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Kimberly88 Asked August 2018

What will happen when my father in nursing home with Dementia/ Alzheimer's runs out of cash?

I have guardianship. I pay for nursing home out of his checking accout. Nursing home told me he won't qualify for Medicaid, he owns property besides his own home. No spouse, Mom died 20yrs ago. What happens when I can't pay nursing home anymore, will they throw him out on streets?


I live 1,870 miles from nursing home, and can't afford to pay his bills out of my own money. His lawyer in his state is not helpful to me, won't give complete answers on anything. How do I apply for Medicaid for my dad in another state, where I do not live in? Would he get Medicaid, if no cash to pay nursing home? I have to pay property taxes in 2 days, out of my own money, dad doesn't have enough cash. I don't want the state to take the property if taxes don't get paid, not to mention I have already been threatened to be removed from guardianship, by his lawyer, and his brother in law wife, despite the fact that they are 84yr +++. Nasty comments from his lawyer, yet won't tell me answers that I need and expect from a lawyer. Help???


Also, won't Medicare pay for incontinance briefs/pull ups if it is chronic, meaning never dry long??
Nursing home is billing 2 different kinds of briefs/pullups, none are covered. Also billing for specified bandages used by wound nurse for ongoing weeping of legs/edema problems.
Thanks

Toadhall Sep 2018
Just another thought. I have said this before but it bears repeating. Keep excellent records. A paper trail of everything. Every receipt, every document, every email, photos etc. Protect yourself and show that you did nothing wrong.

Toadhall Sep 2018
Short answer--get another lawyer. Please get another lawyer. (You may be able to sue the current one, but that's for after you get this straightened out.) You are entitled to hire a lawyer of your choice using your dad's money to help you with legal questions regarding the guardianship. If dad has other property and a home, this should be sold to pay for his care and for taxes and everything else. Do not be paying for anything out of your pocket. (Yes pay the taxes, but save the receipt and reimburse yourself.) You have guardianship, so you should have control over all of his assets. Why are you keeping a home that he is never going to live in again. Please start communicating with a lawyer in the state where your father lives. With modern tech, you would not even have to travel to see the lawyer--do it over a computer. With guardianship you have the power to move your parent to your state--ask a lawyer. Please, please act fast before this spirals out of control. Your dad will only get Medicaid when all of his own funds are used up. I mean all, not just cash. You shouldn't be making a distinction between CASH and other assets. Sell the assets and you have cash- right?

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disgustedtoo Sep 2018
Although (to the best of my understanding anyway) Medicaid doesn't force the sale of the PRIMARY home until after the person passes, there are some rules that override this. It appears they do not apply here (spouse is deceased, no disabled children living in the home?) However, you state that he owns other "properties". THOSE would need to be sold and all proceeds then used to pay for his care before Medicaid will be approved. Keeping GOOD records is important! Once all assets other than the primary home are gone, Medicaid should be approved. Also, HIS assets should be paying the attorney fees and taxes (and any other related expenses.)

Now, as others have said, upon his demise, Medicaid WILL require the home to be sold and for you to pay back of all monies provided for his care. This would come before any other debts or inheritance. Despite some implying Medicaid is crooked, this is how the system works. It IS intended for those who have no assets to provide for their care. OUR tax money pays for this, not the government - they just facilitate by taking tax money from ALL of us. To those who disagree, since her dad owns property, more than just his home, do you agree that YOUR tax dollars should support him, or should he (or guardian using his assets) be paying his own way (including the money from the sale of the primary home)?

As others have said, find a reputable Elder Care attorney, especially one versed in Medicaid rules. Taxes can be delinquent for a short amount of time - this can be settled during the closing of the sale (if you think it will take a long time to sell, get some legal advice - just not from that current lawyer.) There will be fees associated with it being paid late, and probably a lien placed on the property so that they get their tax monies before anyone else. I would discuss this with the tax collector(s). However this would alleviate you having to cover it, but ensure it doesn't get "taken", provided selling does not take years! Perhaps they can accept partial payment for the time being. It cannot hurt to ask!

As for the threats - do you have DPOA OR are you actually appointed guardian by the courts? If you have been appointed guardian by the courts, they would have to go to court and incur all kinds of expenses in order to ATTEMPT to have that changed. There is no other way for them to "take away" your guardianship. If they cannot prove that you are incompetent in your handling of his affairs, are negligent or taking advantage of his finances, they really have no leg to stand on. These are likely very empty threats, but you should not ignore them. You SHOULD find another attorney to handle anything that needs legal handling.

Any legal fees that you incur should be paid from dad's assets. Clearly you say he is pretty much out of liquid cash, so you NEED to get those properties sold. If possible, I would sell them all and then set up a trust for all the remaining monies after all other issues are paid up and use that for his NH. Ensure that BIL/wife have NO access to this trust. Once those assets are approaching depletion, THEN you can apply for Medicaid.

You might also be wise to hire a local (to you) Elder Care attorney. S/he might be able to facilitate issues with the attorney you choose who is in your father's state, and perhaps look into having dad moved to your state, if you would want to do that. Yes, more money is involved, but you need to protect yourself and your dad. Local attorney (to you) might be able to locate a better EC attorney in your dad's area. If money is an issue, perhaps they can also help by setting up an account, where you can pay a minimum until the properties are sold - they can also use the lien method, so they will be assured of getting their fees paid.

The best advice given is DO NOT WAIT!
GraceLPC Sep 2018
Excellent answer, but you missed a key point.
What can happen if courts have not declared POA is in effect. The time to make it Irrevocable and in effect is Now. If father is competant, he can amend the POA to literally take effect tomorrow!! Do this!!!
So many times no one wants to go to court to have LO declared incompetent. The fact that you mentioned "Dad's attorney", makes me think that POA can still be changed... written up by Dad's Attorney at behest of BIL etc.
This just happened to a good friend. They spent a fortune, and ran up a lot of debt during the recession, on maintenance and improvements to the family home. Food, personal care supplies, and staff to care for Mom in her home! She had POA and was to get the house according to the will and trust. 7 weeks before she died other relatives swept in, took Mom to a new lawyer, new will, changed trust, changed FPOA & MPOA, removed her as beneficiary of accounts she funded, to care for her Mom.
So now, her money, plus the value of the house she spend tens of thousands repairing and making Accessible so Mom could stay, gets split 4 ways.
Worse yet, she arrived and was locked vout by the attorney who is now Executor...yeah...not legal to draw up papers making yourself Executor, but that is yet another court battle from across country.
When her mother was in the hospital, she was told she could not get updates, because she was not POA...that is how she found out! Then she was told her Mom was "fine". She is telling hospital staff, she needs to know. She already has tickets for a couple of days from then, but can catch a plane tonight!
She never got to say goodbye! She didn't talk to doctor or head nurse, only an employee she had fired when they asked for huge wage increase day after graduation. This woman also worked at the hospital. So there is a question as to if she was given honest information.
The financial loss was substantial. She can't buy out her siblings.. who didn't even show when their Dad died. They have debt that should have been paid, at least in part, by the Estate. Money used directly for care of her Mom.

The crushing emotional loss was greatest! We can't always make it to be by a LO side, say our last goodbye. No one, especially the person taking care of things, so their LO is being cared for, should be blocked from that time, locked out of the house they made sure didn't go to creditors. The home they were promised.
Revocable POA can be easily changed, elderly LO manipulated, especially if at times they seem lucid to a stranger.
jbclync Sep 2018
Sell the property to pay for his care. That is what it should be used for. As soon as that money is spent you can apply for medicaid. Medicaid covers incontinence supplies, but medicare does not. I would pay a visit to the nursing home and take charge of his incontinence supplies as well as scripts because they charge way more if you go through the nursing home. We had to pay out over $25,000 until the medicaid was approved. Get started ASAP

Ahmijoy Aug 2018
You need to find your own attorney who specializes in Elder Law to help you untangle the out of state real estate issues and help you file for Medicaid. You should do it now since you’re almost out of time and cash. Medicaid will take into account his other properties and you will probably have to sell them for spend-down for him to qualify. You could pay bills with that money. Pray that the properties sell quickly, even for less than their value. Do you have legal guardianship? Why do they want you out? Why does his attorney want you out? This is a financial mess and could wind up costing you lots of money. What will you do if Dad does have to leave the nursing home? If your brother wants to take over, I’d be tempted to let him. It might be a whole lot cheaper for you in the long run.

When my husband was in rehab, he was provided with incontinence supplies and it was paid for by Medicare and his supplemental. But here at home, they won’t pay for those. Only Medicaid will pay for home incontinence supplies.
Kimberly88 Sep 2018
Hi, there is no brother, no other sibling. I have guardianship, but a co-guardian was also appointed, this person is not related to myself, or my father.I want him removed from guardianship, all he is after is money, demands 20.00 per hour for farm labor.
Judysai422 Sep 2018
You can buy incontinence supplies from walgreens or Walmart, etc. On line and put them on recurring status so they get mailed to your dad regularly. Do not give NH authority to buy unless they specifically ask you first.
Kimberly88 Sep 2018
Hi, I never gave nursing home permission to bill for diapers/briefs, they have been just doing it. Dad has incontinence, no one has ever explained or helped with other alternatives for this problem. Thx
Clou1313 Sep 2018
Good luck. Medicaid allows one property, & max $2000 in checking. A low valued car too.

What caught my attention about your post was, youve been threatened .....if you are out of money, then let them remove you.
Considering all THE STRESS you're about to endure.
Someone needs to sell property as stated. In a hurry. Then apply.

In the meantime can they throw him out?
Yes!!! And they will. Its easier to be poor when aging, this i learned.
God bless you.
Ruff times ahead. And by all mean, have a supply store deliver pull ups/diapers.

lynina2 Sep 2018
Medicaid allows your dad to own one home as long as the value of it isn't too high. That figure can vary from state to state. The other property must be sold to pay for his care. After he spends that money down, and he is applying for medicaid, he can state that he hopes to return to his home. That delays the sale of said home to after he dies.

anonymous275053 Sep 2018
Yes Kimberly I would definitely agree with the above Posts as it seems Your Dads Lawyer is dragging His heels and it is time to replace Him with a good Lawyer Who will work with You on Your Da's behalf. This is a very stressful time for You and the last thing You need now is to worry about finance since You live almost 2,000 miles away from Your Dads Nursing Home hence consider putting Your Fathers Home and property up for sale and certainly keep accounts.

anonymous167756 Sep 2018
Why aren't you moving to sell the property? You might want to hire another lawyer, seek a POA, and move to sell the property. Once you are POA, I don't see why you can't fire the current lawyer. Sounds like Medicaid won't kick in as long as he owns property. Do not pay for anything yourself unless you are being reimbursed or have it in writing to be reimbursed once the property is sold. If property taxes are owed, why isn't the attorney handling that. That should not be a guardian issue.
GraceLPC Sep 2018
Can Property be signed over to NH? That will cover expenses gap till other properties sell.
It is not always quick and easy to sell a property. Even if you throw away 10-20% of value in pricing it for a quick sale, plus pay 10% more in Realtor Commission, closing costs, and costs to carry it to closing!
I am a retirer Realtor. I have sold a home in less then a month, and a few days before Sheriffs Sale for Foreclosure.
What state is the property in. Are there Tennants? Some states you need Tennant permission to show the property.
Is it a family property, that is why too full of memorabilia? Who is going to clear it out!
Yes, there are Realtors who will guarantee a sale, what they won't tell you is you have to list at their suggested price, using their appraiser...so 10-20% under market. Then after carrying costs for 3-6 months, you pay them well over a grand, plus 10% commission, plus Buyer & Seller closing costs.
If you can refinance, move it to a trust to pay father's expenses, that might be better.
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