her was in a rehab/nursing home facility in Fort Worth,Tx. After her insurance ran out, we had to get her on Medicaid and transfer to the nursing home side, as she was still unable to care for herself, and we could not. We spent hours and hours with the business office , giving them EVERYTHING they asked for. We were assured her assets (several small life insurance polices ), were UNDER the $2,000 limit. In the mean time, we did not like the care she was given, like day and night from the rehab section. So we proceeded to have her transferred to the nursing home in our small town, where all 3 of her children live. Went over it all again and was assured she would get covered. This was 9-2012. In December 2-012, the Medicaid case worker phoned to say she was OVER THE $2,000 LIMIT. I cashed out her whole life policies and paid down on an irrevocable funeral plan. FINALLY Medicaid was approved, but would not pay the months of 9-2012 through 12-2012. We met with the current facility and they assured us it was all straight this past Spring. Then, in September 2013, we received a discharge letter from them saying we had to cough up $21,000.00 or she would be kicked out. We have mounting medical bills of our own and have depleted all our resources. No one else in the family can or will help. She needs 24 hour care. Of course the original and new business offices pass the buck to ME.My question is, does anyone know of any charities that might help us? I am beside myself. My mother is 90 years old.
I'm assuming you have gotten a "30 Day Notice" from the NH, within the letter there should be a cc to the state Medicaid program and probably your local Area Council on Aging. You should contact both the State program and the Area Council to see what options for long term care she could be placed into.
You could ask for mom could become a Ward of the State of Texas (rather than the NH requesting a forced placement). The state would then take over all aspects of her care and all decisions as to that and the state would pay. It would be a guardianship proceeding held at the courthouse. Call your county courthouse and speak with someone in probate judges courts to see where to start all this. Realize that if you do this, your opinion on mom's care really doesn't count anymore as the court appointed guardian does this now.
On the whole NH situation, the ultimate responsibility on the Medicaid application lies with whomever signed off on the application. If you signed off to be personally responsible for her financial, then the NH can turn you over to collections. If you did not sign off personally on the application, there is nothing they can do to you. So how does the contract read and how was it signed?
Medicaid in TX is in my experience very "date" driven. So if you got a letter of denial on 9/02/13, then you have to send Medicaid a fax or certified letter to appeal the denial within the period of time indicated on the letter. If you don't, the state's considers the denial to be accepted. If all this was last year September (2012), it is just too past the timeframe to get an appeal done.
Now could this be related to re-certification? TX does an annual recertification and you have like 14 days from the letter to provide an update on all their documents and provide the last 4 months of all banking and other financials - including their NH trust account. If you don't, they will get suspended from the program and you get a letter stating that. Then if you still don't get the forms back to the state, they will be declined from Medicaid. The time-frame on all this is very tight too. You can't just wait to do it sometime next month. Please review all the letters you got from the state to see if you submitted all items requested in a timely manner. If not, then fax whatever you can with a detailed letter as to why the delay asap.
Best of luck. This is a nightmare!
Carol