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Otherwise Eligible Serving Penalty: Private Pay Rate or Medicaid Rate

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  • #32028

    Where the applicant has been found to be otherwise eligible for nursing home benefits under medicaid, but is serving a penalty, must the nursing home charge the medicaid rate during the penalty or can they charge the private pay rate?
    Thanks for any info

    #32029

    Hi Jesse,

    Our understanding is that the nursing home will charge a client the private pay rate during a penalty period. Do you currently have a case where that is proving to be otherwise?

    #33442

    The nursing home charges the private pay rate during the penalty period.

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