Can assisted living require that family of a Medicaid resident pay for bed bug extermination?

I agree with GA - this lady has been living in the facility for two years. How likely is it that this very recent infestation originated with her room? - unless somebody brought in second-hand, unlaundered soft furnishings: bedlinen, pillows, mattress topper, eiderdown, rugs or anything like that, which in itself seems pretty improbable.

The facility must deal with the infestation, it must ensure that all rooms are free of infestation; and their giving you notice that follow-ups would be the liability of the residents and their families sounds to me like a bit of a Hail Mary effort to spread the cost burden.

Have other families been told the same thing, do you know? I should ask around, it might be revealing.

I skimmed through most of the answers but wanted to just quickly share one observation:

I think that, unless the admission documents specify otherwise, the facility would have to have some proof that the problem originated in your mother's room, or was specifically lined to her presence.   Otherwise, it seems to me more like an attempt to intimidate and create an unfounded accusation.

Have the admins stated why they think she should have to pay for future treatments?   I'm assuming then that they wouldn't be treating any other rooms?

Immediately contact Medicaid, the Office on Aging in your county, the state ombudsman and all the officials involved in caring for these people. You should NOT have to pay. This is serious and I truly believe something will happen to force the home to take care of and pay for the situation. Stand strong and start checking on this now.

If it is the Rules of the facility, Someone, Hun, Yes, Would need to pay. Get everyone together and Try and Put the Money together or the Job will never get Done. Bad to have Bed Bugs, They spread. No, Not evicted but They will be waiting for the Money for even pay back.

This is facility's responsibility.

I don't think she or the family should be held responsible for paying for additional treatment. It seems to me that the facility should pay for treating the property in its entirety. I would suggest contacting your county Area Agency on Aging and speak with the ombudsmen for advice. It probably wouldn't hurt to contact Medicaid as well to find out grounds for eviction from a facility. In my opinion, there are no grounds for eviction since the facility can't prove she or your family is responsible for the infestation.

Bedbugs can happen from so many possible paths it is impossible to know for sure, but it is unconscionable to me that so many people involved were so slow to consider that as a possibility and allowing her itching to continue and the damn bugs to do their thing for longer. The way they travel from an infested room through walls etc, other rooms adjoining hers should be treated as well. Ideally they will treat with heat, and that means for sure get the valuables and fragile items out. With heat it is usually necessary to open all drawers and closets so the heat can reach into such places. They usually want all clothing laundered or heat treated and bagged. A good facility would do routine checks to keep their facility free. A building can be free and a half hour later some uneducated moron can schlep an old mattress uncovered into or out of the building leaving a trail down hallways and in elevators...Staff need to be educated to know what to look for and the hospice people imo should have known to think about that as well. I hope you are not held responsible for further treatment. BTW, some dogs are trained to detect them and are great...BUT IF ANYONE USES CHEMICALS, that screws it all up because their nose can't detect the smell from the bugs plus exposes them to the chemicals. Also it could have been brought in by an outsider. Example: what if one of the staff picked them up and brought them in? I am aware of a situation where someone observed a little bug in the summer, didn't seem like a big deal...person and his spouse wound up going to ER for unrelated issue and we learned they arrived with them. Found out the couple had hired an extermination company but did NOT do the follow up they were supposed to so they never got rid of the problem...which developed because an adult child with a disability lived in a group home and came to spend weekends with them. She brought them from her group home...

Bed bugs can live in crevices of furniture for up to about a year....but your mom has been there for two years so it is highly unlikely that she is responsible for the problem. Bed bugs, however, can be picked up by people travelling on vacation or they can hitchhike on/in someone's backpack or other purse or bag or another resident or their visitor brought them to common areas of the building where they have set up shop, like a couch or wingback chair. The assisted living facility should pay for the entire facility to be inspected top to bottom and treated where necessary. It is the only way to stop the bedbugs from becoming a chronic problem. Your mom will need assistance from you in properly bagging belongings etc., but she should not be charged.

My Mom’s AL room had the worst infestation imaginable. We moved her out, heated or froze all her clothes, shoes, and bags, destroyed her furniture so as to not pass them on to others, etc. My sister’s home also got an infestation, and what we learned is that if they treat the infestation with high heat, then it will probably also kill the bedbugs that are in her things. But everything has to have a little room — between hangers in the closet, etc., to allow the heat to penetrate. Most exterminators will follow up with pesticide, then check back about the time new ones might be hatching. If there are new ones that have hatched since their pesticide was applied, they can identify that and will repeat the pesticide treatment. This usually takes care of it, unless new ones are somehow being brought in. So when they say you’d be responsible for follow up treatments, they are probably referring not to the initial (very expensive) heat treatment, but rather to any following treatments. Do NOT settle for an exterminator that only uses pesticide. They told us 3 times that they had treated and the bedbugs should be gone — then when we read their invoices, we found out they had treated for bugs we did not have and not for bedbugs, despite the fact that we had bedbugs to show them. It’s worth it to find someone knowledgeable who specializes in bedbugs. They (the bedbugs, not the specialists) are stubborn little critters and, as many have said, they are anxious to explore and conquer any new territory anyone will take them to. The routine of dressing in garbage bags and with gloves is worth the hassle. Then put all your clothes in a black garbage bag anyway and dry them on high heat for at least an hour after you’ve finished, just for good measure. And, btw, Tyvex makes a pajama jumpsuit with a face netting. Until the bugs are gone, it will at least keep them from being able to keep reaching your LO to continue the blood feast. (Order through Amazon). I sympathize. My sister lost most of her belongings to the combination of hoarding and bedbugs. She was a bargain hunter and re-purpose and would pick things up off the street, bring things home from secondhand stores, etc. Exterminator said that was probably where they came from. Have courage and be thorough. It really is a nightmare kind of thing.

It should be the ALF's responsibility. Check her contract about pest management. You may need to contact the licensing agent for the ALF or Better Business Bureau for assistance as well.

I had that happen in an ALF to my mom. It is quite common, apparently. It's the facility's responsibility. And they really have to be aggressive and thorough in treatment.
In my situation, mom's neighbor had them first and they treated his room with heat and pesticide. Somehow they tracked to her room. We had never had experience wth bedbugs, but it explained the "ticks" she swore she saw on her body and the bites that look like a rash.
They had to treat her room and they moved her to another wing, but they let her take whatever she needed for clothing and supplies to the new room and it spread to the new wing. Those critters hitchhike. Her room of course reinfested and they had to treat again.
The protocol was not followed for treatment and prevention. And the kicker was they didn't tell any outside agencies that visited like friends and family and hospice and the staff. So who knows how much havoc that caused unsuspecting visitors.
I was so angry at this facility's poor policies for care that I called every agency I could think of to report. The health department for the city of county is number one call, and then your area agency on aging, or ombudsman is next.
They had inspectors crawling all over the facility the next day. It was satisfying to finally see some action as I moved my mother out of that place to better care.
Moving your LO out means throwing out a lot of things where bedbugs might hide. We had to dress in garbage bags and gloves to inspect and pack her things and spray furniture with bedbug spray. And I took all her clothing straight to the laundromat to wash at once and dry them in high heat. It's a chore, but it did work.

I am pretty sure that this is the responsibility of the facility. Furthermore bed bugs travel. It is highly likely that they have spread from another location in the facility or to another location in the facility by now. It is expensive to treat for bedbugs. Look for legal advice.

This is the AL responsibility to provide a safe, clean environment for mom. I guarantee that the bedbugs are not only confined to her room but throughout the entire facility. These bugs travel and reproduce quickly. The facility will most definitely need to treat the entire building and not on Mom's tab! Good Luck. I hope mom is doing better.

Tell them they own the facility and are obligated to manage pest control. Can't see how she brought in any bedbugs when she hasn't left and no one in family has had problems. More than likely a new patient (or staff member) has brought them from home.

Call your Ombudsman's office and ask them if this charge to a patient is a legal charge. They will get to the bottom of it fairly quick. The medicaid offices and facilities who get calls from them want problems fixed fast with accurate responses.

I would contact the health department, I bet that someone that is affiliated with the facility brought them in. I would also let others know, ie any visitors you come across, so everyone can take precautions to stop the spread.

I would send a certified letter to the administrator and copy the Health department that the family will not be able to cover any of the costs to eradicate the bedbug problem in their facility. I would address the fact that no one that visits mom has any issues in their homes or places of work and that leads to the belief that the facility had someone in, vendor, employee or ??? that introduced the bugs.

This gets it on record that you are denying responsibility for the existence of and the eradication of these horrible creatures.

Be sure and keep a copy and document every conversation. Facilities are great at placing blame and responsibility on others. Don't accept it and fight it if needed. They are being paid to provide a safe, clean environment for vulnerable people. They have failed to do so. They will try to pass the buck.

Let us know how goes it and be mindful of what you store to protect from treatment. These little creatures hide in, on and around everything. Maybe remove and treat photos and anything else that can not be replaced by yourself, but do treat everything.

I agree with Bella, people that have never experienced an infestation don't really understand how traumatic it is. It is not something to be calm about, it needs to be treated with a vengeance. Maybe that would stop the spread.

Thank you for your helpful comments. The ALF just provided a temporary unit for her to move into. We made certain that everything that went into the new unit was cleaned (washed and high dryer heat). We also purchased new clothing, shoes, bedding, etc. Her other unit is supposed to be treated next week. Hopefully all goes well with the treatment.
We will follow your advice and protect the photos and other personal items so that they are not damaged.
I appreciate all the advice and don't consider any comments here to be a rant at all. Until someone (elderly parent, family member, visiting friend) actually goes through this and experiences the frustration and anxiety involved they shouldn't make disparaging remarks. Treatment is very expensive...thousands of dollars....and something as simple as a short visit to a resident can create serious financial issues for the unsuspecting visitor. Especially if they have no idea of the infestation.
We found out yesterday that the ALF actually knew of this more than 6 weeks earlier, not "a couple weeks" as they initially said. That makes it even more frustrating.
With regards to moving, there are very few local options available for medicaid residents. We have looked into these with no luck but will continue to do so.
Last night was her first night in a bug-free room and hopefully her last. Thank you again for all the suggestions.

Wondering what’s going on with your situation? How’s your mom?

Contact the State and complain about her living conditioned and also start looking for another, cleaner, more caring place!!! Dr J Grenan

Oh my goodness my mom went through the exact same thing with bites on her arms for three months!! Numerous itching creams, assisted-living nurses, three doctors, the Admimistrator all said no it’s not bites ! I suspected bedbugs, wanted to take precaution but the administrator shot me down and said “absolutely not there were not bedbugs in our building!!” Looking back I should have went in her room myself and pulled her bed apart, flipped it upside down to check for bugs because no one in the building would do that, they kept telling me , “our exterminator is spraying and they give us the all clear.” I’m itching as I speak. I’ve posted here before about bedbugs and some people told me to quit overreacting, to calm down and let’s see what we can do about the problem. The problem is, no one takes bedbugs serious and that’s why there’s such a “problem” with them everywhere, these facilities want to keep it quiet because they will lose business. Let me tell you it’s all about proper protocol and residents and family members do have the right to know that there are bedbugs in the building. My dad , when he was still at home, had bedbugs and we got them from him, and we ended up getting them in my house from my mom several weeks ago because I had her with me going to doctors appointments etc going back-and-forth. I had to have two vehicles sprayed down, couldn’t drive them for a week, had my granddaughter’s car seat sprayed down, which I found out later I had to get rid of because it wouldn’t pass inspection because of the spray! When the bugs in moms room was finally discovered (and that was when she caught one and put it in a baggie when I was talking to her on the phone and telling her how to do it) they left her in that same room with her resting her head on her kitchen table. Her bed and recliner were flipped upside down. I threw a fit and demanded that they put her in a clean room. The housekeeper told my mother that she would have to find a place to stay like a hotel...Grrr!
Finally administrator agreed to put her up in their show room but they really didn’t like it because she would be on furniture that they are leasing and was afraid of bedbugs getting on it etc etc...
Yes it has been a nightmare, and it didn’t have to be!!!! Catching a bed bug problem is crucial, and can be taken care of with a lot of diligence and hard work but it is doable!!!!! I am not a freak out type of person, but this subject I feel very strongly about. I’m trying to bring awareness everywhere I go because if people would pay more attention to this problem there wouldn’t be such a breakout of these bugs everywhere!
I could tell you so many stories about this it’s crazy, I’m sure I’ll be raked over the coals hear about my rant.
I can’t see how they will make you responsible for the spraying, hopefully others here will guide you on that. I do know bedbugs can be brought in from anyone so they can’t completely blame your mom... more than likely someone else there at the facility has them to.
All of my moms personal belongings got sprayed down with insecticide, totally saturated pictures in their frames, it seeped underneath onto the pictures, the toaster inside and out etc. etc. etc. The room did get heat treated and then sprayed again. I cannot believe the condition of her room when I finally was able to get back in there!! It looked like a tornado hit and then an earthquake. My husband and I demanded that someone from corporate come for a sit down meeting and inspection of her room. They suggested that I should’ve got mom renters insurance to cover the damages because they will not clean up the mess in her room. I’ve reported them all to our Ombudsman, local health depart. and the state nh health Dept and made numerous complaints there, they are still investigating.
We have since moved mom into a new AL, had to buy her all new clothes, shoes, everything since it’s still bagged up.

any questions, just ask...good luck!

In any type of landlord/tenant type of situation, pest control is normally the responsibility of the landlord. But check Mom's paperwork that she got when she first arrived at the facility. There really isn't anyway of knowing how the bedbug first came in.

Usually such insects travel into a room via a new mattress if the said mattress was bought through a cheap wholesaler who didn't take care of the storage facility.

I hope the facility can make arrangements for Mom to sleep elsewhere while her room is being treated. I would put away in the closet and dresser anything of real importance like photos, personal items, etc so the items don't get damage during the treatment.