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Nursing Homes and “Private Pay” Requirements

In this Elder Law Minute, Wes Coulson discusses how important it is to know your rights when nursing homes delay admission to you or your loved one while there is a Medicaid bed available.

Transcript:

Hi! I’m Wes Coulson from Dent-Coulson Elder Law, proudly serving clients throughout the St. Louis metropolitan area and beyond. I’d like to welcome you to our Elder Law and Estate Planning Minute. We do these to help educate people, give them some little tips, and especially to let them know the questions they need to ask, things that they’ve maybe not thought of. Our thought on that is that we can help you best if you realize the things that you need help and that we can help you with. So I hope you enjoy. Thanks!

We’ve seen a disturbing trend developing recently of facilities that have Medicaid beds available, nevertheless telling prospective residents “you have to private pay for 6 months before we will move you into a Medicaid bed”. The reason that particularly disturbs me is, it is, in fact, illegal for them to do that. For someone who might not believe me, let me read you first, federal law, and then Illinois law. Here’s what federal law has to say:

“In the case of a person eligible for Medicaid, a nursing facility must not charge, accept, or receive, in addition to any amount otherwise required to be paid under the state plan, any gift, money, donation, or other consideration, as a precondition of admission, expedited admission, or continued stay in the facility.”

In other words, if you are making your required income contribution for a Medicaid recipient, that’s all that they can require you to pay. They can not do what they’re saying they can do. Here’s Illinois law, part of the Illinois Public Aid Code specifically on point:

“A facility participating in the medical assistance program is prohibited from failing or refusing to retain, as a resident, any person because he, or she, is recipient of, or an applicant for, the medical assistance program.”

In other words, if you’ve applied for Medicaid and there is a Medicaid bed available, they can’t refuse to admit you, they can’t refuse to delay, or they can’t delay your admission. My perception is that they’re facilities in this area who are bullying people into doing it nonetheless. Don’t let that happen. You need legal representation. You need someone who knows your rights and will advance them. We’ll be happy to help. Thanks!

Also looking for information about Medicaid and Asset Preservation? Visit these articles:

    • Do Living Trusts Protect Assets From Medicaid or VA Spend Down?
    • How an Asset Preservation Trust Protects Your Life Savings From Long-Term Care Costs
    • Why Do I Need an Asset Preservation Plan?

“Your Trusted Advisor on the Elder Care Journey”

Dent-Coulson Elder Law is dedicated to providing families in the St. Louis area with their Elder Law needs. Our practice areas include Asset Preservation Planning, Veterans Benefits, Medicaid Eligibility, Alzheimer’s Planning, Special Needs Planning, Estate Planning and more. We understand the financial challenges you may face as you and your loved ones grow older. At Dent-Coulson Elder Law, our clients’ well-being is our number one priority. For immediate help, call (618) 632-7000 (IL) or (314) 567-9292 (MO), or Contact Us and we will get in touch as soon as possible.

Veterans Benefits O'Fallon ILFor Immediate Help

If you or a loved one needs immediate help with a planning matter or legal issue, please contact us, and we will get back to you promptly.

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774 Sunset Blvd Suite 200
O'Fallon, IL 62269
IL: (618) 632-7000
MO: (314) 567-9292

415 W. Virginia Ave.
Effingham, IL 62401
(217) 330-5500

Fax: (618) 632-7333
Send us an email

Front office building of Coulson Elder Law

Front office building of Coulson Elder Law

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774 Sunset Blvd Suite 200
O'Fallon, IL 62269
IL: (618) 632-7000
MO: (314) 567-9292

415 W. Virginia Ave.
Effingham, IL 62401
(217) 330-5500

Fax: (618) 632-7333
Send us an email

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