Hello my mom has been on medicaid for the last 6yrs I recently put her in a memory care unit about 6 months ago she has medicare and medicaid she also has a spend down and has long term care. The nursing home called me yesterday stating that her care has been denied by medicaid because failed to provide 5yrs bank statements. Is this necessary when she already has medicaid ? Seems abit odd they would be requesting this when they know she has a spend down.
Programs.
In NY you are allowed $31,150 to remain in a person's account. Any checks in the last 60 months over $2,000 will be required to have a receipt. If unable to provide or it is considered an non allowed Medicaid spend down expense it will create a penalty to the person. The patient will either need to be pay back in full or the person will need to pay out of pocket until the penalty in days time period is fulfilled.
I am currently working with an eldercare attorney and my uncle has a $8,750 non allowed expense. The facility costs 625 per day and we need to either have his accounts amount to $31,150 less 8,750 or pay the facility the per day charge of penalty that is for 14 days.
Also, If you are in NYC there are variations to the regulations.
Are you sure she's been on Medicaid for the last 6 years? If she still has a spend down then I don't know how she's qualified yet. She has to spend down all her assets to the NYS Medicaid required level before she is approved for Medicaid. In many states she would also need to qualify medically, and be assessed as needing LTC. The info in your post is somewhat confusing. Please provide more info.