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LilyMoon Asked April 2023

How to get a senior in assisted living who doesn't qualify for Medicaid?

I asked a similar question on here about a year ago. My boyfriend was trying to get his mother into assisted living and there was a facility she was going to go into until they checked and found out that she doesn't qualify for Medicaid.


 


She is 69, low-income, and can't afford assisted living because she doesn't get enough social security. She doesn't qualify for Medicaid because she had property in her name within the last five years. Her parents had passed and she was given a house. Her brother felt the house was rightfully his and started to threaten to sue her for it so she signed it over to him.


 


But because of that, she doesn't qualify for Medicaid.


 


She has been living with us for two years now and it has been a nightmare.


 


Yesterday, she fell and broke her arm. She was taken to the hospital but they didn't admit her. They said with where it broke surgery won't be needed and so they wouldn't keep her.


 


My boyfriend is taking his vacation this week and now has to take care of his mom. Her living with us has already been too much for him and now this is just going to make it worse.


 


I live in Texas and I've tried contacting different facilities. I've contacted Area Agency on Aging more than once. They either never respond or one time had me contact someplace that doesn't even handle anything that has to do with seniors.


 


She needs to be in assisted living and I'm at a loss for what to do.


 


Are there any programs that will help pay for assisted living besides Medicaid? Is there a way to get her into assisted living without Medicaid?


 


I truly do appreciate any help.

CTTN55 Apr 2023
From your reply to me below with some more background info, I am wondering just how motivated your BF is to do anything at all. She's been living with you 2 years already? What exactly is involved in taking care of her? How is she being "catered to"?

When he's away at work, since you work from home, are you doing the caregiving then? Do you help her with personal hygiene? Meds? Or what?

Now that she's broken her arm, there's a lot more work for someone (BF? You?), right?

Can she be left alone?

So your BF has 3 siblings, and they all have washed their hands of her. Your BF could have done that, too...do you think he has any intention of making a life with you without her? And for you -- are you sure you want to stay with BF if your life with him will always include his mother living with you? It just doesn't seem that her moving out is very important to him, or he would have done more research before now. It seems it is up to you to do the research.

JoAnn29 Apr 2023
Your MILs problem is the house. There are penalties set based on the Market Value of the house at time MIL turned it over to her brother. How long ago was that now? How did Medicaid find out about the house transfer if not as asset on her application? Were u honest with the AL?

I think you need help from an elder lawyer with the Medicaid application. There are so many rules and each person's situation is different. There will be a penalty for the house. There is a formula that is used. So from date of application there will be this penalty. You will have to care for her during that penalty period. When the penalty period is up, you should be able to place her. Or, wait till 5 yrs and one day from the date of deed transfer and place her.

"In New Jersey, Medicaid penalties are calculated by first assessing the total gift amount and dividing it by $343.85 per day, about $10,000 per month. The resulting number translates to the number of days (months) one must wait before she is eligible for coverage."

If I figured this correctly, lets say MILs house was worth 200,000 you divide that by the 343.85 that equals 582 days divide that at an average of 30days in the month it comes out to 19.4 month penalty. Meaning if u applied today you could not place MIL until sometime in Nov or Dec of 2024. If the house was worth less than 200k the penalty will be less time. But she has to apply to find out what the penalty period is.

"The Penalty Period generally begins on the date one applies for Medicaid and is denied for the sole reason of violating the Look-Back Rule; it does not start the date a disqualifying transfer was made. In some states, the Penalty Period might begin on the 1st day of the month in which one submits a Medicaid application and is denied. Once the Penalty Period is over, one can reapply for long-term care Medicaid."

Note what I posted is for NJ but States usually have the same basic rules.

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AlvaDeer Apr 2023
Oh Oh! This is a mess.

You have a somewhat unique problem here that should serve as a DIRE warning to others.
What the state is now claiming is that your MIL, having those properties, instead of selling them FOR HER CARE, GIFTED THEM to her family. That's something the state simply will not stand for. You can well imagine why. Say someone is wealthy enough to have 5 homes--say they want free care from medicaid instead of selling those homes for their care--so say they GIVE THOSE HOMES to their kids and then say "Gee, I have no money".

I hope igloo is around as she always has the best input on anything involving medicare and medicaid. You might consider sending her a private message to please look at your message on Forum if she isn't about on Forum today. I will send her a private message so if she is around she can look in to comment here.

I myself would now go to an elder law attorney for advice. This is something I see as needing expert input. You must realize that if there WERE NO CHILDREN you MIL would be cared for. You need now to find out how that is done and I couldn't wish you more luck.

mstrbill Apr 2023
You need to have a state social worker come out for an evaluation. Call state elder services, tell them MIL needs help. Tell them you or boyfriend are unable to provide caregiving services all the time because you have to work. You do not have to give up your responsibilities for her, no matter what anyone might tell you. If MIL would be in danger if she were alone or if you can't provide adequate supervision if she needs it, APS should take action. I'm surprised you didn't get anywhere with AOA, that seems strange. I believed I replied to your previous thread as well, I'm sorry to hear nothing has changed. You need to get APS involved. Of course, if they feel she is OK by herself and not in danger, nothing will change, but you must insist, and boyfriend has to be on board as well, that you can't safely take care of her and you can't be there because of job responsibilities.. If she is mostly safe by herself, and the caregiving is mainly cleaning up after her, I'm afraid you might be stuck.
LilyMoon Apr 2023
I talked to my boyfriend today and told him that he needs to call the Area on Aging here and tell them the care she needs is too much so he needs help to somehow get her into assisted living or something. I suggested to him that we go to the office if he can't get to talk to anyone on the phone.
mstrbill Apr 2023
You need to have a state social worker come out for an evaluation. Call state elder services, tell them MIL needs help. Tell them you or boyfriend are unable to provide caregiving services all the time because you have to work. You do not have to give up your responsibilities for her, no matter what anyone might tell you. If MIL would be in danger if she were alone or if you can't provide adequate supervision if she needs it, APS should take action. I'm surprised you didn't get anywhere with AOA, that seems strange. I believed I replied to your previous thread as well, I'm sorry to hear nothing has changed. You need to get APS involved. Of course, if they feel she is OK by herself and not in danger, nothing will change, but you must insist, and boyfriend has to be on board as well, that you can't safely take care of her and you can't be there because of job responsibilities.. If she is mostly safe by herself, and the caregiving is mainly cleaning up after her, I'm afraid you might be stuck.

CTTN55 Apr 2023
I can't find your question that you asked here a year ago. What was the advice from this forum? Did you follow any of it?

Other than the broken arm, what are your BF's mother's conditions that necessitate AL?

How has it been a "nightmare" having her live with the two of you for two years?

What happens when your BF goes back to work? Do you work, too?

Is your BF an only child?
LilyMoon Apr 2023
She has 3 other children but they won't help with anything. When her husband passed away, they pushed her off on my boyfriend.

No one wants anything to do with her and I understand why. She expects too much of people. She wants to be taken care of and catered to while at the same time wanting to be in control and be woman of the house. She is also a user, which is why her sister wouldn't take her in.

I work online because I have anxiety.

She has diabetes, heart problems, and bone disease. She might have some other problems, but I'm not sure. I know when we tried to get into assisted living before they told my boyfriend she does qualify medical-wise. The only problem is money. She doesn't get enough social security to pay for it and we can't afford it. The rest of the family isn't doing anything to help.
BarbBrooklyn Apr 2023
Methinks she should be living with her brother who got the house.
LilyMoon Apr 2023
I think so too. Or living with one of the family members that pushed my boyfriend to take her.
lkdrymom Apr 2023
Medicaid normally does not pay for assisted living. Someplaces will accept it after two years of self pay. Her mistake was giving away the house, I cannot understand why she would do that. Why did he deserve it more than she did? Why wasn't it a 50/50 split? Unfortunately her poor decision making has put you in this situation now. Go back to the Office on aging. Make an appointment to see them and get a list of resources to contact , not just one.
LilyMoon Apr 2023
It seems in Texas Medicaid will pay for assisted living. That is what the facilities have told my boyfriend, including the one that was going to take her until they found out she wouldn't qualify.

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