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My brother & I are helping my sister with arrangements to transfer from SNF for therapy, to LTC and Medicaid coverage. He is her POA and has an appt with elder care atty later this week. We don’t want her to remain at the current facility for LTC, but we’re too short on time & will need to start Medicaid process while she’s there and then move later. (She’s at day 61 of the possible 100.) This forum has been extremely helpful with my research. My question for now, though, is related to communication with the business office of the facility. Here’s the back story.
At care meeting (6 wks ago) we told the social worker that we had interest in LTC and Medicaid & she said the business office would reach out to us. (At the time, we had a sliver of hope she’d progress to AL level.) The facility is in Baltimore, MD. I rec’d phone call the following week from a NY # & since I didn’t recognize it, let it go to VM. It was the business office, and in VM they gave me a different # to call back. I called that back, and it was a NJ #.
Okay, it’s outsourced, 3rd party, I can see that, but this adds difficulty when we're not able to work together in person. We communicated weekly, always updated her honestly on where we were on research, getting POA setup, etc. Acknowledged the need to coordinate with them, but about 3 weeks ago, they became more aggressive about starting the process although we weren’t ready. I asked what would be the first step in the process, what do we need to do, or was there info they needed from us, etc. The answer was they need her bank account # and routing # so that they can get the spend-down started! Is this as unbelievable as it seems like to me? That’s basically what my question is today. (So grateful to this forum, now armed with knowledge about dangers of authorized representative situation. We have a meeting later this week with SW of facility & conference call to the business office in NY/NJ.)

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I am in Canada, in Ontario to be exact. Yes. It's unbelievable but it's true. There is no insurance that covers my husband and I have an ongoing nightmare every month. The home thinks of only money and it hurts and hits at the same time. I fought back. I put a stop payment on the first cheque as it cut into MY money, little that it was. I went without eating for almost a month and stop buying ANYthing. Every month it has been the same thing. Money first. Then we can talk about what my husband needs or wants. I don't know if all homes operate the same but this home is under the government and the government doesn't give a damn what your going through. They want the money upfront and that is that.
Just my two cents worth.
Temper.
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JoAnn29 Apr 2022
Here the spouse not in care is called a Community spouse. Medicaid allows for splitting of assets. Also, the CS gets enough money to live on from the couples monthly income. Hard to believe that Canada does not have something like this.
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absolutely no way they ever get her banking #. Never ever. If y’all did this, the scenario would be….. say Sissy has $23,456.00 in a bank account, they would prebill her for $21,456.00 leaving her $2,000.00 as 2k is the standard asset maximum allowable under LTC Medicaid.

They r assuming you are overwhelmed and will acquiesce to whatever they say. Forgetabtit. & the elder atty can put a stop to this.
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kibrij Apr 2022
Yes, you nailed this! Spoke with my brother (POA) today after he received a phone call from business dept - it was all about the Prebill!
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This is how nursing homes operate. The business end is always in another state because most facilities are chain franchises and under the ownership of a big company but with shareholders who buy stock in them.
They DO NOT need her bank account number and routing number. NO WAY! Once the POA is done naming you or your sibling or both, instruct the facility to send you a written bill every month. Then pay them with a certified cashier's check from the bank.
You say she's at day 61 of a possible 100. I'm assuming she's on Medicare. Here's what the facility she's in is going to try to pull.
They will collect payment in full from both Medicare and your sister's secondary insurance. Then they will clean out her bank account and also collect the full payment in cash.
You do not have to allow them any access to her banking. Make them send you a written, itemized bill every month.
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kibrij Apr 2022
Thank you, I've learned so much from these forums - the advice is priceless! It breaks my heart thinking about all the vulnerable people out there that get caught up in this & picked clean.
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Are you using the facility to set up Medicaid, bad idea. I would not give them any banking info. As POA your br can do the spend down.

I personally went to Medicaid and sat with a caseworker and filled out Moms application. I was given a list of things I needed to provide. I started the process April. Mom had 20k left. I placed her May 1st and she paid for May and June. I confirmed the caseworker received all paperwork and proved spend down in June. July 1st Medicaid started. In my State of NJ you have 90 days to complete the process.

This is going to be hard to explain. The process does not wait for you. Your sister may have 39 days left that Medicare will pay for her care. The NH section needs to have you Medicaid pending to except your sister into their care. So the sooner u start the process the better. If your sister has enough in assets to pay for her care a month or more, great but you need to start the process before her money runs out. Like I did with my Mom.

I don't really see the need for giving these people bank info. As long as spend down is done within the 90 days by your brother, there is no need for them to be in control of the account. I may give them a copy of her statement with acct info blocked out but unless MD is different than NJ, I would not give them any info. I would call Medicaid to run it by them. Be involved with how the process works and how long u have to complete the process.
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kibrij Apr 2022
Thanks for info, copying & pasting this so I can give to my brother. I'm usually good at grasping information in my brain, but it's the getting it from there out into words that leaves much to be desired lol.
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