Flip the Script: Nursing Home Money (#3 of 5, for now)

“It’s not right,” Carlos complained.  “That son of mine isn’t telling me what’s going on with my money.”

“You’re worried about your finances?” Carlos had been anxious and irritable for most of the three months since his admission to the nursing home.

“Yes!”  He pounded one fist into another.  “I know how to take care of my bills!  I’ve been doing it all my life!  Who is he to take over?”

I’d heard similar concerns many times over the years.  “It’s hard when the kids start acting like the parents,” I empathized, “but there really aren’t bills to worry about now.”

“How can there be no bills?  Who’s paying for me to be here?” he asked angrily.

“Well, Medicare and private insurance when you first got here, but now that you’re long-term, your stay will be covered by Medicare and Medicaid.”

“But what about my rent?  And my doctor’s bills?”  His tone softened only slightly.

“All that’s covered, ” I explained gently.  “You’re basically living in a money-free world now.”

He looked puzzled.

“Your food, medication, doctor’s bills — that’s all paid for,” I told him.  “You don’t have to worry about it.  You’ll get $50/month here in New York for things like your telephone, clothes, take-out, or a special trip.  Otherwise you can pretty much live without money.”

“Humph!” Carlos replied, staring out the window for a moment before turning back to me.  “Well, I want to see my phone bills.  My son better bring those to me!”

8 thoughts on “Flip the Script: Nursing Home Money (#3 of 5, for now)”

  1. Anonymous, my understanding is that the residents' stays are covered by Medicare and Medicaid, but I'm always ready to learn something new. Can you explain a little more?

  2. That's news to me, too. Much of our money woes this year have come from the fact that Medicare and Medicaid have cut their payments per resident.

  3. Once you are on Medicaid for Long Term Care, that's it. However, if your condition changes and you are readmitted after a 3 day stay to a hospital and it has been determined that you could benefit from physical therapies, Medicare will pick up again for a limited time. Not sure, but some Medicare Part B may also reinstate or cover some things.

  4. Anonymous, it sounds like you're referring to a Medicare Part A/Part B issue. You're right, different things are covered by Part A immediately following a hospitalization. In general though, as K.Tree and others I spoke to off-line confirmed, residents' stays are covered by Medicare and Medicaid.

  5. Dr. El,
    Most significantly, no matter what third party is paying the bills, is the feeling of loss of independence that occurs when we lose control of the ability to take care of our financial obligations. Like it or not, the rights of passage we go through from being under our parents care to becoming responsible adults is financial independence and paying our bills. Therefore, not being able to pay our bills means we are no longer able to care for ourselves.

  6. Sue, that's exactly the issue. Very well put, and thanks for helping to get us back on track. It's a very real struggle to retain a sense of independence and control when a lifelong identity as maintainer of a household is taken away. A new identity must be forged, and much of my work involves assisting residents to create a positive, empowered vision of themselves in a situation where they often feel disempowered.


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