September 7th, 2016
While
it is illegal for a nursing home to discriminate against a Medicaid recipient,
it still happens. To prevent such discrimination, nursing home residents and
their families need to know their rights.
The
potential for discrimination arises because Medicaid pays nursing homes less
than the facilities receive from residents who pay privately with their own
funds and less than Medicare pays. Nursing homes are not required to accept any
Medicaid patients, but Medicaid payments are a steady guaranteed payment, so
many nursing homes agree to accept Medicaid recipients.
When a
nursing home agrees to take Medicaid payments, it also agrees not to
discriminate against residents based on how they are paying. Medicaid
recipients are entitled to the same quality of care as other residents. A
nursing home that accepts Medicaid cannot evict residents solely because they
qualified for Medicaid (although it can refuse to accept more Medicaid patients
once the number of Medicaid patients reaches whatever the facility has set as
its maximum).
Unfortunately,
discrimination against Medicaid patients does occur, and the discrimination can
take different forms. The nursing home may refuse to accept a Medicaid
recipient or may require that a resident pay privately for a certain period of
time before applying for Medicaid. When a resident switches from Medicare or
private-pay to Medicaid payments, the nursing home may transfer the resident to
a less desirable room or claim that it doesn't have any Medicaid beds.
There
is at least one way that nursing homes can treat Medicaid recipients differently,
however. Nursing homes are allowed to switch residents who were privately
paying for a single room to a shared room once they qualify for Medicaid,
although the resident must be given notice and a chance to appeal. In
addition, the nursing home is not required to cover personal and comfort care
items, such as a telephone or television. In some states families are allowed
to pay the difference to get a private room or the care item. Other states do
not allow any supplementation.
Keep
in mind that these are general rules and that the rules in your state may be
somewhat different regarding what is discriminatory. Your elder law attorney
can tell you the precise rules for your state.
If
you feel you have been discriminated against by a nursing home, contact your
state's long-term care
ombudsman or your attorney.
For
a guide to the 20 common nursing home problems, including discrimination
against Medicaid recipients, click here.
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