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My father needs nursing home care. He came from the hospital to have rehab then the plan is to keep him in the nursing home. There were no beds avail in the rehab side so they put him in the long term side while doing rehab. The sales guy at nursing home says I need to sign the admission agreement right away. I'm going to the medicaid office today to apply for dad.

I want to have an attorney review the document prior to signing. Can they kick dad out if I take a few days to have it reviewed? Dad was admitted to the facility on Thurs. Fri, I received the papers and asked to have the weekend to review and he wants them signed today (Monday).

Thank you for all of your advise!

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Runner - I see red flags in this if the facility is pressuring you….and NOT in your favor either. You're feeling this vibe arent you????
If dad is being discharged from after a 3 day hospitalization with MD orders for rehab, then dad is fully qualified for the MediCARE rehab benefit. That is a pretty hard & fast rule and the facility knows that. If you want to hear this on your own go to the CMS (Centers for Medicaid & Medicare site) and google or call CMS.

The facility will be paid 100% for days 1 - 20 by MediCARE. I would NOT sign anything until at least dad is there for that period of time and AFTER you have discussed dad's "progress" in rehab. The "progress" determination is a big deal - it is a determination IF dad can continue in rehab. Medicare will pay 80% of the rehab from day 21 - 100 as long as dad is progressing. The therapists have some degree of discretion in doing the determination too (like is dad trying or is he stubborn and won't do the rep's) so you want to do whatever to work with the PT OT's and dad to keep him as "progressing" as much as possible.

BTW Medicare payment to the facility is like more than double what Medicaid would ever pay - so a facility wants them to stay in under Medicare benefit. I'd be concerned that 1. the admission guy is clueless on this & 2. that you are being essentially forced under duress to do sign something asap. Now after day 21, dad will need to pay the 20% - most better secondary insurance policies cover this, so find out what secondary dad has. If he has none, then the 20% is private pay unless he qualifies for MedicAID.

Make sure this place takes Medicaid for all beds and takes residents as "MEDICAID PENDING" - this is very very important. If they don't - but they take Medicaid - they can bill at full private pay rate till dad has cleared and been accepted by Medicaid. You should get the overcharge once dad is cleared by Medicaid but with Medicaid application taking anywhere from 3mos to a year, that is a whole lotta funds in limbo. And if dad has a Medicaid eligibility issue, that $ is gone. Comprende?

The facility should have a page that lists what documentation is needed for the Medicaid application. For my mom's NH Medicaid admission, I pulled together all the items and it was close to 100 pages. Don't faint - a full 1/2 of this was all pages of her very old insurance policies (life and funeral) as the old ones are like 20+ pages each and legal…..Now the NH looked over the documents to determine IF they would take mom in as Medicaid pending. Mom was in IL for a couple of years prior to going into NH (she bypassed the AL stage too) & still had her home, so her "pattern of spending" was pretty clear as to just where all her $ had gone to to get her to impoverishment for Medicaid. But if there is something that the NH admission saw that was an issue (like mom had 85K 4 years ago, gets $ 1500 in SS and lives with family and now has only 1K so you know that's totally off), the NH can choose not to accept the resident as "pending". You want to get that list to get this stuff together and figure out if there is likely to be any issue with where his funds went the past 5 years.

Also I'd look about for another NH just in case. The pressing you to sign is not good, I'd be wary. You could use saying "all paperwork needs to be evaluated by counsel" to delay this as well (even if you don't have an attorney). That should put the admission guy on alert that you are not to be trifled with.
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If your father was in the hospital for 3 days before being admitted for rehab, Medicare is payable at 100% for the first 20 days, then 80% for days 21-100. The remainder is payed using patient funds, or, if available, Medicaid. In their haste to have you sign papers, it may not be understand that he is Medicare eligible for those first 20 days. And make them aware that he is Medicaid pending. Any NH I have been involved with, has been understanding. If it gets to be several months where no payment is made, then there would be a problem.
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Why are you signing for your father? Why can't he he sign himself? You sign and you are responsible for payments
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We're being dunned for Mom's time in rehab after 81 days when the facility staff assured she was covered for 100 days. Mistake or deception? Don't know if having an attorney review the papers would have helped, but probably wouldn't hurt.

Good luck with the process you are starting. The care your father receives won't be the same as at home, but you might want to choose your battles. If they close ranks against you as a trouble-maker, it could be your father who suffers.
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Are you POA? then you can sign "as POA for xxxx". Do Not sign without that designatjon. If you are not POA, don't sign, or else they will send you the bill. And if you do have POA I hope you have already been to bank with your dad, the banks can be a wild goose chase (even if you have POA). The best would be for your dad to sign. I don't know why at attorney would have to review--if this is a Medicare certified SNF they can't be doing anything unsavory on their admission papers.
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contact an Elder attorney and explain your situation. once you have them on your side (so to say), you can let the nursing home you have an attorney working with you and you will sign as soon as you can. I think most times the paperwork is general, but always better to be safe. And if you are POA, you can sign your name in place of your father, with POA behind your name. you then won't be responsible for any bills. I am POA for both parents, father in NH, and currently just went Medicaid pending. The nursing home has been notified by our Elder attorney and even though they are still required to send out bills, they know that no money is coming their way until my father is either approved or not approved. good luck. and I didn't get when you said the "sales guy"..........are you sure it wasn't an "administrative staff person"?
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YES! IF he can sign anything, he should sign it.

By paying an attorney and a Medicaid consultant, I saved more headache then I would have had I signed them myself.

Do NOT sign anything unless it's reviewed! The attorney I contacted (I didn't know her at all) was going to do it for free (first consultation) but I actually felt I had to pay her, so I did. That's how important this is.

If you look at some of those agreements, there are pages missing. That's the first thing the attorney saw, i.e., 1 of let's say 26 pages. Well, the next page was 5 of 26 pages, and the list goes on. The parts where they wanted me to sign were highlighted in yellow. I was strongly advised to have my mother sign these if she could. Well, she 'could' and she did.
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Oh, and no they cannot kick him out of the nursing home until it's reviewed. Absolutely not. It took me at least a week to get the papers signed and quite frankly, those in the office looked at me with a greater amount of respect for having asked questions and asking for the paperwork that was missing.
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Oh, and I strongly recommend you get a consultant for the Medicaid stuff. There was a lot of paperwork and time constraints that my consultant met (I wouldn't have met them) ... i.e., does your dad have funeral plans in place, stuff like that. I used my mother's money to buy a pre paid funeral plan, etc. I used it for the attorney, the consultant, etc. Do NOT do this alone unless you absolutely, positively know what you are doing. Many of these consultants are former employees straight from the government who know the ropes and have set up their own firms. They have contacts within the medicaid offices. I'm sorry, but if that's what it takes, then I'm willing to pay for it, even if it means I had to charge it. It saved me lots of headaches....Good luck.
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Always. Never sign for nursing home without lawyer review and never let them say you have to sign it today. I was advised of this by my elder care lawyer.
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