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Dear Advocate…


Dear Advocate:

I am having a difficult time finding a nursing home willing to accept my partner who is on Medi-Cal upon admission. What else can I do?

Sincerely,

Lost in Lassen County

Dear Lost:

Finding a nursing home is hard. It can be especially difficult to find a nursing home willing to accept you when you are transferring from home or an assisted living facility as opposed to a hospital. People are often told the myth that there are no “Medi-Cal beds” available, or that there is a waitlist for a Medi-Cal bed. In reality, a facility cannot have a limited number of “Medi-Cal beds.” Any nursing home that is Medi-Cal certified must make every single bed in the facility available for residents paying through Medi-Cal so long as the resident needs nursing home services and those services are paid for.

This myth is perpetuated because many nursing homes don’t want to accept Medi-Cal’s lower reimbursement rates. Instead, they prefer Medicare or private pay. It is much easier to get accepted into a nursing home when one is transferred from a hospital because after a three-night stay as an inpatient at the hospital, Medicare will pay for rehabilitation services at a nursing home. Often residents’ will use this as a way to get placement, and when their Medicare coverage ends, they switch to Medi-Cal.

It is illegal for a nursing home to discharge a resident based on a change of payment from private pay or Medicare to Medi-Cal and residents’ have the right to transfer to Medi-Cal payment if they are eligible. (W&I Code §14124.7(a); 42 CFR §483.15(c)(1)(i); 42 USC §1396r(c)(2)(A)). It is also illegal for a nursing home to discharge a resident while their Medi-Cal is pending (W&I Code §14124.7)..

Page Last Modified: July 16, 2020