Many disabled and elderly residents of New York will soon be expected to pay more personal funds toward their nursing home expenses. The changes are being implemented to minimize government spending by reducing the number of people eligible for Medicaid. Medicaid was originally conceptualized as a program to protect the poor and disabled. As the population ages, many people are seeking benefits under Medicare that the system never considered– middle class people living in nursing homes.
Qualifying for Medicaid is not easy. A thorough background check is conducted for each recipient. All assets must be disclosed- including, bank accounts, homes and even vacation homes. If the Medicaid recipient has any assets to speak of, the assets must be ‘spent down’ their current assets in order to receive Medicaid benefits.
The process of determining Medicaid eligibility is further complicated by marriage. In many states, a spouse not living in a facility is considered to be a ‘community spouse’. The community spouse is generally entitled to keep a faxed amount of assets and keep a house and car.
In, New York, close to 80% of the nursing home residents are recipients of Medicaid. Nursing home residents who qualify for Medicaid receive substantial discounts for the for the facilities. At many nursing homes, the Medicare reimbursement rate is so substantially discounted, the facility actually loses money every day for each Medicaid patient it provides care to.
In order to keep their facilities open, many nursing homes are asking for financial documentation when a person applies.
How can we continue to foot the bill for 80% of the nursing home population?