Medicaid Nursing Homes, Know the Facts

Medicaid nursing homes can be key resources in providing long term care for your family member. Nursing home care is very expensive. Medicare only covers short term nursing care for rehabilitation after a qualified hospital stay.

Often times dementia patients stop progressing during rehabilitation because they have difficulty following instructions and dementia may reduce their motivation to improve. When a patient stops improving, Medicare will no longer pay for his stay in a skilled nursing facility.

If your family then begins to pay the cost of long term care in a nursing home out of family resources, you soon see that your resources are quickly being used up.

When faced with a Medicaid spend down of your family member's assets, it's important to get professional advice from an attorney or other qualified person who specializing in helping people qualify for Medicaid. Your local senior center or bar association can help you locate a Medicaid specialist.

If your family member is already a Medicaid recipient and needs care that cannot be provided at home, he will need to live in a Medicaid nursing home.

Not all nursing homes or skilled nursing facilities (SNF) accept Medicaid for payment. You may find that your family member has to go on a waiting list to transfer to a nursing home that accepts Medicaid. The challenge is to find a facility that is close to where the family lives so that family members can visit often.

Some families decide to pay privately for a few months to ensure that their family member lives close by and in a facility that the family and your family member feels comfortable with.

When your family member has been admitted to a nursing home that accepts Medicaid as a patient who is paying his own bill and then he later qualifies for Medicaid, federal law does not allow patients to be discharged from the nursing home based on converting to Medicaid.

If you suspect that your family member's short term stay in a nursing home may turn into a long term stay, find out which nursing homes accept Medicaid and make this question a part of your initial fact finding about a home.

The Medicare website has a nursing home search feature that includes whether or not a nursing home accepts medicaid. Click here to connect to the Medicare website. The more planning you do, gives you more control over where your family member lives.

When your family member needs a Medicaid nursing home:

  1. Unless your resources are unlimited, always verify that the skilled nursing facility that your family member is entering accepts Medicaid.
  2. Be prepared mentally and financially that your family member with dementia who is receiving physically therapy may soon stop progressing and no longer be eligible to have his skilled nursing care paid for by Medicare.
  3. Explore non-nursing home alternatives for Medicaid patients in your community like Home Health Agencies (HHA) or Programs of All Inclusive Care for the Elderly (PACE) to see if these program will provide the care your family member needs.
  4. Locate a Medicaid specialist to help you smoothly navigate the qualification process.

Additional Nursing Related Resources

National Critical Care Institute -- Nursing health care provider training and certification


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