Nursing home costs are notoriously expensive. A recent study found that the average cost for a semi-private nursing home room was $7,148 per month. Most people are not able to pay for this out of their own funds. In California, for example, two-thirds of the state’s nursing home residents use Medi-Cal to pay for part or all of the costs.
Nursing Homes Discriminate Against Medi-Cal Patients
It can be very difficult, however, for someone relying on Medi-Cal to get into a nursing home as a new resident. The Los Angeles Times investigated the problem. They talked to advocates who said that nursing homes systematically and illegally discriminate against Medi-Cal patients. The nursing homes prefer patients who pay with their own money or with Medicare.
What Can You Do?
- It’s harder to get into a nursing home if your loved one is not coming directly from a hospital. You could try “creative maneuvering,” perhaps seeing if your loved one’s doctor will admit him or her to a hospital first. Another option, if possible, is for your loved one to enter the nursing home as a private-paying patient, then switch to Medi-Cal after his or her money runs out.
- If your loved one is in a hospital, work with the discharge planner as soon as possible to find an appropriate nursing home.
- Medicare will pay all of the cost for the first 20 days of nursing home residency and part of the costs for an additional 80 days, but only if the nursing home is approved by Medicare and only if your loved one is entering the nursing home within 30 days of being a hospital inpatient for three days or more. After 100 days, Medicare’s nursing home coverage ends.
- In California, Medi-Cal may help with the co-payments (currently $164.50 per day) from day 21 to day 100, and will take over payments after day 100. It is illegal for nursing homes to evict residents because they are switching over to Medi-Cal. If a nursing home tries to discharge your loved one, you should consult a nursing home advocacy or legal services organization, a long-term care ombudsman, or a nursing home lawyer.
The attorneys at Garcia, Artigliere & Medby are passionate defenders of the rights of nursing home residents. If you ever need any assistance, call us at (800) 281-8515 to find out more about how an experienced nursing home lawyer can help you and your loved one.