Nursing home care can be very expensive. Many private health insurance policies don’t cover these long-term care services. For California residents who need long-term care, Medi-Cal is the most common source of funding. In fact, Medi-Cal covers nursing home care expenses of nearly 65% of Californians residing in nursing homes. However, applying for and receiving assistance from Medi-Cal takes planning. Getting your parents prepared for the potential need for long-term health care, nursing home planning is a must. What happens if your loved one is unlawfully evicted from a nursing home? Let our Los Angeles Medi-Cal planning lawyers help you deal with this situation if it arises.
Nursing home abuse
There are so many different types of nursing home abuse. One type that has become far too common is when nursing homes evict residents who are disabled and unable to afford the cost of nursing home care. An example of this type of abuse is when a Medicaid-managed plan drops a resident for becoming ineligible for high-level care. Once social security benefits run out for someone who is disabled, if that person has few financial assets, they may be left with nowhere to go. Reports of improper evictions from nursing homes in California, Illinois, and many other states have been on the rise recently. Relatives and nursing home residents have begun to come forward to report this abuse.
Lawsuits for improper eviction have increased
Consumer advocates have confirmed that nursing home abuse and unlawful conviction concerns have resulted in more lawsuits. In fact, it has been reported that complaints of improper evictions in California have gone up by 70 percent just in the last five years. A significant number of disabled and low-income individuals who have been evicted from nursing homes have no permanent housing options or reliable medical care after being improperly evicted.
Unfortunately, some of these evictions may technically be legal, but they are certainly still unethical. There are federal laws that allow nursing homes to discharge patients if the patient no longer needs the services being provided or the facility can no longer meet their needs. The same is true if a resident fails to pay for services without reasonable notice or if the patient risks the safety or health of other residents. The only good news is that, in most cases, the law requires the nursing home provide at least 30-days notice before involuntarily discharging (evicting) a patient.
Medi-Cal and nursing home care
Medi-Cal is California’s state Medicaid program. Like all other Medicaid programs, it is funded by both federal and state funds but run by the State. The California Department of Health Care Services (DHCS) manages long-term care programs in California, including nursing home services. In general, skilled nursing facilities offer round-the-clock skilled nursing care in addition to other supportive services. Nursing homes are typically rather expensive, averaging approximately $7,000 per month in California. Most people cannot afford to pay their own nursing home expenses. That is where Medi-Cal benefits come in.
Payment for “medically necessary” nursing home services
Med-Cal benefits are limited when it comes to nursing home benefits. Medi-Cal only pays for nursing home services when those services are deemed “medically necessary.” California defines that term “medically necessary” as “reasonable and necessary to protect life, to prevent significant illness or significant disability, or to alleviate severe pain.” In order for Medi-Cal to pay for a nursing home stay, the patient’s treating physician must prescribe that nursing home case based on the need for continuous, around-the-clock skilled nursing care services. This type of care may also be referred to as “intermediate care.”
Nursing home planning for seniors
Nursing home care can be very expensive. Many private health insurance policies don’t cover these long-term care services. For California residents who need long-term care, Medi-Cal is the most common source of funding. In fact, Medi-Cal covers nursing home care expenses of nearly 65% of Californians residing in nursing homes. However, applying for and receiving assistance from Medi-Cal takes planning. Getting your parents prepared for the potential need for long-term health care, nursing home planning is a must. Let our Los Angeles Medi-cal planning lawyers help you be prepared.
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