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My 80 yr old mom is currently in a rehab facility (after falling 3 weeks ago), she spent 3 days in the hospital (after being admitted from the ER), then transferred to rehab after her hospital stay.
As some of you may know my mom has no other assets other then get home which she has a reverse mortgage on.
Her limit (to draw anymore funds from her home is down to $48,000).
After that is gone, she has no other $ other then her paltry SocSec ($700/monthly).

My mom wants to desperately go back home to live but her imbalance issues are still what's preventing her from being able to walk unassisted & I am afraid she will be in danger if she goes back home (she lives alone) w/her small dog.
I live nearby but must work 6-7 days a week so I can't be there w/her for anything other then making daily stops to clean her house, do laundry, run errands, etc.
I don't not have a large income myself in order to help pay for 24 hour live in nursing care & even if I did, her house is not set up for that.
Would my mom be able to move into a "senior" building or is that called "assisted living" building so she can be in a smaller (apartment, since her house would be too much for her to maintain) and most important have a daily home visit from someone who works in that building?
Would Medicare and/or Medicaid (she has both) pay for that?
Thanks to all who respond.

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I agree with tacy022. I would ask for an assessment and be present to ensure they are realistic. I would be clear that you cannot take care of her daily needs. You are working 6-7 days per week. To take care of all of her needs, besides a little outside help once per week, is rather unrealistic, especially, if she cannot get around unassisted.

I'd be frank about what the situation is. I would stress that she can't cook, do laundry, change linen, bathe, buy groceries, and that she is mostly immobile. I'm not sure sure how they think she's able to live alone. However, if a family member is there to say that they will do all those things for her, they will likely rely on your word.

I know that when a senior falls and is unsteady on their feet, has poor balance and continues to push it, then more fractures usually follow. They must know this too. I would ask that she apply for any and all benefits, including Medicaid, and see what she qualifies for.
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I am currently in battle about the medicaid HBC, waivers, Community First Choice, specifically in home attendant, family being paid as caregivers and many other services to dementia victims and family.
I have discovered that the federal government gets the blame for things that are not right, but in fact, our representatives have for decades legislated some wonderful support. Our representatives continue to amend rules, daily to our advantage. The feds either share costs with the state or often even entirely fund the 'services'. The feds often even fund the state's administration costs, but the state agencies and plan carriers tend to use 'latitude' and 'options' to illicitly make their own rules ..uh... 'policies' for their profit and convenience.
My fair hearing is solidly based on the state government workers frequent statement, "we don't follow all the federal rules, we have our own policies". And "yes there is a contract with the plan provider, the insurance company, but we 'give them latitude'.
Give 'latitude' to the entity that can most profit by exploiting us?
The best example is when I read in the federal code about services we are suppose to be receiving under the Social Security 1915 acts, the state official said "but we operate under the 1115", to make me believe that they didn't have to follow federal regulations. I researched the 1115 demonstration and it is contrary to what he was implying. The 1115 brings many of the benefits that have been established for DD, developmentally disabled, to the aging and disabled. It expands on the 1915 acts and does not limit in any way for us. The limits are placed on the state government to 'waive' the regulations that restrict the services only to certain groups to include us in the services. This can be internet searched on the 1115 waiver demonstration and Community First Choice. I won 2 fair hearings and DHS conceded 2 others in another state because I learned the state administrative code which directed me to the federal codes. Now I am fighting this state and it is the same. This state's administrative code is primitive by comparison but I know this."Unless a rule is explicity waived and published in the 'Federal Register', the state will follow the federal rule.
Summary. The health plan provider will manipulate for profit. The state workers at all levels will be complicit by ignorance, complacency or for bonuses, either monetary or accolades. Do not just accept their decision. They do not want you to know. Challenge them.
Do know that it is difficult to find an attorney with experience in these matters.
CMS.gov is the best source of information because of who they are.
Be aware that there are some differences in Medicare and Medicaid.
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The state administering program gives a 'capitated', a set amount for each person to the health plan. UHC is a popular one. Say they get $5000 a month to provide services to each person. 100 people is $500,000.
For HBC, they are to compare cost of nursing home to keep at home. The state tells UHC what services to provide, such as PT, attendants, homemakers. UHC is contracted to provide authorized services up to that amount of 5000 per person. It is possible that a hard case, needy client, will use all of that, but UHC makes that up with the client that only needs $1000 service.
UHC get to keep the other $4000.
Of course they will try to deny or limit services such as attendant care. They are not allowed to, but they are finding ways by manipulating definitions and clauses, and mostly by not informing you of how it works.
In my state, the case manager is an employee of the plan provider.
Conflict of interest much?
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Medicaid doesn't pay for assisted living facilities in most places. You would have to look at nursing homes. Medicare doesn't cover either. Medicare covers 21 days in a rehab.

People who are in assisted living, are paying for it themselves. I would look at decent nursing homes.
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Ellerysir: Praying for you, sir. That must be h##l on you!
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Thank you for prayers. I find that even a concerned mention of someone results in a Spirit sent prayer. Physicians describe Christy's manifestations of FTD as hellish but I would rather deal with her all than the 'help' agencies for a moment, truly.
I am at peace though, because I know His name. His actual name.
Psalms 91:14
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But, people aren't accepted for admission to nursing homes unless they have the needs for the skilled nursing at the nursing home, her Mom does not sound as if she has those needs. Is that not true?
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It depends on the state she's in. I wasn't able to see where she is located, but in some states, such as NC, they have a program like Medicaid called Special Assistance. If you qualify for Medicaid medical, you most certainly will qualify for NC Special Assistance. It pays for Assisted Living for those who need it according to a doctor. So you if you need assistance with bathing, dressing, meals, medication, etc. you can qualify or if you are disabled. I would check with the applicable state's benefits to see what they offer.
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It all depends on the requirements and limitations of the state's home and community-based waiver program (the Medicaid waiver program for the elderly and disabled) I can say though that most state's HCBS waiver program does not cover assisted-living, just nursing home care and in-home care. Also, in most states, a skilled nursing level of care is not required. In fact, most people in nursing homes don't receive a whole lot of skilled nursing care. Instead, they receive what's called an intermediate level of nursing home care. This is largely personal care. (but if a person needs a lot of personal care then they may need to go into a NH) So, I would seek some local advice from your area agency on aging or if you can afford, an elder law attorney. This feels like to me a situation ripe for in-home care paid for by a Medicaid HCBS waiver.
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I want to have my mom move into an assisted living apartment.
We live in IL.
She has Medicare & Medicaid.
Only asset is her home which has a reverse mortgage.
That's almost gone w/$48,000 left to draw from.
Mom gets $753 monthly S.S & SSI.

So in order for my mom to go to an assisted living apartment, she would need to sell the house, pay back the reverse mortgage what is owed, then if any remaining $ from the sale, that would be taken by Medicaid so she can go live in assisted apartment??
Is that correct?
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