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Mom with dementia has lived with me three months. my mental and physical health is failing. she was denied Medicaid after 7 months in assisted living, the doctor would not grant her long term care qualified. She can do little for herself but walk and feed herself. we've used all her equity and her SS is too much to pay for Medicaid for assisted. Help! I know I can't do this indefinitely.

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Get her to another doctor. I'm thinking that Medicaid won't step in because she doesn't need skilled care. That's a problem. Perhaps another doctor may see it differently.
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AL is a profit center as it is almost always private pay. Yes there are waivers for AL in the states that do waiver programs but the # of beds are limited and almost always filled from the waiting list at the AL from current long term residents who have been there 2 or 3 years as private pay.

Here's my suggestions -
1. speak with admissions at the current AL and let them know that there will shortly be no more private pay available for her and do they participate in Medicaid waiver for AL and where would mom be on their list
2. About your mom having too much income for Medicaid, has anyone mentioned mom doing a Miller Trust? if the situation is that mom would qualify for Medicaid except for the fact that her monthly income is over whatever the ceiling is in your state, then IF mom's income is from a guaranteed source, she can do a Miller to get her income below the Medicaid maximum. Miller works like this, say mom gets 800 from SS and then 1K from dad's federal guaranteed retirement and then 500 from her own state employee guaranteed retirement and she is in TX which has a max for Medicaid monthly income at $ 2,163.00. Mom gets $ 2,300 so is over by $ 137.00, that $ 137 is the amount the Miller Trust gets and VOILA! mom is now good for income for Medicaid. Now Miller has to be done by an attorney who knows how to make it work for your state laws. Some states have Miller build each month and then when they die that balance escheats to the state, other states have it such that their full monthly goes to the NH so there is nothing left extra. Needs to be done by experienced elder law attorney, not a DIY project, really.
3. If is more the case that mom really needs to go into a NH as the AL just will not work for her to stay, then I'd suggest you go and see like 4 - 5 NH and get at each NH the contact info for the medicaid director of each NH. Your mom needs to become a patient of one of these MD's. It could be that 1 MD will be the medical director of a couple of the NH too. These guys know just how mom's chart needs to read for her to qualify for the medical part of Medicaid. She will need the fat chart to show the need for "skilled nursing services". I moved my mom from IL to NH and totally bypassed the AL stage and it took about 6 months of her going every 4 - 6 weeks to the new gerontolgist who was the medical director of 2 NH that were going to be the ones she went into. The doctors visit that mom had a 10% weight loss and a bad H&H lab work, the new MD wrote the orders for skilled nursing care needed and I moved her out just a couple of days after the 30 day notice to the IL. If you move mom from AL, you need to read carefully the contract so that you are not on the hook for an additional month. Also the AL will not send you a check for any days not used if you move out early too. You want to have it such that you only end up having to maybe pay for her final 2 - 4 days at the AL. Understand?

Often to meet the standards for "skilled nursing services", it can mean just a change in how things are done. Like mom got prescribed the Exelon patch rather than the pill…..why? well the patch requires someone to put it on and then to monitor that it's placement is done in different parts of their back which the patient can't do on their own; another thing is to have the med's compounded, so instead of taking a pill, it needs to be crushed or mortared and blended which is something that can meet the standard of "skilled care". Also they will need to have some sort of co-mobidity to bolster their need for skilled , so it could be something as simple as them being prescribed 81 mg aspirin for cardiac condition. Now your mom's age may be a factor in doing this and having the MD work with you, my mom was in her 90's so age was on her side for errors even though she was pretty good on her ADL's and has Lewy Body Dementia so good cognition at the time. If your mom is late 70's or early 80's, it is going to be somewhat harder to get the need for "skilled" done. Good luck.
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my bad, it should read "then I'd suggest you go and see like 4 - 5 NH and get at each NH the contact info for the MEDICAL DIRECTOR of each NH. Your mom needs to become a patient of one of these MD's." Medical director NOT Medicaid director
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Get in contact with a benefits consultant. We used ERBC. They pointed us toward VA Aid and Attendance, did not charge a fee. They recommended WE fill out the VA 2680 form and have the MD sign it.
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