ISO insight/advice on nursing homes, Medicaid, etc

[Anonymous]

Anonymous wrote:

Anonymous wrote:PP (social worker whose spouse is a NHA) on the other thread here. You mention trying to go the assisted living facility route for her spend down. I have to say that this does not sound like a good plan to me. What you need to do is get her into a nursing home while she has some assets and let them be spent down while in the nursing home where they will then assist you in the Medicaid application process. It's far easier than trying to get into a nursing home in a Medicaid pending status.

The reason why you need good credit to get into an assisted living facility is this. Once the money is gone to pay the bill, you have to leave. If you don't leave voluntarily, you get evicted through whatever channels the state has set up for that to happen. (Nursing Home regulations vary by state and you mention that you are not in Maryland so I don't know what the eviction process might be). The reason for good credit is to insure that you are going to pay your bill.

One of the places we are looking at has an assisted living facility and a nursing home. The latter takes Medicaid. Ideally she would transition from assisted living to the nursing home as necessary. How does one get admitted to a nursing home? That's what puzzles me. My mom's doctor, whom I am not particularly fond of as he seems overly focused on preserving my mom's dignity with little interest in how that plays out when she is at home on her own, may refuse to admit her. She can't meet the ADLs (is that the right acronym) on her own as she basically doesn't trust herself. The doctor seems more focused on if I am respecting my mom's HIPAA.

PP here. So your questions then are will she be able to transfer to the nursing home after she runs out of money and how will that process occur. There is criteria for Medicaid to pay, financial being only one, which you should inquire about.

You don't need her own doctor to admit her. And, unless her doctor has privileges at the nursing home, he will be out of her life once she moves to a nursing home. She will have to switch to one of the doctors who have privileges at the nursing home you choose.

[Anonymous]

Anonymous wrote:

Anonymous wrote:16:40/8:04, please say a little more on put in her account. Put in the account in the assisted living facility?

FWIW, the city government where my mom is is such bad shape that they only have aides for people over 90. Anyone younger is on own or at mercy of friends/family.

I meant bank accounts. Get her signed up for online banking. I am sure she will give you her banking info, then get her signed up for online bill pay. Then you can pay her bills from HER accounts. You can put money in HER accounts and that way you are never givi g any creditor your checks or your info.

This is what I did. I opened an account online, transferred the social security payment and pay her bills online.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP, you should really consider moving her here. It is extremely difficult to manage anything and make sure she is getting the care she needs without someone looking after the situation. My MIL had a son where she was at who refused to do anything. It was a problem as she got taken advantage of. At a minimum, place her on the assisted living wait lists here (and the waiver)... it takes months to years so no harm in doing it early. She can have some assets depending on the program. Many do not make you sell your house or car but you can only have so much in cash - usually ranging from $2500 to 10,000 - it is basically $2500 for medicaid.

How much is her social security check?

There are several places in MD that are income based depending on the support she needs. It is worth it to look into them.

If you sell the house, she gets nothing, it is a non-issue.

I have 2 siblings in her area, who have done a tremendous amount, but these kinds of details are over their heads. Yes, I am aware she gets nothing when the house is sold - just trying to keep her in good credit until we decide what to do.

Very interested in this waiver - worry that it is state specific and probably won't help.

Most states have similar programs. It is just hard to find information on them. I would not worry about her credit. That is the least of your problems. Get her on wait lists here and in her home state. You do not have to decide today.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP, you should really consider moving her here. It is extremely difficult to manage anything and make sure she is getting the care she needs without someone looking after the situation. My MIL had a son where she was at who refused to do anything. It was a problem as she got taken advantage of. At a minimum, place her on the assisted living wait lists here (and the waiver)... it takes months to years so no harm in doing it early. She can have some assets depending on the program. Many do not make you sell your house or car but you can only have so much in cash - usually ranging from $2500 to 10,000 - it is basically $2500 for medicaid.

How much is her social security check?

There are several places in MD that are income based depending on the support she needs. It is worth it to look into them.

If you sell the house, she gets nothing, it is a non-issue.

I have 2 siblings in her area, who have done a tremendous amount, but these kinds of details are over their heads. Yes, I am aware she gets nothing when the house is sold - just trying to keep her in good credit until we decide what to do.

Very interested in this waiver - worry that it is state specific and probably won't help.

Most states have similar programs. It is just hard to find information on them. I would not worry about her credit. That is the least of your problems. Get her on wait lists here and in her home state. You do not have to decide today.

You can put here on the waiver here. It is just a phone call and no proof of residency. For Medicaid and other programs she has to actually be in the state. We could not do any benefits till she set foot on md. I got her an id, changed her address to ours, etc.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:PP (social worker whose spouse is a NHA) on the other thread here. You mention trying to go the assisted living facility route for her spend down. I have to say that this does not sound like a good plan to me. What you need to do is get her into a nursing home while she has some assets and let them be spent down while in the nursing home where they will then assist you in the Medicaid application process. It's far easier than trying to get into a nursing home in a Medicaid pending status.

The reason why you need good credit to get into an assisted living facility is this. Once the money is gone to pay the bill, you have to leave. If you don't leave voluntarily, you get evicted through whatever channels the state has set up for that to happen. (Nursing Home regulations vary by state and you mention that you are not in Maryland so I don't know what the eviction process might be). The reason for good credit is to insure that you are going to pay your bill.

One of the places we are looking at has an assisted living facility and a nursing home. The latter takes Medicaid. Ideally she would transition from assisted living to the nursing home as necessary. How does one get admitted to a nursing home? That's what puzzles me. My mom's doctor, whom I am not particularly fond of as he seems overly focused on preserving my mom's dignity with little interest in how that plays out when she is at home on her own, may refuse to admit her. She can't meet the ADLs (is that the right acronym) on her own as she basically doesn't trust herself. The doctor seems more focused on if I am respecting my mom's HIPAA.

You are much better off private paying for a few mo this in a nursing home vs assisted living to get your foot in the door. Once there they then will float you for a few months prior to Medicaid being approved if she meets criteria.

PP here. So your questions then are will she be able to transfer to the nursing home after she runs out of money and how will that process occur. There is criteria for Medicaid to pay, financial being only one, which you should inquire about.

You don't need her own doctor to admit her. And, unless her doctor has privileges at the nursing home, he will be out of her life once she moves to a nursing home. She will have to switch to one of the doctors who have privileges at the nursing home you choose.

[Anonymous]

OP here. While my DM can be challenging, she does realize at many moments that she needs help and wants more contact with folks. What kind of MD should I take her to for the evaluation? As I mentioned, her current doc was an abysmal failure, bordering on professional neglect - my DM was out of her meds, her husband was dying, and the doc kept focusing on my mom's HIPAA - that it was more important for my mom to be the one to make the call about her meds, rather than just get the meds.

Also regarding the waiver one PP refers to, what does this cover? What is it called? I keep hearing that Medicaid cannot cover room and board @ assisted living, so what does the waiver cover?

Really appreciate everyone's comments and advice!

[Anonymous]

Look for a geriatric specialist
Ask around, you want references and once you get her a new doc and your mim fills out paperwork be sure that she puts down that the doc can release medical info to you!

[Anonymous]

There are elder law attorneys who can advise on these issues and who can be quite good at talking with older folks who are scared/mad/sad about leaving their homes.

It might be worth paying for a consultation with one.