Can A Family Agree to Pay A Nursing Home or Assisted Living Residence for A Private Room When Their Loved One is Receiving Medicaid?

Posted in NJ Medicaid

By Fredrick P. Niemann, Esq. of Hanlon Niemann & Wright, a Freehold, NJ Medicaid Attorney
It’s a question I’m asked often.  It’s also one that causes a lot of confusion within the nursing home community.  Some nursing homes think that any form of private payment violates Medicaid laws.  That is incorrect, it’s perfectly legal.
Here’s the general fact pattern – Mom qualifies for Medicaid, which pays for a semiprivate room, that is, a room with a roommate.  If the family wants a private room for Mom, they can pay the additional charge, provided of course that the home has a single room available.
What is the going rate for a private room? Generally it ranges from $25 to $30 per day. While Medicaid is picking up the semiprivate room rate its reimbursement rate is much lower than the private pay rate. You see, Medicaid …
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