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SGeorge24 Asked April 2021

What are my options if a Nursing Home won't accept my mom?

My mom is currently on Medicaid Waiver for home care. She was approved for 31 hours per week but the home care agency only has somebody available for a couple hours twice a week. The agency on aging has evaluated my mom as not being able to be left alone, so I became her full-time unpaid caregiver, but I'm able to bill for the few hours the home agency doesn't work. I've already heard about how unacceptable, irresponsible and inexcusable it is to leave my mom alone for even a few hours.


We all know my mom needs to be in a Nursing Home, but because she is already on Medicaid Waiver, she will need a facility with a Medicaid bed right from the start.


My mom flat out refuses to go to a Nursing Home, she said it's her house she has the right to stay here until she dies and nobody can make her leave. My mom's caseworker is siding with her and expecting me to keep my mom at home and care for her. Nobody can talk to her about a Nursing Home without her going ballistic, so we would have to trick her. The home would have to put up with her hollering, screaming, demanding to go home, trying to walk away, refusing to eat, throwing food, etc. On top of that there could be a penalty period for her Medicaid.


She put her house in a Life Estate back in 2008 and since she's 96 now, a lawyer said if we sell her house, she would get less than $4,000 and I would get the rest, but then after she passes away, the house would go to me and Medicaid wouldn't be able to touch it. The only way for her to pay the penalty period would be for me to give her my share of the house, but then I don't have a place to go and she couldn't be sent home because there is no home.


I won't be able to stop her front porch remodel which is going to cost her Medicaid Waiver around $10,000. The vertical lift alone cost $4,000 then they have to break up and remove the cement front step, build a wood deck, level the area next to it and pour a cement pad for the lift. There is no outdoor outlet, so they will have to install one and I wish them luck with that. The house has an old fuse box with four 15 amp circuits. They are supposed to connect to an available 20 amp breaker, but there isn't one. They are also going to have fun running the electric wire for the outlet which could increase the cost that Medicaid pays and if I have my way, my mom won't be here long enough to use it.


She also has some questionable transactions on her checking account that she may receive a penalty period for.


So what happens then if the Nursing Home calls me and tells me I need to come get her and take her home? Does that mean I'm stuck caring for her? Nobody else is able to willing to do it, No family has even been here in the past year.


I know it won't be that difficult to remove the deck and pour new cement steps after my mom is gone, so I'm not too overly concerned about what it will do to the house, just the amount Medicaid is going to have to pay for something my mom may never use. They feel they need to proceed because there is a chance my mom will be sent home.

AlvaDeer Apr 2021
We have been on this journey with you for a while now, and are aware of that 15,000 investment by medicaid in your mother's home, in the interest of keeping her in that home. That they made that investment means I think, that they will be especially tough on you if you, as her POA, decide on placement with medicaid funds. You have already taken actions that insure you, not the taxpayer, will get Mom's home, so there will be no recovery of funds. I would think they would be ruthless in going through Mom's accounts looking for signs of further gifting. Just my guess, but each state is different.
Early on, before the work itself began on the home, you told us that you believed she may have to go into care. I wonder how adamant you were in telling the medicaid folks that before they started the contract and work on what is really for all intent and purpose YOUR home.
I have never looked up the state you live in; that I know of I have NEVER heard of California Medicaid putting an investment of 15,000 into remodel of a home for a senior, especially when it is clear there will be no recovery on that investment at all at any time. I sure could be wrong; I was a nurse, not involved in medi-cal itself in my state.
Whatever the case is, it is. You have the caseworker. If it becomes more work than you can do you can demand placement for your Mom, whether the caseworker likes that or not. I think none of us can guess what will happen. But I sure wish you the best. I know you are clearly worried about all of this all of the time. Be as honest as you can be with the caseworkers; tell them if push comes to shove you may have to resign your POA and let the State take over guardianship, care and placement for your Mom as best they can. However, now that her home was made your home they may do what THEY can to recover cost. I sure wish you luck, hope you will continue to update us.
SGeorge24 Apr 2021
When I came here about a year ago, my mom couldn't remember what she did with the combination to dad's old safe. The thing weighs 3,000 pounds so there is no moving it. When I was finally able to get in, I found all these papers my mom had made out back in 2008. I had no idea what a Life Estate was until I was able to talk to her lawyer who really isn't the sharpest tack in the drawer. Turned out she had sold me her house for $1 and retained a Life Estate interest for herself and it's been recorded on the books in the County office. I didn't even know about the Life Estate when I signed my mom up for Medicaid Waiver.

My mom's caseworker with the Agency on Aging said that she could authorize my mom to have a walk-in shower and wheelchair ramp installed. This whole process takes months as the authorization was put in last summer. Some time later I get a call from ATP, they want to evaluate the house for modifications. I receive the blueprints and they want to rebuild the whole house. Someplace in the confusion, my mom signed some papers and they were mailed back. I think it happened while I was gone for a few hours and my mom's neighbor was watching her. She did sign the papers herself, but her neighbor was confused and thought it was something that needed to be signed and returned right away, so he was trying to be helpful. Months later we received a letter with the total amount each project was authorized for. I called them and asked if they could just install a shower without remodeling the whole house but they said "NO!" Medicaid funds won't pay for a shower unless we have an accessible bathroom. They said that should have been made clear during the house evaluation. I told them I was POA for my mom and they would be doing the remodel over my dead body. They said they could permanently halt the bathroom remodel but the front porch had already went to the contractor. ATP said if the project is stopped, the contractor can't get paid. What has to happen is the contractor build the deck with the vertical lift, ATP inspects the work and if it passes, the contractor gets paid with Medicaid funds. They said if I don't like it, I'm free to tear the deck back off at that point and pour new cement steps. They don't care if they are causing future Medicaid problems for my mom, they just want to get paid.

My mom's house isn't worth that much and allowing all the modifications to happen would exceed the value of the house, plus they are having to pay for home care, home delivered meals, medic alert, etc.
Daughterof1930 Apr 2021
Your caseworker shouldn’t be “siding” with anyone, the caseworker is supposed to be involved to find the best plans for mom, not judging you. When she’s unsafe in her home without constant supervision, it’s not wrong to look at other options. Do I understand that you’re hoping to live in mom's home after she’s gone? Is selling it now and going your separate ways an option, mom goes to NH and you find a new place? You cannot be forced into caregiving and mom’s care is past what is healthy for you
SGeorge24 Apr 2021
I'm sure when my mom set up her life estate, she did so to make sure that I would not end up homeless. The house isn't worth that much and would likely be hard to sell. It's a small house on a small lot in a small town and isn't even in a good location. It's suitable for maybe 1 or 2 people but would not be ideal for a family. I'm not really attached to the house, but it's better than most rentals and it's shelter from the cold and the rain. The lawyer said if we sell now, my mom couldn't sell without my permission and then she would get less than $4,000 and I would get the rest. I could deed the house back over to my mom and sell it to her for $1, but then Medicaid gets everything from the sale of the house and I get nothing. What happens if the house sits on the market for months and my mom can't afford to pay for the nursing home?

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mstrbill Apr 2021
Its a tough situation you are in, but it sounds like it may be to your advantage financially at least to stay with her at home and take care of her. If you decide its too much for you you can leave and let the State take guardianship of her but then you will need to find a new place to stay. You never can ultimately be forced to take care of someone if you are unable to or unwilling to. Of course it is not that simple, but imagine if you became incapacitated or had a psychiatric break or went to jail. What would happen to mom? The State would step in and ensure her safety. Along the same lines, if mom was in a nursing home and the nursing home called you to pick her up, you could make yourself scarce. Or you tell your moms caseworker you can't be there all the time anymore. Maybe you need to work to earn a living. Ultimately its up to you.

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