What to Do If You’re Running Out of Money in a Nursing Home or Assisted Living

Last Updated: Mar 14, 2024

Tony’s mother, Carla, is paying for nursing home care, but her funds are running low. They’re both worried about what will happen next. Tony thinks Medicaid will pay for the nursing home after Carla’s money has run out, but he’s not sure. Will he have to cover his mother’s expenses? Will Carla need to change nursing homes? Will there be a wait before Medicaid starts covering the bills? How does she even apply?

Running out of money in a nursing home can be a nerve-wracking situation, and it’s only natural to have a lot of questions, just like Tony. That’s why it’s recommended to have a Certified Medicaid Planner on your side in times likes these – they can answer all your questions and facilitate a seamless transition from private pay to Medicaid. If you connect with our team of professionals soon enough, they may even be able to help you save some money before it’s all gone and still qualify for Medicaid.

The unfortunate truth is, nursing homes can discharge residents for lack of payment, but they do have to follow some guidelines while doing it. The specifics can vary by state, but in general nursing homes must obey two rules when they discharge a resident:

• Nursing homes must give the resident or the appropriate family member/guardian a written notice 30 days prior to the date of the discharge.
• Nursing homes must provide a discharge plan.

That discharge plan must include the location where the resident will be moving to, a summary of the resident’s mental and physical health, a thorough post-discharge care plan and information about all of the resident’s necessary medications and medical equipment. The location where the resident will be relocating to must also agree they will admit the resident for the discharge plan to be considered complete.

Medicaid can help in these discharge situations, but 30 days isn’t long enough to apply and get approved. Ideally, one would start the Medicaid application process a year before running out of money. Even with that much advance notice, consulting with a Certified Medicaid Planner is a good idea. If you get a late start with the planning and the money is almost gone, consulting with a Certified Medicaid Planner is a must.

Professional planners understand Medicaid’s financial eligibility requirements and will know when you or your loved one will meet those requirements and become eligible. They can also help you gather all the financial paperwork you’ll need for the application, which is the most time-consuming part of the Medicaid application process. These documents need to clearly illustrate the applicant’s financial history for the five years (in most states) before they applied. If you don’t have the right documents or it looks like you’ve violated Medicaid’s financial rules, your application will be denied and you could be penalized with a period of ineligibility. Our team of professionals at Eldercare Resource Planning knows exactly which documents you will need and where to get them, and they know how those documents should be organized and submitted to the state so your financial history is clear to the Medicaid officials reviewing your application.

Our Certified Medicaid Planners are familiar with typical response times from state agencies, so they can help you with the delicate timing of becoming Medicaid eligible, applying and being approved without having a lapse in coverage. Medicaid Pending and Retroactive Medicaid can cover costs if the timing isn’t perfect, and our planners know how to use both and which states allow them. If you’ve applied for Medicaid but haven’t been approved or denied yet, you have Medicaid Pending status, which means you can immediately start receiving care from some nursing homes and caregivers. With Retroactive Medicaid, the state will cover unpaid bills for up to three months prior to the Medicaid application date.

Our team will know if the nursing home you or your loved one is living in even accepts Medicaid, and if it has any available spaces for Medicaid recipients.

There’s also a chance we can help if you’re running out money in an assisted living facility. In most states, Medicaid does not cover room and board in assisted living facilities, but there are exceptions in some of the most populous states – California, Texas, New York, Florida and Illinois. Our planners know which Medicaid programs provide that kind of help in those states, what the eligibility requirements are, when you might meet them and how you can apply. Some states that will not cover room and board in assisted living facilities will cover long-term care benefits in those facilities with Medicaid programs, and our planners know all the ins and outs of those programs, as well. It’s also possible that an assisted living resident is qualified for Medicaid’s nursing home coverage and could relocate to a fully covered nursing home, if they wanted, and our team could help with that transition.

Whether you’re running out of money in a nursing home or an assisted living facility, our Certified Medicaid Planners can help you avoid the hassle and embarrassment of getting discharged. The sooner you start planning the better off you’ll be, so get started now.

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