I had a relative recently die. After his death he was approved for Medicaid retroactive for his last 6 months. We were self paying about $15000 per month to the nursing home. His NAMI was $21000 for the first month and $8000 after that.When we requested a refund they billed us $21000 for the month we had paid in full and deducted it from refund due. He also died the 3rd of the month and we had paid the $900 due for the 3 days but nursing home deducted $8000 from refund for 3 days. Can they do this?
If my understanding of this is correct, then the answer to your ?'s should come from the state as to whether the NAMI paid was correct. I'd suggest you get the info from the state, compare the figures and if looks like repayment due, then send a registered letter to the NH with a 30 day notice of refund to be paid. There could be a sticky in that whatever funds need to be paid to the "estate of" and there needs to be executor named with Letters Testamentary issued to get this done.
But I'd bet that as they were Eventually Medicaid approved, the NAMI paid was right.
Also do you know the status of their PNA? Nys - I think - has pna at $ 50 a mo. Personal needs allowance, it's $ that is the resident gets to keep each month & not paid to NH. If the NH was getting paid all his monthly income the PNA amount was set into a personal needs trust account there at the NH. Like for my mom in TX pna was $ 60, so every mo all her monthly income (like SS) was paid to the NH for her Medicaid SOC (share of cost) EXCEPT for $60. PNA if there were funds in the account at the time of death, that $ should be paid to the estate or perhaps to whomever name was on file for this.