If the article does not give me enough to make one point then clearly it does not give you enough to make the other.
Awwww touché. But I've worked in the industry, I did the billing, I know the qualifiers for private pay, medicaid, medicare (100 days) and if you are not a resident in a
'non for profit' LTC facility then you are very likely to be placed out of the LTC facility if your 'head in the bed' isn't being paid!
I noticed that you have not helped us to understand how a LTC can abuse people. Go ahead tell us.
Since you asked:
Private payer > runs approximately $5,000 dollars month per person: {this may very according to the number/amount of meds that each resident will require} this does not include any: therapy services, beauty/barber shop visits, no private phone, no cable TV. And the billing cycle is invoiced by the 10th and payable by the 15th and will accrue late fees & interest once it is 30days past due and on the 45th day the facility will be looking to place you at the curb if you and your responsible person have not found a new place to relocate too! And by the 90 day in arrears you will be out the door!
Medicaid payer> you have to meet the criteria for this to qualify and that basically means you are indigent: No property, no vehicles, no savings account, no IRA, no 401K, no trust, no annuities and your basic income does not exceed $18,000 per person or $25,000 married. I will preface this with this disclaimer: the Kansas Dept of Health & Human Services, Area Agency on Aging, AARP were trying to come up with some more equitable solution to the previous years of forcing a man & wife to divorce one another to save the family home/savings account/retirement funds but there was still a 5 year period that they had to meet the guidelines before one or the other could qualify for MEDICAID assistance. In other words they were screwed and it was horrible to get assistance once you lost your health insurance coverage if you couldn't divorce the other spouse then the illness of the sick one can and will destroy you financially (until death you do part). Medicaid billing was just going on line via Blue Cross & Blue Shield during my LTC time and it was a nightmare! We were forced to bill semi-monthly and had to wait for verification for that billing period for days and if there was an error on their computer receiving you might be behind by the next semi-monthly billing period rolled around, and then they would not cut checks for that billing cycle until the 15th and the 30th of each month, so the LTC facility was at least 45 days waiting for A R checks to roll into the bank from automatic bank transfer and if there was an error it would and could take months to correct the incorrect check that was deposited. "NIGHTMARE"
Medicare payer > 100 days is all any one instance of a medical claim gets paid by Medicare {never-ever go over those 100 days you will not get paid for that head in that Medicare bed in that or any nursing facility} So you hope that the Hospital told you correctly the number of days that they are billing for prior to the resident being transferred to your facility and that the medical codes for that specific injury/illness/combination of problems are documented correctly or you will not get paid. There are specific beds on specific hall ways that have to be set aside as 'MEDICARE BEDS' {so if any resident is in that specific bed and they run out of those 100 days they will be moved and moved quickly...sorry, you like that roommate will that isn't what you are in there for, and you're out of medicare days so we have to move you today, but we'll try to find you someone 'NICE' to shove you in with}. While this resident is in a MEDICARE BED they will be receiving therapy: OT/PT/RT and that is all provided in house but billed at a 125% mark up that Medicare allows. Medicare billing is handled the same way as Medicaid via Blue Cross & Blue Shield and it takes every bit as long to wait for your money and they are very, very slow to pay. Once the 100 days is up the resident becomes a billable to either: Medicaid, Medicare part 'B', Private Payer w/Insurance, Private Payer w/no insurance.
I am being consistent. The constitution gives the gov the power to stop people from harming each other. It does not give gov the power to actually help in this way.
If that was true then why would we have federal funded agencies such as: HUD, HHS, Soc.Sec.A., VA, Medicare, Medicaid, CIA, FBI, etc., etc., etc.,
The author conveniently did not provide enough information to get those facts. Maybe the author is hiding something. But if anyone here can give just one example of a person with details showing that they can't get their medical needs met I will recant. I have made this challenge before and it won't happen.
Oh, BOY
Whenever I have seen cases that did not get enough support it was because people recognized that the need was not really that great.
But if Americans are not willing to donate enough funds to help others what makes you think they will be willing to vote enough funds to help others?
I personally have more faith in my fellow man. If there is a need Americans will fill it.
You keep getting out on that 'LIMB' of your assumed knowledge about this woman's financial source and this is becoming very, very telling about what you DO NOT KNOW ABOUT MEDICAID and how people qualify for MEDICAID.
I was an administrator (in a private company) for medicaid benefits in Illinois for about five years. I know full well that there are income and asset criteria.
Well, that certainly sounds so, well just so pat answer and easily said, but unfortunately humans and their view points about what 'charity and welfare' that they want to accept are as far apart as Sara Palin and the TRUTH {as she sees it}.
My statement stands. If she had the money she should pay it herself and if she did not have the money then she would have qualified. If she did not have the money then the program that denied her was medicaid.
Very, Very understanding about those older folks and how they understand these hard choices, aren't you
Even the poorest of Americans are swimming in material wealth. Middle class America even more so. The vast vast majority of middle class Americans own so much crap that if they just did not buy it they could easily save money.
Here is where you really, really loose touch with reality and I leave you standing in your own quicksand!
I don't need to do any fact finding to answer that one. EVERY SINGLE American has those two resorts. They either have money or they qualify for medicaid (or their states version of it). If they have the money then when they spend it they will qualify for medicaid.
Tied all up in a pretty verbal ribbon and just laid out on the table like that is the TRUTH AND NOTHING BUT THE TRUTH AS YOU SEE IT...
If you have any stories with details that can be checked about LTC's discharging people when that would endanger their lives post them here.
As BOOBTHEBUILDER SAID "do your own googling" the stories are out there and in every nursing home in every state in every location, just open your ears and do your own research...the stories abound {if they are lucky enough to get printed press for the stories} but look and you shall find!
Because it is the governments job to protect people from getting their lives endangered by the actions of others.
Absolutely, that's why there are patient advocates and 800 phone numbers listed at each and every LTC facility in America...but not every nursing home is a 'non profit' facility and they do not have to keep residents who are unable to pay and are not a Medicaid payer source!
Go ahead and show us how a LTC facility can endanger the life of a person it discharges and not get sued without demonstrating that it is the fault of government.
As with Hospital dumping that was illuminated in the media, LTC facilities are quite capable of doing the same thing...just try to catch them at it and that is a slippery worm to hang onto, but it is done...go stake out some inner city LTC facility.