Due to non-allowed gifting of large amounts over $2,000, my uncle is going to incur about a 1.50 month penalty period. During this phase, my uncle's eldercare attorney indicated that we could try to negotiate a lower rate than the $634 per day self-pay rate. He is currently a resident and has been at the self pay rate from July to Nov 2024. He is currently paying NYS Medicaid NAMI.
Has anyone had success with negotiating a lower rate for the nursing home? Any helpful negotiating tactics you can provide?
Yes, my uncle has a very good attitude for his circumstances. He is very well liked with most everyone there. He has had minimal issues so that is definitely a plus. I am amazed at how well he has adjusted. Honestly, it is a relief to know that he is much safer and has regular meals.
Hopefully, they will work with him/me and discount the full self pay rate. I did find on the NYS gov website the daily rate Medicaid is reimbursing the facility for the Medicaid LTC patients. The difference is mind boggling. So I have some leverage in negotiations. My uncle has been IP since March 2024 amd paid in full every month. First as IP rehab. He maxed out his 100 days and was transfered in June to the long term care unit. From July to October he paid full self pay rates and then applied for Medicaid LTC on November 1, 2024.
Thanks to this forum I have learned so much. Thankfully I didn't blindly follow the SW suggestions for spending down assest since there recommendations favor the facility. The SW are wonderfully with patient care services but as far as Medicaid LTC application is concerned I feel an attorney is essential.
If so, the facility will be way more inclined to be ok on negotiating a lower bill. It’s the devil you know situation.
also if the Nh is pressing on Uncle making the Nh to be representative payee for his SSA, you/POA kinda need to let them be it. Personally I never ever did that for my mom and her 2 NH, but if there’s an issue, them being his rep pay guarantees they get his SSA.
Try to find out the LTC Medicaid day rate paid. It could be called the “Developmental services and care facility rate”. That’s your negotiating goal and then 10% above it and be willing to upfront pay 50% of those weeks he’s got the penalty. 1.5 months isn’t much of a penalty period. Plus he’s been paying full tilt till now. Me, I’d come in with a cashiers check at the LtC rate plus another for the 10% for 3 weeks less Uncles SSA income to have to give them at the meeting. Bird in hand. Maybe bring in the SSA rep payee document too.
Meeting is scheduled by the DON but brings in billing dept, the SW and maybe the floor nurse and you all together & hopefully all kumbaya.
We went through a couple of periods of uncertainty with my mom’s eligibility & renewals. I had made it a point to bring or ship to the activities gal Mardi Gras beads & throws. So worth it as she was always effusive as to what a fab resident mom was; and I did snacks for every care plan meeting. Once word got out that snacks would be a fixture, staff always showed up, even dietary which normally sent just a post-it. One time the SW was late, rushed in saying I’m not too too late, am I as she’s scanning the tabletop.
Good luck; you got this!!!
I know you're a regular here.
And I know you will know Igloo.
My suggestion is that you attempt to write her a private message?
She's the best at this stuff but she's not always on the Forum. She may pick up messages? I am just guessing. But I would run to her kicking and screaming.
I have no idea of how all this works and my mind just doesn't grasp that they can tell us "Hey, you gifted and so we won't pay for ___________days". Because I can't get that you have MONEY to pay if you are asking for Medicaid. I mean you already wiped out the accounts if that's where you are, so I never get that whole thing. Are you to rob a bank? (Hey, there's an idea).
Best of luck. Hope you get some answers.