid allows and Moms SS thats it.

I would ask for an explination..in writing that is understandable.
If mom is on Medicaid they may need confirmation she still qualifies.
If mom is on Hospice they may need confirmation that Hospice has recertified her. Although that is done every 3 months.
I find it VERY odd that a facility would send a text about a matter like this.
Texts are NOT secure and any information should not be sent through a text. I would not respond via text with ANY personal information.

Make them explain. There's a hidden fee in here somewhere that either they don't want to pay for themselves, or because the management sees a way to make a quick One-Time-Buck off of the residents.
I'd check over whatever they want you to sign for very carefully. Read the fine print because there's something that is going to result in your mother paying more for something or you agreeing to cover the cost.

I agree with Mom. If you are simply curious you should as the facility administration itself, because these things differ facility to facility and State to State, and as Barb says it may have been a rule not recently enforced due to covid. The facility is simply checking that your Mom has not fallen into money she is now holding in her account (inheritance or otherwise) and that she still qualifies for governmental help. It will be a simple matter to give this information to them for her own good.

When your mom went into the NH, you completed an application for LTC Medicaid, and submitted lots of financial documentation, correct?

I believe many states suspended their yearly recertification requirements due to COVID.

As mom has no money, I would simply give them the records they are asking for.