Need Medicaid for nursing home care. She is currently in a self pay facility, but no more funds to pay. Must be moved by end of October.

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It is possible but I am going to give you one bit of advice and that is to call your state’s elderly protective services, notify them of the situation and make sure you don’t take her home with you. You do not have to take her home with you. The state will take her under protective services if necessary.
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Debstarr53 Oct 2021
I totally agree. Taking her home will result in long term care by the OP. When my mom gets to that point, she will NOT be coming home with me for even one night, not because I don't love her or want the best, but I can't care for her fulltime in this home.
What you do is apply for Medicaid, tell the caseworker wherever the 50k went, they will either approve or deny but regardless you do not take her home. You let the state take guardianship, the state or facility may file suit to seek to recover from the entity where the 50k went if Medicaid is denied
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Riley2166 Oct 2021
I agree fully - tell the truth but do NOT take her home. This will force them to place her and care for her.
50 large is a lot of $$. There needs to be a police report filed.

Whomever is her POA needs to do this as a requirement of their “fiduciary duty”. If it is you and you didn’t, just contact the police asap and say you just became aware of the theft. A lot of police departments have a SAFE or community affairs officer that deal’s with things like this. The police report will be needed to ever have LTC Medicaid view the 50k as ok to be waived and not have a transfer penalty placed on her Medicaid application (cause Medicaid might could view the $ as gifted to a person). She has to be willing to sign off on the police report.

Joann's spot on that AL have totally different requirements as to how a discharge can be legally done. AL can discharge a resident for inability to pay and place them in a shelter if the AL wants to. Now that bad bad public relations optics for a facility so they won’t do that but instead more likely will find a reason to contact EMS as mom has presented something of concern (like a TIA as they are real subjective) and needs to go to the ED/ER to be evaluated; then once in the ED the AL will refuse to take her back; mom then becomes the problem of the discharge RN at the hospital; they will do whatever to get you, your siblings, a family friend, etc, to come and take her into their home and she is no longer a problem for the hospital. If your mom is in an AL and stops paying her bill and your state’s Medicaid does not pay for AL & this AL does not participate in the Medicaid program, they do not have to let her stay there.

Now if she’s in a NH, as almost all NH participate in Medicare, they have to have them do a “safe transfer” which Medicare requires. Which means they move to another NH or get sent to the hospital via EMS to the ED / ER. And again, the old NH may not take them back once they are ready to get discharged from the ED/ER, or from a 2 day “observation” or actual hospitalization. If a NH wants get rid of a resident, they can find a legit way to do this.

I’ve got to ask, just how was she scammed out of 50k?
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You need to file for Medicaid NOW and let them help you with this.

You should have started the application a few months ago.

Was a police report filed for the 50k? If not, that needs to be done or they will have a hard time believing it was a scam.

I would be telling whomever is telling you that mom has to be gone that she doesn't have any place to go.
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I don't think by law a private pay facility like an AL, is under the same regulations that a Nursing home is by "safe discharge". Its just like renting an apartment, you can't pay you need to leave. I know of a local AL who lost their Medicaid contract and those who were on Medicaid had to find other accommodations.

Does the AL except Medicaid? In NJ if you have private paid for at least 2 years and the AL has medicaid beds, Medicaid will pay.

Yes, you waited too long. Its going to be hard to find a placement with Medicaid pending. How long ago was the scam? If over 5 years it won't be counted. Like said, hopefully u contacted the police.

So, you options right now is pay for Moms AL or bring her to your home till you can get Medicaid applied for. Its at least a 3 month process. You apply, prove that Mom has spent down her assets, provide paperwork needed, and get her placed. Not sure if you get everything needed before 90days, thats the limit, you can get Mom placed earlier with Medicaid paying. You need to talk to a Medicaid caseworker.
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I can't say for certain but I believe there's a specific way to address this in tax returns.  You may have to hire a good accountant familiar with scams to help address this, and how to claim it as a loss.

I'm so sorry to learn that your mother was financially abused like this.

This might help, but I'd search for more specific information on addressing scams on income tax returns.  This may help in finding care for her.
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She should be helped to apply for Medicaid and moved to a facility that accepts Medicaid. Make an in-person or video appointment and also search online at Social Security website about how they will view the "scam." They might also guide you to other resources to help your mom. Please talk to social worker where your mom is located for assistance from other local resources.

While that is happening, please report the "scam" to the local police as well as banks or financial institutions involved. All these authorities should be able to advise you on what to do about the "scam."
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If the funds were scammed by a relative - as in, she gave them the money or her PIN to access an account - the bank will probably not return the funds and more than likely would be considered a gift from your mom.

If there is a police report to show she filed on the person or made an attempt to get the funds back, there may be enough proof to show it was a real scammer unknown to her.

You probably need the help of an elder attorney. This isn't something new. People get scammed every day. An atty will know the ins and outs.
Helpful Answer (4)
mstrbill Oct 2021
There is no need to pay for an elder attorney in this case.
We stopped some scam attempts on my and my mom's accounts( family friend who had been living in my house) this past Summer. There was a small electronic trail( right back to the ex family friend) I turned it over to the detective. We have everything well documented as I am POA for mom. Thankfully fast action prevented loss.
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Just not enough information. But the short answer is that nursing home care is based on resources, not including a family home. I just dont know enough from your comment. But any nursing home should admit based on her social security and any other incomes and assets. Family home value is exempt. If all she is SS its just a matter of getting her to a NH. Medicare or Medicaid is the business of a NH. That is step one. Then what of the scam. That is going to be a separate situation for you. Has a report been filed? Was it a relative that did the scamming or someone else? Is there any chance at all of getting the money back or was it transferred to a phone scammer? But the private pay can't be part of that problem. And if they can't accept just her social security, then a NH is the option. If and when you might recover the money, she can go back to private pay but right now she will need somewhere to go, home with you or a NH. Word of CAUTION: Do Not do direct deposit to a NH. Just go by and pay each money when billed and DO NOT simply do a direct draft of a bank account. Its too long to go into, but it involves when a resident is classed as Medicare vs Medicaid and it can, and will, switch back and forth on which service pays. Example, your mom will go into a NH as Medicare, NOT Medicaid. If she goes to the hospital for even one day, for the next 100 days her "bed" is reclassed to Medicaid and her direct deposit funds to a home could build up past the $2,000 allowed amount. Go over that and YOU will be billed for the full month of care which could run upwards of $6,000 or more per MONTH until the $2,000 amount is reduced. The nursing home will not tell you this but if you go in once a month, they will tell you there is no charge that month and you know what to do about that $2,000 limit, right? Don't direct deposit and Don't do auto draft on a bank account if you aren't watching it like a mother hen. Just go down and write a check.
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Lymie61 Oct 2021
Just to clarify I think you switched Medicare and Medicaid here, Medicare is the health insurance everyone has after 65, Medicaid is what one needs to qualify for based on finances and it picks up all the expenses after Medicare Heath benefits. I am surprised there isn’t a safety net for patients in the scenario you describe where billing may shift but that doesn’t affect patient care when they are transferred back to same facility after a hospital stay. I get why Medicare benefits need to be used first before Medicaid LTC kicks back in and I do know that once a patient is gone (a patient somewhere else, hospital and or rehab) the same room isn’t always kept open but I thought they could go back to the same LTC facility when ready. It probably does depend on the greediness of the facility what a PIA!
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