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Frequently Asked Questions

1. If my loved one goes into a nursing home, will they take the house?

No. For some people, owning a house means they are not eligible for Medical Assistance. In that case, they may sell the house to pay for nursing home care, but the state does not take the house. If your mother uses the Maryland Medical Assistance program to pay her cost of care in a nursing home, the state may place a lien on her house after her death to recover correctly paid benefits. However, the state will not place a lien on the home if there is a chance your mother will become well enough to return home.

Also, the state will not place a lien on the home if a spouse or certain dependents are living there. When the Medical Assistance recipient dies, if he or she does not have a surviving spouse or a surviving child who is unmarried and under 21 or is blind or disabled, the state can recover from his or her estate what Medical Assistance paid for nursing home care after the individual turned 55 years of age. If the person is survived by a spouse, a child who is unmarried and under 21, or a child who is blind or disabled, the state cannot recover from the estate until the surviving spouse dies and there is no longer a surviving child who is unmarried and under 21, who is blind or who is disabled. The state has no claim against the estate of the surviving spouse or child.

The Maryland Legal Aid Bureau offers more information about the how Medical Assistance coverage in nursing homes operates.

2. How can I help my loved one understand that she needs to stay at the nursing home? She can't seem to make the adjustment.

How to help your loved one depends on her mental status and the reasons for her desire to leave. If she does not feel at home in the facility, or is having trouble adjusting to her new surrounding, ask for a meeting with the nursing home social worker to discuss the situation. The social worker will work with your loved one to help her make the adjustment, and may be able to offer you suggestions on how you can help too. It may help to bring her favorite photographs and a few personal belongings to make her feel more at home. Also, visit often and encourage other family to visit.

If your loved one is suffering from a dementia, adjustment may be more difficult as she may not remember why she needs to stay at the nursing home despite how well you may explain the reasons. A support group may help you work through this and offer you more specific ways to help your grandmother.

3. What qualifies someone for a level of care in a nursing home?

The level of care for which a person is eligible is determined by evaluating how much actual assistance the individual needs with activities of daily living (dressing, bathing, walking, eating, toileting, transferring) and how much nursing supervision and medical care is required. An independent agency, KePRO, determines medical eligibility and level of care for nursing home placement.

4. Do Medical Assistance residents get the same services as private pay residents?

Yes. Medical Assistance residents are entitled to the same care and services as private pay residents receive. If you feel your loved one is not receiving the care he or she should, you can report the problem to the appropriate nursing home staff or to an outside agency.

5. What legal documents should my loved one have in place before entering a nursing home?

All adults should strongly consider making certain decisions before a crisis hits. Executing a Financial Power of Attorney and Advance Directives, including a Living Will and Do Not Resuscitate Order, enable the competent adult to direct what care he or she may want in the future. If your dad is not mentally capable of executing these documents, Maryland law offers other legal remedies that may enable you to ensure that his wishes are met. Making and prepaying for burial arrangements is helpful as well.

6. What does Medicare pay for in a nursing home?

Medicare may pay a portion of the bill for a very specific period of time if the patient is determined to need skilled nursing care. The maximum benefit period is 100 days. Example of skilled needs may include an open wound that needs dressings and treatments, a tracheostomy, a newly placed feeding tube or the need for extensive physical and occupational therapy. Most people do not qualify for skilled care for an extended period of time. The majority of nursing home care is paid for privately or by the Medical Assistance Program.

7. What activity programs are available at a nursing home?

Activities at nursing homes are developed to meet the needs of the residents. Many activities are conducted in small groups to provide opportunities for socialization, while others take place in large groups. While most activities occur on the grounds of the nursing home, some facilities are able to offer field trips to interesting places in the community.

8. Can I bring my loved one home for the holidays?

You can bring your mom home for the holidays as long as she has prior approval from her doctor. However, if you wish to have her stay overnight or longer, you will need to review the nursing home contract regarding nursing home bed hold policy. This will specify the number of days of leave she may use without losing her bed. If your mom is receiving Medical Assistance, she is allowed to spend up to 15 nights of approved leave away from the nursing home each year. Clearly you want to be certain you are able to give your mother the amount of care she needs before you bring her home for a visit, but if you and her doctor feel it is possible you may want to consider it.

9. If I find the nursing home is not right for my loved one, can we move them to another facility?

You may move your loved one to another facility at any time, but it is important to read your contract to learn how many days notice you need to give the nursing home so that you do not incur an additional expense.